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Burnout and mental health challenges among physicians reflect the emotional demands of clinical work within complex healthcare systems and threaten workforce sustainability and quality of care. Emotions are central to clinical practice and to physician’s identity; however, medical education offers limited structured training to help students recognize and manage their own emotions. Although international competency frameworks emphasize reflection and responsibility for well-being, guidance for teaching emotion-related skills, defined as the ability to recognise, regulate, and reflect on one’s own emotional experiences, remains limited. This qualitative study explored how Swiss medical programs integrate training related to physicians’ own emotions and examined stakeholder perspectives on medical students’ preparedness to apply self-directed emotional skills in clinical practice, with the aim of identifying gaps and informing future educational approaches.

We conducted a curricular document analysis across seven Swiss medical schools and undertook semi-structured interviews with key stakeholders (n=20), including faculty members, facilitators, and educators (group 1, n=8), as well as medical students during their pre-clinical and clinical years, and junior residents (group 2, n=12). Data were analysed using reflexive thematic analysis.

Across all groups, identified themes reflected a mismatch between high emotional load and limited emotional preparation. Three interrelated themes were identified: Emotional preparedness is insufficient and inconsistent, describing the limited integration of emotion-related training within formal curricula, practical barriers to accessing optional teaching, and a lack of concrete strategies for students to process emotional experiences. Medical culture suppresses rather than supports emotions, covering how hierarchical structures, norms of emotional restraint, gendered expectations, and a predominantly biomedical discourse shape students’ emotional socialisation. Finally, Emotional competence is valued and emerging but not yet embedded, reflecting widespread recognition of the importance of emotional skills for clinical reasoning, learning, and relationships, yet unclear curricular ownership, limited role modelling, and a lack of longitudinal integration.

Our findings highlight a gap between the emotional demands of clinical practice and educational preparation in basic medical training. Preparing future physicians requires moving beyond individual coping strategies toward structured, longitudinal, evidence-informed curricula that integrate emotional self-awareness, regulation, and reflection into identity formation, alongside faculty development and a clinical culture that legitimises discussion of emotions.

Although emotional competence is seen as central to physicians’ identity, current medical culture provides insufficient structures for its recognition, development, and formal teaching and evaluation.