142 Chapter 5 They connected these intrapersonal aspects to two meaningful experiences. First, they emphasised that ‘meaningful encounters with others,’ such as indigent patients, had helped them to change their focus from themselves to their patients and their students. …then it comes through the patients, because the patients that come in are poor. There [in patient care] it’s more obvious, because it impacts their health. And it impacts their access to care. (S01) Second, they emphasised that adverse developments in society and the medical profession were influential in their maturation. For example, one of the educators emphasised that changes in his medical discipline had made him more motivated to make students aware that being a doctor is a calling. ...the development of family medicine over the past ten years, more management and fewer home visits. So it has become more of a… no longer a calling but more a trade. (…) and then I wonder how can you still do that… [inspiring the students to consider this calling]. (L04) DISCUSSION Based on the findings of this follow-up study we conclude that maturation as a medical educator can occur but is not guaranteed: less than half of the medical educators with the potential to grow in awareness of educational competencies, identity, or mission, showed maturation in our study within the period of a decade. Our finding that none of the interviewed educators reverted to a less inclusive phenotype may imply that medical educators’ awareness of their educational qualities, once acquired, will not regress and is deeply integrated into the being of an educator. A noteworthy finding from our study is that the educators who initially focused on adverse contextual aspects (the Critic phenotype) all matured toward a more inclusive phenotype. Our findings suggest that the Critic phenotype may not be a permanent end-stage phenotype nor a ‘starting’ phenotype. Educators’ awareness of their educational qualities may become temporarily distorted due to dissatisfaction related to adverse professional or private circumstances. Our findings suggest that once educators experience a lack of support from their departments or institutions, they have three options for coping with
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