Professional identity formation and the limits of intelligibility in medical education: a queer reframing

Abstract

Abstract Professional identity formation (PIF) has become a central tenet of medical education, yet its dominant assumptions leave a constitutive question underexamined: under what conditions can diverse configurations of knowledge, body, affect, and authority be recognized as legitimately medical in the first place? Building on a growing critical PIF literature that has mapped the normative pressures shaping who can become a physician—whiteness, patriarchy, cis-heteronormativity, Euro-centrism—and documented the agency and resistance of minoritized learners, we argue for a complementary move: theorizing the regime of recognizability itself. Drawing on Queer theory, we reframe PIF as a regime of professional intelligibility sustained by performative reiteration: less a matter of how identity is formed than of how recognizability is constructed. Intelligibility names the normative field that pre-determines which medical identities can be seen and validated; performativity names the everyday enactments—clinical evaluations, communication styles, embodied comportment—through which that field is reproduced and, occasionally, resignified. We illustrate this analytic by using a recent study of lesbian, gay, bisexual, transgender, intersex, queer, and asexual (LGBTIQA+) medical trainees alongside the participants’ own account of crafting a “Care Weaver” physician identity, showing how scenes of clinical foreclosure, calibrated self-presentation, and uneven concealment make the regime, and its porosity, empirically visible. We argue that representational inclusion, while necessary, leaves the criteria of recognition intact: a trainee may be wholly visible yet remain unintelligible as a physician. We close by outlining a research agenda that asks how the regime of intelligibility is inscribed in daily artefacts, how iterated performances resignify professional norms, and which conditions let alternative configurations take hold—so that the field might help sustain more plural ways of being recognized as a physician.