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

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.