Emotions May Be the Missing Key to Medical Professionalism, Researchers Argue

For more than a century, the ideal doctor has been imagined as a figure of cool rationality: someone who suppresses grief, fear, and outrage in order to remain objective at the bedside. A new perspective article published on 16 October 2026 in Frontiers in Medicine argues that this ideal is not a universal standard of professional conduct at all, but a culturally specific inheritance—one rooted in Western colonial traditions and in the Cartesian separation of emotion from reason, which portrays feelings as a corruption of objective clinical knowledge. The authors, a team of medical education researchers at the University Medical Centre Groningen in the Netherlands, contend that emotions are not threats to professionalism but essential resources that qualify clinical decision-making by helping physicians understand themselves, their patients, and the context of care, and by anticipating the consequences of their decisions.

The stakes of this argument become visible in clinical training, where trainees encounter death, uncertainty, suffering, and systemic injustice at a stage when their professional identities are still forming. Research cited in the article shows how these encounters evoke vulnerability—stepping beyond one’s comfort zone into situations of risk and limited control. Trainees in end-of-life care, for example, are shocked by the physical realities of death while navigating a culture that treats dying as taboo and values emotional distance as the appropriate professional response. Junior doctors entering clinical practice report that uncertainty, responsibility, and fear of being judged incompetent make vulnerability inevitable. In Brazil, daily encounters with structural inequities leave trainees feeling powerless as they witness the suffering of marginalized populations. Yet trainees are implicitly expected to manage these experiences alone, through individual emotional restraint.

When emotionally charged experiences cannot be openly acknowledged, the authors argue, they may give rise to shame. Shame transforms emotional distress into negative judgments about the self, leading trainees to interpret vulnerability as evidence that they are inadequate or do not belong in medicine rather than as a natural response to complex clinical practice. Medical education can become an environment fruitful for shame, where hierarchical relationships, psychologically unsafe learning environments, perfectionism, and experiences of underrepresentation increase the likelihood and intensity of shame experiences. In this context, many trainees adopt what researchers call a cloak of competence, hiding their emotions and struggles to avoid being perceived as unprofessional. Instead of supporting reflection and growth, shame reinforces emotional suppression, identity dissonance, and isolation—shaping how trainees come to understand themselves as future physicians.

The consequences extend beyond individual distress. Trainees frequently hold the implicit assumption that being a good doctor requires suppressing emotions, a process that progressively reduces their awareness of their own feelings and those of others. When professionalism privileges emotional distance, it reflects perspectives largely rooted in Western societies of the Global North, where cultural norms shape how emotions are experienced, expressed, and discussed in everyday life. Trainees may struggle to reconcile their own emotions and values with expectations of detachment, creating identity dissonance—the distress of being unable to align one’s personal values with a detached professional role. Over time, these unresolved tensions can lead to isolation, burnout, cynicism, and a diminished sense of purpose. Innovative initiatives, such as music-based pedagogical activities, have successfully promoted emotional education in medical training by normalizing emotions within medical practice and strengthening trainees’ emotional awareness, but such interventions remain the exception rather than the norm.

To counter this dominant model, the authors adopt a decolonial perspective that questions whose values, ways of knowing, and ways of relating have been privileged in medical professionalism, and whose have been marginalized or excluded. From this standpoint, professionalism becomes a culturally situated and negotiated social contract that can be reimagined through multiple ways of knowing, relating, and becoming a physician. The article draws on three complementary perspectives—queer epistemologies, the South African philosophy of Ubuntu, and Freirean critical pedagogy—to broaden current understandings of professionalism, then turns to transformative learning theory to explain how vulnerability and emotional tension can become catalysts for learning.

The first perspective comes from research on queer identities in medical education, which illustrates how trainees act as care weavers, drawing on lived experiences of marginalization to transform personal vulnerability into a relational capacity for empathy and clinical insight. For these trainees, marginalization acts as a lifelong disorienting dilemma that prompts a transformative rejection of dehumanizing professional norms in favor of radical connection. Queer epistemologies hold that knowledge is produced through embodied and affective experience, and that the feelings generated by living athwart a norm—discomfort, disorientation, shame—disclose how that norm operates in ways not available from within it. The authors are careful not to treat marginalization as productive in a way that would justify its harms: their claim is not that exclusion is educative, but that knowledge generated under conditions of exclusion should be recognized as knowledge rather than discounted as personal experience. This capacity resonates with bell hooks’ understanding of the margin as more than a place of deprivation—a space of resistance, creativity, and transformation where new ways of knowing and being can emerge.

