Professional identity changes during the COVID-19 era among pre-medical college students: Insights for medical educators

Abstract Introduction Professional identity formation is known to be responsive to outside forces. Previous longitudinal research has shown changes occurred pre-and post-COVID-19 pandemic among medical students. The purpose of this longitudinal study was to assess changes among pre-medical students. Methods With a 100% response rate, 85 Career Eulogies (CE) from 2015 through 2025 recorded a free text response to the prompt: "Imagine that you are ready to retire from medicine in the distant future. In about 50 words, write a short speech outlining what you would like to be said about you at the retirement ceremony."  The responses were coded into previously validated clusters and generalized estimating equations were used to assess changes in the CE clusters of patient relationships, quality, compassion, and passion. Results The CE patient relationship cluster decreased during the pandemic, stabilized, and then steadily recovered from 2023 to 2025. The CE compassion cluster showed a significant decline from 2015 compared with 2022, followed by a rising trend from 2022 to 2025. There were no changes for the CE passion cluster. In the entire population, there was no change in the quality cluster. Among men, there was a significant decrease in the quality cluster during the pandemic, and this remained low until it recovered in 2022. No change was seen among women. Discussion The authors postulate that the decreases during the pandemic in mentions of patient relationships and compassion were related to lack of shadowing opportunities during the pandemic as well as widespread misinformation and suspicion of medical providers that undermined the doctor patient relationship. The gender difference in the quality cluster could be explained by men generally placing more emphasis on quality of care outcomes, while women were focused more on quality defined as the process of individual patient interactions. As this is one population studied, these results will need to be confirmed in other more diverse groups with repetitive longitudinal measures. Conclusion This longitudinal study found that, during the COVID-19 pandemic, premedical students in this program made fewer references to patient relationships and compassion in their Career Eulogies. Among male participants, references to quality decreased significantly during the pandemic but subsequently returned to pre-pandemic levels.