From novice to professional: comparing professional identity formation in undergraduate medical students: a cross-sectional study.

backgroundProfessional 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.

methodsA 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.

resultsOf 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).

conclusionsPIF 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.