Medical Education in 2026 and the Process of Professional Identity Formation: Resident Perspectives from a South American Training Program in Cardiology

Abstract Background: Professional identity formation (PIF) is a cornerstone of medical education, representing the internalization of professional values, norms, and behaviors. In 2026, medical education faces evolving challenges, including the integration of artificial intelligence (AI), competency-based medical education (CBME), and emphasis on diversity, equity, inclusion, and belonging (DEIB). This study explores cardiology residents’ perspectives on PIF within a South American training program, highlighting contextual influences in a resource-variable setting. Methods: A qualitative study was conducted using semi-structured interviews with 15 cardiology residents from a Brazilian training program. Thematic analysis was employed to identify key themes related to PIF processes and influencing factors. Results: Four main themes emerged: (1) Navigation of tensions between ideals and realities of practice; (2) Role of mentorship and clinical experiences in identity integration; (3) Impact of cultural and systemic factors in South America; and (4) Future-oriented adaptations, including AI and DEIB. Residents described PIF as a dynamic, non-linear process shaped by workplace socialization. Conclusions: In 2026, PIF in cardiology residency emphasizes resilience, cultural adaptation, and technological integration. Findings underscore the need for tailored educational strategies in South American contexts to foster humanistic, competent cardiologists. Keywords: Professional identity formation; Medical education; Cardiology residency; South America; Qualitative research; Competency-based education