Purpose
Starting medical school is a major transition for students. They must adapt to a new environment and begin to think, act, and feel like a physician, a transformative process known as Professional Identity Formation (PIF). Since there is an association between PIF and clinical communication skills and moral reasoning, it is important to introduce students to it as early as possible in medical training, reinforced with coaching and nurtured by an inclusive learning environment.

Methods
In the summer of 2022, we incorporated the nine question Professional Identity Essay (PIE) with a peer coaching component into our seven-week summer prematriculation course (PMC). Our PMC was available to all incoming students accepted to our medical school and we had twenty-one students out of a class size of approximately 140. The average age for the PMC students was 26 and 33% were underrepresented in medicine (URiM), similar to previous cohorts. Our PMC is structured using team-based learning focused on biomedical sciences with weekly assessments, self-reflections, and peer coaching. We recruited ten fourth-year medical student volunteers to be peer coaches and provided them an introductory session on coaching. The average age for the coaches was 27 and 20% were URiM. PMC students completed the PIE and sent their responses directly to educational psychologists who provided written feedback within one week. The students then discussed their PIE feedback with their coaches. This structure was repeated in 2023 with a class size of twenty-three and 16 peer coaches.

Results
For 2022 and 2023 combined, the coaching and PIF/PIE components of the course received average student evaluations for level of satisfaction of 4.63/5 and 3.86/5, respectively (N=35; 79.5% response rate). 

Conclusion
We learned from the 2022 student feedback that students would have appreciated a peer coach whose pathway to medical school and personal identity aligned to their own, which we were able to incorporate in 2023 and saw improved coaching evaluations. Students commented that the PIE written feedback, especially the description of the PIF stage level, was initially difficult to interpret and became clearer only after the debrief session. Incorporating the PIE into the PMC still requires ongoing refinement to optimize student receptivity.