{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:58:28Z","timestamp":1791367108211,"version":"4.3.1"},"update-to":[{"DOI":"10.12688\/mep.21548.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000}}],"reference-count":26,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["mededpublish.org"],"crossmark-restriction":false},"short-container-title":["MedEdPublish"],"abstract":"<ns5:p>\n                    Introduction Mentorship functions as a stabilizing relational framework in high-demand medical education environments. This international collaborative study between the Defence Services Medical Academy (DSMA) and Avalon University School of Medicine (AUSOM) examines the \u201cDual-Identity Dilemma\u201d\u2014the structural tension between professional medical identity and institutional military role expectations. While mentorship is central to professional development, hierarchical military structures may shape its psychosocial accessibility. Methods An explanatory sequential mixed-methods design (QUAN\u2192QUAL) was conducted. Quantitative survey data were collected from 251 DSMA cadets and 100 AUSOM students to provide a civilian international benchmark. Within DSMA, qualitative interviews (n\u00a0=\u00a08 mentors) and focus groups (n\u00a0=\u00a08 mentees) explored identified quantitative \u201cfriction points.\u201d Descriptive statistics, ANOVA with Bonferroni correction, and effect size reporting (partial \u03b7\n                    <ns5:sup>2<\/ns5:sup>\n                    ) were applied. Results Mentorship expectations were high across both cohorts. However, DSMA cadets reported higher communication barriers (65.2%) compared with the civilian benchmark. Within DSMA, ANOVA revealed significant variation across academic years in communication barriers (p\u00a0&lt;\u00a0.001, \u03b7\n                    <ns5:sup>2<\/ns5:sup>\n                    p\u00a0=\u00a0.092) and career guidance (p\u00a0=\u00a0.001, \u03b7\n                    <ns5:sup>2<\/ns5:sup>\n                    p\u00a0=\u00a0.084), with Year 2 showing the highest descriptive communication-barrier level. Qualitative findings identified perceived hierarchical authority gradients as barriers to psychosocial openness and suggested that mentors may function as \u2018identity integrators\u2019 by modelling ways in which clinical and military role expectations can coexist. Conclusion Institutional context may influence mentorship accessibility in dual-role educational environments. The Dual-Identity Dilemma provides a conceptual lens for interpreting how hierarchical authority relationships and competing role expectations may affect psychosocial mentoring in military medical education. Structurally responsive mentorship approaches warrant further evaluation.\n                  <\/ns5:p>","DOI":"10.12688\/mep.21548.2","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T09:54:07Z","timestamp":1789206847000},"page":"19","update-policy":"https:\/\/doi.org\/10.12688\/mep.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Dual-Identity Dilemma: A Comparative Study of Mentorship Structural Barriers in Military and Civilian Medical Education"],"prefix":"10.12688","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5676-5692","authenticated-orcid":false,"given":"Zaw","family":"Phyo","sequence":"first","affiliation":[{"name":"Medical Education Department Yangon Defence Service Medical Academy (DSMA)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6122-1914","authenticated-orcid":false,"given":"Reshma","family":"Fatteh","sequence":"additional","affiliation":[{"name":"Willemstad Cura\u00e7ao Avalon University School of Medicine (AUSOM)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4361-4075","authenticated-orcid":false,"given":"Ye Phyo","family":"Aung","sequence":"additional","affiliation":[{"name":"Medical Education Department Yangon Defence Service Medical Academy (DSMA)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj Kollukkad","family":"Mani","sequence":"additional","affiliation":[{"name":"Willemstad Cura\u00e7ao Avalon University School of Medicine (AUSOM)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8692-3348","authenticated-orcid":false,"given":"Sateesh","family":"Arja","sequence":"additional","affiliation":[{"name":"Willemstad Cura\u00e7ao Avalon University School of Medicine (AUSOM)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sireesha","family":"Bala. A","sequence":"additional","affiliation":[{"name":"Willemstad Cura\u00e7ao Avalon University School of Medicine (AUSOM)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3774-6868","authenticated-orcid":false,"given":"Tun Tun","family":"Naing","sequence":"additional","affiliation":[{"name":"Medical Education Department Yangon Defence Service Medical Academy (DSMA)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tayzar","family":"Hein","sequence":"additional","affiliation":[{"name":"Medical Education Department Yangon Defence Service Medical Academy (DSMA)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0943-488X","authenticated-orcid":false,"given":"Khin Aung","family":"Htun","sequence":"additional","affiliation":[{"name":"Medical Education Department Yangon Defence Service Medical Academy (DSMA)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,9,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"653-659","DOI":"10.1080\/0142159X.2024.2359967","article-title":"Did the students\u2019 satisfaction rates at Avalon University School of Medicine correlate with the occurrence of accreditation site visits?.","volume":"47","author":"S Arja","year":"2025","journal-title":"Med. 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We are glad you found our research on the Dual-Identity Dilemma novel and interesting. \u200bHere is our response to your points:  \u200b\n<b>Praise and Summary:<\/b> Thank you for agreeing with our findings on how military rank can make open communication harder for cadets.  &nbsp;  \u200b\n<b>Measuring Identity Formation in Future Studies:<\/b> We agree completely with your advice. In this paper, we focused on measuring communication problems and workload balance. In our next projects, we will use validated tools like the \n<b>Tagawa (2019) Professional Identity Formation (PIF) scale<\/b> to measure cadets' professional identity directly.  &nbsp;  \u200b\n<b>Recommended Literature:<\/b> Thank you for sharing the articles by \n<b>Mayer et al. (2025)<\/b> and \n<b>Khalili et al. (2013)<\/b>. They are very useful for our future work.  &nbsp; \u200bThank you again for helping us improve our research. \u200bSincerely, \n<b>Zaw Phyo<\/b> \n<i>(on behalf of all co-authors)<\/i> Corresponding Author, DSMA","URL":"https:\/\/mededpublish.org\/articles\/16-19\/v2#referee-comment-3774","order":1,"name":"referee-comment-3774","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/mep.23401.r46671, Anila Jaleel, Shalamar Medical and Dental College, Lahore, 07 Oct 2026, version 2, indexed","URL":"https:\/\/mededpublish.org\/articles\/16-19\/v2#referee-response-46671","order":2,"name":"referee-response-46671","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}