Cripping the Transition to Practice: A Longitudinal Qualitative Analysis of Disabled Doctors’ First Year Experiences

Abstract

Abstract Introduction The transition from medical student to doctor is demanding. Although research has explored preparedness and wellbeing, disabled doctors’ experiences remain underexamined, risking a homogenised understanding of a process that is likely experienced unevenly across learner groups. Materials and methods We conducted a longitudinal qualitative study using a phenomenological approach, following six disabled final-year medical students through their first year of postgraduate practice in the UK. All six completed interviews before and shortly after starting work, four completed a third interview, and two completed all four interviews. The 18 interviews were analysed using reflexive thematic analysis, with crip theory informing interpretation. Results We constructed four themes: negotiating legitimacy and belonging, living with the fluctuating pace of clinical practice, access work as ongoing labour, and seeking survivable futures. Belonging rose and fell across placements, access arrangements were repeatedly renegotiated, and fluctuations in pace shaped wellbeing and participants’ sense of professional legitimacy. Difficulties did not follow a consistent trajectory of decline. Rather, participants developed strategies for navigating recurring tensions, often at significant personal cost. By the end of the year, some were orienting career planning toward contexts where practice felt sustainable. Discussion Transition for disabled doctors was recurrent and context dependent, with changing placements requiring renewed negotiation of disability legitimacy and access. PGME support should reduce the individualised labour of maintaining adjustments across rotations and address how expectations concerning pace and productivity shape supervision and judgements of competence.