From novice to professional: comparing professional identity formation in undergraduate medical students: a...

Professional identity formation (PIF) is central to medical education, shaping students into competent and ethical practitioners. Despite its recognized importance, data on PIF's cross-sectional variation across year groups in Pakistani undergraduate medical education remain limited. This study assessed PIF across all five MBBS years and examined associations with academic year group and gender.

A comparative cross-sectional study was conducted (November 2021-April 2022) at Liaquat College of Medicine and Dentistry, Karachi. All 450 MBBS students (years one to five) were invited via universal sampling. A 27-item adapted version of the Professional Identity Five Factor Scale (PIFFS), covering five dimensions of professional identity, was administered online. Kruskal-Wallis tests with Dunn's post-hoc comparisons (Benjamini-Hochberg FDR correction) were used for year-group comparisons; Mann-Whitney U tests were applied for gender comparisons. Effect sizes were calculated using eta-squared (η²) and rank-biserial correlation (r). Statistical significance was set at p ≤ .05.

Of 450 students, 361 participated (80% response rate; Cronbach's α = 0.76). Overall PIF scores ranged from 3.5 to 3.8 across year groups, with lower values in the fourth-year cohort and higher values in the final year; these are between-group differences and do not represent within-student change. Kruskal-Wallis tests revealed significant between-group differences for all five dimensions (p < .05); Dunn's post-hoc comparisons identified Year 4 as the primary driver of significant pairwise differences in four of the five dimensions. Omnibus effect sizes were small (η² range: 0.021-0.047); pairwise effect sizes were small to medium. Significant gender differences were found for Dimensions C, D, and E, with male students scoring higher on all three (p < .05). Among first-year students who had already identified a preferred specialty, 68% were female (p = .034).

PIF scores varied across undergraduate medical year groups, with consistently lower scores in the fourth-year cohort compared to adjacent year groups across multiple dimensions. These findings suggest that PIF remains moderate overall and that the fourth-year period may benefit from enhanced mentorship and reflective learning support. Longitudinal and multi-centre studies are needed to establish developmental trajectories.