The second perspective, Ubuntu, is a South African relational ontology that understands personhood through the principle I am because we are. Human beings become who they are through their relationships with others, making identity an ongoing and collective process of becoming—one that extends to professional identity, positioning the process of becoming a physician as inseparable from relationships with patients, colleagues, communities, and society. In Ubuntu, emotions are not private inner states belonging to an isolated individual but relational forces that disclose, sustain, and repair the bonds through which people connect and care for one another. Compassion, empathy, kindness, and emotional presence allow physicians to recognize their shared humanity with patients and colleagues. Epistemologically, clinical truth and personhood are not objective facts extracted by an isolated observer but relational understandings co-constructed through communal interdependence—knowing a patient requires going beyond disease pathology to listen to their story within their communal context. Emotions also create the conditions for solidarity, positioning professionalism as a collective practice grounded in compassion, mutual responsibility, and shared humanity.

If Ubuntu locates professionalism in relationship, critical pedagogy locates it in structure. According to Freire’s critical pedagogy, in which dialogue and the reading of one’s social world are the conditions for critical consciousness, learners are encouraged to connect their emotional experiences to the historical, social, and institutional contexts that shape healthcare. Inspired by this tradition and drawing on the Brazilian context, researchers have proposed a Pedagogy of Connection that emerged from the close integration between medical education and the country’s public healthcare system. From the beginning of their training, Brazilian students participate in community and primary care settings, encountering the complexity of patients’ lives, the realities of social inequality, and the challenges of delivering equitable healthcare. These early patient encounters can evoke uncertainty, frustration, and a sense of powerlessness as learners recognize that many health problems are rooted in broader social and structural conditions. The Pedagogy of Connection responds by creating educational spaces where these experiences can be explored collectively through dialogue and critical reflection. Presence—an emotional, rational, and spiritual openness to patients’ suffering—allows emotions to inform decision-making, and feelings of frustration or moral outrage can make systemic problems visible, contributing to the development of critical consciousness and positioning the physician as an agent of social justice.

Together, these perspectives reframe professionalism as a process that develops across emotional, relational, and structural dimensions of medical education. Transformative learning theory provides the framework for understanding how emotionally significant experiences can challenge existing assumptions and become opportunities for learning. Transformative learning begins with a disorienting dilemma—an experience that challenges previously held assumptions and frames of reference, prompting critical reflection that engages both cognitive and affective dimensions. Clinical settings provide a unique context for this process, as trainees routinely encounter emotionally and ethically complex situations. Experiences such as first encounters with end-of-life care or reaching the limits of one’s own capabilities can leave trainees feeling overwhelmed, powerless, uncertain, and alone, unsettling their assumptions about care and their professional role. Rather than representing signs of incompetence, these emotional responses can become disorienting dilemmas that prompt critical reflection and shifts in perspective when learners are supported in acknowledging, making sense of, and expressing their emotions.

The authors propose reconnecting professionalism with emotions by recognizing vulnerability as a source of learning, relationships as central to professional identity, educational spaces as sites for dialogue and critical reflection, and transformative learning as a process of collective meaning-making. Crucially, they do not offer this as a new universal standard to replace the old one. They argue instead that emotional engagement is constitutive of professional identity formation, while the meanings, expressions, and legitimate forms of that engagement are shaped by the cultural, structural, and historical contexts in which physicians learn and practice. By positioning emotion as a legitimate way of knowing, feelings are recognized not as subjective distractions from clinical practice but as perceptual tools that deepen understanding. Relational professionalism calls for educational spaces where emotionally challenging experiences are explored collectively rather than carried individually—spaces of radical openness where vulnerability, uncertainty, and emotional tension are recognized as shared opportunities for reflection rather than personal shortcomings, enabling learners to cultivate professional identities grounded in connection, solidarity, and social responsibility.

Subject of Research: Decolonial reframing of emotions in medical professionalism and professional identity formation

Article Title: Can emotions be professional? A decolonial reframing of professional identity formation

Article References: Camargo Collet, S., Ribeiro, L. M. C., van der Goot, W. E., de Carvalho Filho, M. A., & Olmos-Vega, F. M. (2026). Can emotions be professional? A decolonial reframing of professional identity formation. Frontiers in Medicine, 13, Article 1952561. https://doi.org/10.3389/fmed.2026.1952561

Image Credits: AI Generated

DOI: 10.3389/fmed.2026.1952561

Keywords: medical professionalism, professional identity formation, emotions, decolonialism, medical education, Ubuntu, queer theory, critical pedagogy, transformative learning, vulnerability, health professions education, clinical training