Creating health systems citizens: enhanced professional identity formation through a para-curricular distinction track in health systems transformation and leadership.

Background: As healthcare systems grow increasingly complex, medical education must evolve to prepare future physicians to navigate and improve the environments in which they practice. Integrating Health Systems Science (HSS) into medical education is essential to equip learners with the mindset and skills needed to catalyze change and address systemic challenges. This transformation requires not only new knowledge but also the intentional development of a professional identity rooted in systems awareness and leadership.

Methods: The Brody School of Medicine established a three-year, longitudinal para-curricular program, the Health System Transformation and Leadership Distinction Track, known as Leaders in INnovative Care (LINC), starting the summer after the first year of medical school and continuing to graduation. LINC provides transformative curricular experiences that instill the HSS knowledge, skills, and mindset to develop students to become change agents and as future physician leaders for the changing environment. In-depth, semi-structured interviews of participants from the first two LINC cohorts were conducted to explore early impacts on participating students after completing the first year of this program. Qualitative analyses were conducted trom interview transcripts o determine emergent themes.

Results: All scholars (n = 15) were interviewed at the end of their first year in the program. Five key themes emerged: 1) increased critical thinking, 2) leadership, 3) developing awareness of HSS, 4) career trajectory, and 5) a sense of connectedness. Students reported adopting a systems thinking perspective on healthcare, recognizing the interrelated components of the system and their role as physicians within it. The development of advanced skills, a sense of connection, and leadership qualities were evident early in the program, with learners perceiving that they view healthcare differently than peers.

Conclusion: Themes from this study suggest that the LINC program fostered critical thinking, leadership, and a systems perspective early in training. Enhanced educational experiences in HSS can accelerate professional identity formation as change agents, with the potential for curricular expansion to include all medical students. Future efforts are needed for advancing assessments, tracking longitudinal outcomes, and collaborating across institutions to identify best practices in developing medical students as "systems-citizens."