Clinical subjectivation: anthropologies of contemporary biomedical training.

Introduction Throughout the 1970s and 1980s, medical anthropologists increasingly turned their attention to the examination of biomedicine as a sociocultural system (see Gordon 1988 and reviews by Gaines and Hahn 1985; Hafferty 2000; Hahn and Kleinman 1983). A significant portion of this study focused on medical education, exploring the ways in which biomedical practitioners—primarily physicians but also nurses and other members of biomedical health care teams—learn both the ''art and science'' of medicine. These early studies recognized the central role that clinicians can play not just in One key way to understand clinicians is to study the process by which they become biomedical professionals. The articles in this special issue apply anthropological theory and methods to the analysis of contemporary biomedical training, engaging with a number of recent changes in the field of biomedicine and employing recent insights from the field of anthropology. Medical education today must be examined within the context of new emphases on multiculturalism, global health, and health disparities; an increasing concern with standardization and evidence-based medicine; the development of for-profit and managed health care; demographic shifts among health practitioners, most notably the increasing percentage of female medical students; increased recognition within academic medicine of the so-called ''hidden curriculum'' (Hafferty 1998; DelVecchio Good 1995); and the introduction of various forms of the culture concept itself into medical education. Given the emerging and novel nature of many of these developments in biomedicine and biomedical training, the articles in this volume draw upon recent study in philosophy, science studies, and anthropology that addresses the role of experts and expert knowledge in contemporary society. While most previous studies on clinical training have focused on socialization, this volume instead shifts the focus onto the production of clinical subjectivities. What kinds of people are formed through contemporary processes of clinical training, and how do these evolving subjects transform health, power, and other aspects of social life? In this introduction, we present a brief history of theoretical and ethnographic approaches to clinical training, from professional socialization to the medical gaze. We then introduce the papers in this volume, which highlight the contemporary moment in the anthropology of clinical training and the insights into biomedicine that can be gleaned from a renewed approach to expert subjectivities.