BACKGROUND: Concern about burnout has prompted increased attention on fostering physician resilience throughout the educational continuum. Studies indicate that lack of meaning-making and connection (domains of spiritual wellbeing) place physicians at risk for burnout. While evidence support including spiritual care in comprehensive patient care to help patients/families heal from impactful experiences, few studies explore physicians' spiritual wellbeing as they routinely confront suffering and death in their daily work. Storytelling taps into spiritual aspects of human experience. This study, unique in the literature, examined the stories physicians chose to tell about spirituality and medicine over 20-years, from trainee to practicing physician, to explore how these experiences impact professional development and wellbeing. METHODS: Design: Qualitative individual interview study - secondary analysis of a rich dataset of physician interviews, gathered over 20-years beginning in first-year residency, regarding attitudes and approach to spiritual care. For this new study, researchers extracted and analyzed the previously unexplored stories participants spontaneously told during interviews. SETTING: Participants completed the same USA residency program and now practice throughout USA and Canada. PARTICIPANTS: In study-year 1, all residents (PGY1,2,3) participated
response rate (RR) 97%, reflected a diversity of personal beliefs (atheist to religious). Researchers followed the PGY1 class for 20-years (2002-2020), interviewing them in study-years 1, 3, 11 and 20 (RR 100%, 100%, 97%, 54%). DATA COLLECTION: Researchers extracted stories from interview transcripts. ANALYSIS: 4 researchers analyzed 204 stories from 66 interviews with 34 physicians, using grounded theory. RESULTS: Irrespective of personal spiritual beliefs, trainees and practicing physicians told numerous spirituality-related stories. Longitudinal story themes-(1) Dissonance to Integration, (2) Formation and Transformation, and (3) Accidental to Purposeful Healing - reflected physicians' ongoing spiritual journeys as they grappled with meaning, values, purpose, and connection in their daily work. Spiritually impactful moments, whether distressing or uplifting, occurred throughout physicians' careers influencing professional/personal development, resilience and clinical approach. Spiritual practices (religious/secular) and reflection fostered healing for patients/families and physicians. CONCLUSION: Physicians' longitudinal spiritual-care stories provide new insights into their professional/personal development. Reflection on spiritually impactful moments, both distressing and uplifting, may trigger transformative learning towards meaning-making, resilience, burnout prevention and positive physician identity formation.