Medical student professional identity formation in the COVID-19 pandemic era: A longitudinal view from a regional campus

Background Previously published cross-sectional studies showed the COVID-19 pandemic had a dramatic effect on medical students, including concerns about disruption of their training as well as increases in depression and anxiety. Some also reported their confidence as clinicians was shaken and they were less satisfied with their education. This unique longitudinal study reports an annual measure of professional identity formation termed the career eulogy (CE) before and after the pandemic era. The CE is a previously validated instrument that provides a view into the way medical students hope to be viewed at retirement. Methods Ninety-nine students across all years of medical school at a regional rural campus recorded CEs during the summers of 2018 through 2023. Using previously developed professional identity clusters, longitudinal changes were analyzed using generalized estimating equations to account for data collected on each student repeatedly over multiple years. Statistical significance was set at p < .05. Results Significantly fewer mentions of quality (13% decrease), compassion (46% decrease, p=.006), and passion (51% decrease, p=.007) clusters occurred post-pandemic. There was a slight return of frequency of quality mentions in the summer of 2022 coinciding with vaccine development and new treatment options, and then a decrease again after a year of the omicron variant wave. Initial analysis showed no change in frequency of the patient relationship cluster, but analysis by gender showed a significant increase in female and decrease in male mentions. Conclusion The changes in student CE cluster frequencies can be explained by the fear, uncertainty, and helplessness felt by all providers as well as mistrust of physicians by some patients. The gender difference may show a difference in coping methods used during such an overwhelming time. These findings may provide useful insights as medical educators plan for future pandemics and other disruptions.