To enter into a profession is to take on a new identity, and literature
around professional identity formation (PIF) has taken off in medical
education (Sarraf-Yazdi et al., 2021). However, the PIF literature has been
characterized as interventional rather than exploratory, with little
attention to PIF as a socialization process (Sarikhani et al., 2022). Drawing
upon a year-long ethnographic study with third-year medical students in the
Northeastern United States, I identify “don’t rock the boat” as a guiding
principle of medical students’ PIF around their role in addressing the social
and structural determinants of health. Subsequently, I offer an analytical
turn from PIF towards social reproduction. I find that students utilize
practices like not reporting problematic behaviors or systemic injustices in
their learning environment to avoid “ruffling feathers,” to secure good
evaluations from their preceptors. I also describe how the students
acknowledge they are playing the “game” of medical education and articulate
that speaking up against the status quo is inherently unsafe for medical
students. The medical students communicate their regrets about this, but
despite their best intentions, they resign themselves to the game. Therefore,
I argue the framework of social reproduction reveals the professed
professional value of social justice in medicine is incompatible with the
professional dispositions of passivity and individuality inculcated in the
medical student habitus. I argue that utilizing the framework of social
reproduction highlights the critical need to adopt counter-training as a
guiding principle in curricular development to cultivate an alternative
medical student habitus that aligns with social justice efforts.