Due to the importance of medical students in the buildup of the health system and the influence of professional identity in their study, the aim of the study is to focus on the impact of academic satisfaction and professional identity on Chinese medical students during their career transformation, taking into consideration other factors that play a role in this relationship. 735 junior and senior medical university students from two training hospital were surveyed by using a cluster sampling method. The questionnaire included academic satisfaction scale, career transition psychological scale, simple coping style questionnaire and professional identity questionnaire. Pearson correlation and process plug-in model 6 were used for chain mediation analysis. The results show that in the career transition period, there is a direct relationship between academic satisfaction and career identity, and a chain intermediary relationship between academic satisfaction and self-confidence and coping style. In addition to our findings, we also assert that academic satisfaction has a direct impact on self-confidence and positive coping style in the transition period, and is a predictor of professional identity, whether directly or through the chain intermediary of self-confidence and coping style in the transition period. The results showed that academic satisfaction was sequentially associated with increased self-confidence, and then increased positive coping styles, which resulted in higher professional identity among medical students.