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What is professional identity formation in medicine?

Adrian Reynolds, PhD
Education
September 3, 2025
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“Did I get dumber?” This poignant question from a medical student, asked in frustration after receiving a lower-than-expected grade, became the focus of a forty-five-minute academic coaching session. Simply put, my role as a learning specialist was to foster a mindset shift: from “my grade determines my self-worth” to “my grade reflects where I am in my learning right now and guides my next steps.” Helping the student build this awareness was an essential first step. It allowed them to work through the complex connections between their personal identity, grades, and an evolving identity as a future physician.

Moments like these make it clear that academic coaching is not about giving students test-taking tips. It goes much deeper: It requires the learning specialist to skillfully tap into a body of knowledge ranging from educational psychology to evidence-based coaching principles and the science of learning, all in one session. This is no small task. It is the hidden work of the learning specialist within the hidden curriculum. At the core of this hidden work is the process of professional identity formation (PIF).

The concept of PIF is not new. It dates back to the 1957 seminal work of sociologist Robert Merton (“The Student-Physician: Introductory Studies in the Sociology of Medical Education”), who described PIF as a social ecosystem where institutional hierarchies, values, language, and cultural norms collectively define what it means “to think, act, and feel like a physician.”

A frequently overlooked phase of learners’ PIF is the transition from pre-med to medical school. To really understand that transition, we need to look at the professional identity formation of the learning specialists who coach them: What do they do? How do they do it? What knowledge and skills do they draw on to support student success?

The 2010 Carnegie Foundation’s landmark report, “Educating Physicians: A Call for Reform of Medical School and Residency,” made this bold assertion: “Professional identity formation—the development of professional values, actions, and aspirations—should be the backbone of medical education.”

To that end, research on PIF has primarily focused on medical students, trainees, and practicing physicians. However, the PIF of learning specialists has received little attention. As academic coaches, learning specialists help students and trainees learn how to learn based on scientific evidence. We help build aspects of professional identity that the core curriculum may not cover in depth. We provide guidance with developing metacognitive and self-regulated learning skills. This includes applying evidence-based study techniques, and in more extreme cases, navigating test-taking anxiety. Learning specialists also provide coaching on skills such as strategic goal setting and effective time management. Drawing upon our learners’ performance data and personal reflections, we help them craft individualized learning plans, among a host of other responsibilities. Our direct involvement in shaping learners’ professional identity formation is also reflected in how we train and supervise peer educators (teaching assistants, or TAs).

Beyond these technical skills, we create safe, welcoming spaces for our learners. We listen deeply, asking powerful questions that lead to mindset shifts about learning (e.g., fixed to growth mindset), the unlearning of ineffective study habits, and the formation of new ones. Now more than ever, our work forms the foundation for adaptive learning skills. These are the very skills that allow learners to thrive in an increasingly competency-based environment.

Despite the learning specialist’s key role in shaping the PIF of students and trainees, their own professional identities often go unexamined. Many enter medical education with graduate degrees in K-12 education, counseling, higher education, coaching, and curriculum development. What happens, however, when a professional identity built in a non-clinical learning environment meets the highly specialized, hierarchical world of medicine? How do these professionals tap into their educational expertise to drive learner success? Equally important, what supports or barriers exist as they work to build a new professional identity and claim their place in the medical education community?

In the medical education environment, there are numerous challenges. Establishing credibility can be a constant uphill battle. The essential skill of learning how to learn is often relegated to the margins of the curriculum, labeled a “soft” skill—important but optional. Role ambiguity adds another layer of complexity. Job titles vary and academic backgrounds differ. Responsibilities may overlap, and in some cases, there is no clear academic home for the learning specialist, especially if the position never existed before. Working through identity dissonance is another formidable challenge. How does a learning specialist integrate a well-developed identity as an educator or counselor into a space that speaks a different professional language? How do they navigate interprofessional boundaries, advocate for students, and engage in interdisciplinary collaboration?

These questions are worth exploring. They encompass everything from onboarding to personal fulfillment and job satisfaction to long-term career sustainability. They determine whether the learning specialist feels a strong sense of belonging or feels marginalized.

Why does it matter, you may ask, to shine a light on the PIF of non-clinical learning specialists? It matters because the work of the learning specialist is not peripheral. Our work is not remedial. Our work is not merely a support resource. It is not reactionary. We are not the fix-it folks. Our work is not an appendage to the curriculum.

Rather, I would boldly argue that the curriculum stands on the shoulders of our work.

When a learner struggles to manage overwhelming content, they meet with a learning specialist. When they feel crushed by self-doubt, they meet with a learning specialist. And yes, they also meet with us when, in their own words, they want to study “smarter,” not just harder. Learners come to us when they want to optimize how they study, think, plan, and learn. Even high-performing learners meet with us when they want to push further or “sharpen the saw.”

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Competency-based learning models, precision education, AI-enhanced learning, mastery learning, wellness initiatives, among other learner-centered approaches are all rewriting the medical education playbook. Learning specialists will continue to play an increasingly central role in leading this transformation. It is time we recognize not only what they do, but also who they are becoming in the process.

Adrian Reynolds is the founding director of the Office of Academic Enrichment and assistant professor of professional practice in the Department of Medical Education at the University of Miami Miller School of Medicine. With over two decades of teaching and academic coaching experience, he specializes in the applied learning sciences, integrating socio-cognitive and sociocultural approaches to support learners across the educational continuum. Since 2016, he has conducted more than 1,000 one-on-one academic coaching sessions with medical students, residents, and fellows, while also launching high-impact academic support programs and developing science of learning courses for learners from high school to graduate levels. His scholarship, published in journals such as Medical Teacher (2020) and Clinical Teacher (2022), focuses on building adaptive learning skills through personalized academic coaching. More recently, he has incorporated large language models into coaching to enhance goal attainment, academic achievement, and well-being. More of his work can be found on his podcast and LinkedIn.

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