COVID As a Catalyst: A Qualitative Study Of Professional Identity Formation among US Medical Students During COVID-19

Phenomenon: Students become physicians not only by mastering medical knowledge, but also through a process of Professional Identity Formation (PIF). In this study, we used the conceptual framework of Jarvis-Selinger et al. to explore the impact of COVID, as a major public health crisis, on the PIF of preclinical medical students in our country. Approach: At two U.S. medical schools, we interviewed 28 medical students twice as they moved from first to second year during the 2020-2021 COVID pandemic and explored the impact of COVID-19 on PIF. We coded the transcribed interviews and identified themes using constructivist thematic analysis. Findings: We identified three themes: 1) mental health and wellness impacts; 2) inhabiting identity as a health professional during COVID; and 3) questioning the role of physicians in society. Routines and support systems were disrupted, undermining wellness and confidence in professional choices. Students noted the need to be public health role models, and COVID prompted feelings of pride, while also causing them to question expectations of self-sacrifice amid a new politicization of medicine. Students felt that physicians must be increasingly engaged in public health and political communication. Insights: Our findings inform medical educators seeking to build a scaffolding to support PIF during a public health crisis, and highlight the importance of current events and politics on PIF. Our recommendations include the need for student support, longitudinal mentorship, curricular space to discuss the impact of sociopolitical factors on PIF, and revisiting foundational concepts such as professionalism to take into account the social and political context. Our findings add to understanding of PIF during the COVID pandemic, but are also relevant to teaching and learning during future public health crises.