We aimed to examine medical students' perceptions regarding their professional identity and explore their creative narratives utilizing the Dialogical-Self Theory (DST). This is a mixed-method study. First-year medical students at Tehran University of Medical Sciences (TUMS, Tehran, Iran wrote a creative narrative about their perspectives on their future profession. Based on DST, qualitative-directed content analysis and summative approach were used to identify and quantify different "I-positions" to assess professional identity formation. One hundred eighty-eight first-year medical students at TUMS participated in the study in 2021-2022. In the creative narratives, the reference to "I" was more than other pronouns (he/she/they). The use of "I" positively correlated with rank in the university entrance exam (P value = 0.03). The highest application of "I" per participant belonged to the "present I-position," and the lowest to the "promoter," which has the highest rank in the formation of professional identity. Women tended to use the "present I-position" more than men (P value = 0.03). First-year medical students have accepted their self-role in forming professional identity; however, they have not found a vast perspective of it, as shown by their inability to use meta I-position and promoter I-position. Therefore, educators must provide plans within the curriculum to enhance competencies of professional identity formation. These plans can include incorporating narration writing to encourage medical students to reflect on their professional identity.
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