‘Us versus them’: A social identity perspective of internal medicine trainees

Social identity, collective self and group membership

‘A social group is a collection of more than two people who have the same social identity—they identify themselves in the same way and have the same definition of who they are, what attributes they have, and how they relate to and differ from specific outgroups’ [30]

Identifying as a Manchester United football fan, as opposed to any other football team supporter

Social categorisation, prototypes and depersonalisation

‘People cognitively represent groups in terms of prototypes—fuzzy sets of interrelated attributes that simultaneously capture similarities and structural relationships within groups and differences between the group … you see them through the lens of the prototype—they become depersonalized’ [30]

A group of teenagers being seen as a collective of trouble makers

Motivation

Self-enhancement

‘People strive to promote or protect the prestige and status of their own group relative to other groups because group evaluation is self-evaluation’ [30]

A political party highlighting the ways they are morally superior than their rival party

Uncertainty reduction

‘People strive to reduce subjective uncertainty about their social world … they like to know who they are and how to behave, and who others are and how they might behave … self-conceptual certainty, renders others’ behaviour predictable and therefore allows one to avoid harm and plan effective action’ [30]

Self-uncertainty in students leading to seeking group membership e.g. joining a radical environmental group

Social attraction and group cohesion

‘Social attraction is a function of how much one identifies with the group and how prototypical the other person is—it is positive regard or liking for the prototype as it is embodied by real group members.—the warm feeling of oneness with fellow members’ [30]

Favouritism in recruitment due to religious background with an employer favouring those of the same religious group

Social comparison

‘Intergroup social comparisons do not strive toward uniformity and assimilation; instead, they strive to maximize differences between self, as ingroup member, and other, as outgroup member’ [30]

Pupils of one school comparing themselves to another and seeing them as inferior

Intergroup relations

‘At the level of intergroup relations, this idea explains why groups compete with each other to be both different and better’ [30]

Citizens of one city competing for the reputation of being a better place to live compared with another city

Social influence, conformity and group norms

‘Norms are the source of social influence in groups because they are prescriptive, not merely descriptive. The self-categorization and depersonalization process explains how people conform to or enact group norms’ [30]

Adults in the UK conforming to government advice and wearing masks during the COVID-19 pandemic when in shops or on public transport even after legal restriction ceased

Social identity, collective self and group membership

‘We think of ourselves as medics- you’ve got the GPs [General Practitioners], the medics, the surgeons … we do categorise ourselves into those areas’ (T104I)

Social categorisation, prototypes and depersonalisation

‘There’s certain specialties … I mean, it’s the same in every area, have a reputation … there are some where you know it’s going to feel … might be a bit more challenging on the phone in terms of accepting referrals’ (T9W)

Motivation

Self-enhancement

‘You can’t bad-mouth your own, so you’ve got to bad-mouth someone’ (T6W)

Uncertainty reduction

‘I wonder whether actually sometimes for me now it is more the expectation of tribalism that then colours the way that I approach the conversation, and then if you start off on that foot then you set the tone of the conversation’ (T11I)

Social attraction and group cohesion

‘I think usually within your own team it’s less of a problem generally because you feel part of the team … there’s been a bit more communication through the day about things’ (T9W)

Social comparison

Differing priorities

‘Their [the surgeons] priority is often the patients that they can go and do a definitive thing to, do an operation on, fix a problem … each specialty has its own hierarchy of problems and they don’t often mesh’ (T3W)

Intergroup relations

Tension

‘I’ve never been shouted at by my specialties from the hospital but I’ve been shouted at by ED [Emergency Department] … when I was working in ED I wasn’t shouted at’ (T51W)

Social influence, conformity and group norms

Outgroup derogation

‘… and some of that becomes learned, there’s this thing that everybody knows that talking to neurosurgery or talking to the bed manager is a nightmare … it becomes this sort of banter thing where you just use a particular department as a butt of a joke’ (T18W)

Hierarchy

‘A nurse in charge didn’t care when a consultant wore his smart watch but when I wore one he did care … it seems like there is a different rule’ (T87W)