A decade-wide view into medical student professional identity formation using the career eulogy: Are Gen Zs different?

Introduction Students born after 1996 (Gen Z) perceive themselves as distinct from millennials. Earlier surveys described Gen Z as valuing relationships, meaningful work, financial security, and happiness. Over the past decade, medical school populations have shifted from predominantly millennial to Gen Z. This study examined changes in professional identity formation across this period, using a validated career eulogy instrument. Methods From 2015 to 2024, 113 medical students at a rural regional medical school completed an annual career eulogy (98% participation). Students responded to the prompt: “Imagine you are retiring from medicine. In about 50 words, what would you like to be said about you at your retirement ceremony?” Free-text responses were coded into validated thematic clusters. Generalized estimating equations assessed differences in the theme frequency by generation and gender. Results No significant generational differences were found in themes of quality, patient relationships, calling, community, coworker, service, or family. However, Gen Z students were significantly less likely to mention passion (p Conclusion Findings diverge from earlier studies of college students and assumptions about current medical students. If replicated, these results may prompt medical educators to reconsider how professional identity, wellness, and mentoring are addressed. The lower emphasis on passion, compassion, and enjoyment among Gen Z students may suggest the need for curriculum redesign to help students find fulfillment in leadership and community engagement. Gender differences suggest further complexity. Women across generations more often emphasized patient relationships and Gen Z women mentioned passion less, which may require educators to support new ways of fostering passion and connection. The increased mention of coworker relationships among Gen Z men may signal evolving values. Continued use of the career eulogy and similar tools will help clarify how future physicians form their professional identities and what support they need during training.