From Novice to Professional: Tracking Professional Identity Formation in Undergraduate Medical Students

Background Professional identity formation (PIF) is central to medical education, shaping students into competent and ethical practitioners. Despite its recognized importance, data on PIF's longitudinal trajectory in Pakistani undergraduate medical education remain limited. This study assessed PIF across all five MBBS years and examined associations with academic progression and gender. Methods 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. The validated 28-item Professional Identity Five Factor Scale (PIFFS) — measuring five dimensions “knowledge about professional practices”, “experience with the profession”, “role modeling, professional self-efficacy”, and “specialty preference” was administered online. Responses were rated on a five-point Likert scale. Data were analyzed using SPSS v23.0; non-parametric tests (Kruskal-Wallis H) were applied given non-normal distribution, with significance set at p ≤ 0.05. Results Of 450 students, 361 participated (80% response rate; Cronbach's alpha 0.76). Overall PIF scores increased from year one (median 3.6) to year three (3.7), dipped in year four (3.5), and recovered in the final year (3.8). Knowledge about professional practices and role model identification remained stable; experience with the profession showed the greatest progression. Professional self-efficacy rose steadily except for a fourth-year dip. A significant gender difference was found in year one for specialty preference (p = 0.034), with 68% of female students already identifying a preferred specialty. No significant gender differences were observed for role model admiration. Conclusions PIF progresses across undergraduate medical training but remains moderate overall, suggesting it requires greater curricular emphasis. The consistent fourth-year decline highlights a critical transition period requiring targeted mentorship and reflective learning interventions. Medical institutions in Pakistan should incorporate structured PIF strategies — including role modeling, mentorship programs, and reflective practice — into formal curricula to support the holistic development of future physicians.