Navigating Uncertainty and Becoming a Doctor: A Reflexive Thematic Analysis of Medical Students’ Lived Experiences During Clinical Rotations and Professional Identity Formation
Background: The transition from preclinical education to clinical training represents a pivotal stage in undergraduate medical education. During clinical rotations, students move from structured classroom learning to complex healthcare environments where they encounter uncertainty, increased responsibility, evolving professional roles, and emotionally challenging patient interactions. Although previous studies have examined academic performance, burnout, and clinical competence, less attention has been paid to how students experience this transition and construct their professional identities within authentic clinical settings. Objective: To explore the lived experiences of fourth-year MBBS students during clinical rotations, with particular emphasis on professional identity formation and experiences of uncertainty in clinical learning environments. Methodology: An interpretivist qualitative study was conducted using Reflexive Thematic Analysis (RTA). Twenty fourth-year MBBS students undertaking core clinical rotations at a teaching hospital in Pakistan participated in semi-structured interviews selected through purposive maximum variation sampling. Interviews were audio-recorded, transcribed verbatim, and analysed using Braun and Clarke's six-phase reflexive thematic analysis. Methodological rigor was enhanced through reflexive journaling, peer debriefing, an audit trail, and transparent reporting consistent with SRQR and AMEE Guide No. 131. Results: Five interconnected themes emerged: emotional disruption during clinical entry, negotiating professional identity through participation, reframing uncertainty as professional growth, belonging through relationships and psychological safety, and reflection as a mechanism for development. Students described clinical transition as emotionally demanding yet transformative, with identity formation shaped by authentic participation, supportive supervision, and reflective engagement. Uncertainty gradually shifted from a perceived threat to a valuable learning opportunity within psychologically safe environments. Conclusion: Clinical rotations represent more than opportunities to acquire clinical competence; they are developmental experiences that shape students' professional identities, emotional resilience, and approaches to uncertainty. Medical education programmes should intentionally foster psychologically safe learning environments, strengthen supervisory relationships, and integrate structured reflective practice to support students' professional development during clinical training. Keywords: Clinical Rotations, Medical Education, Professional Identity Formation, Qualitative Research, Reflexive Thematic Analysis, Uncertainty.