Integrating fixed norms and relational responsiveness in medical education: Redefining autonomy

In this short communication, we reconceptualize autonomy in medical education, particularly within the context of professional identity formation (PIF). Traditionally, autonomy has been framed as independence and achievement based on 'fixed norms'. However, identity is also shaped through 'relational responsiveness', which emphasizes mutual engagement and co-construction. Drawing on Asian cultural understandings of selfhood, we propose viewing autonomy as integrity enacted within a network of mutual responsibility. We argue that both fixed norms and relational responsiveness are essential, and we introduce a preliminary framework that highlights their complementary roles. While responsiveness fosters adaptability and connectedness, it can lead to identity diffusion if not grounded in internal standards. A blended model of both modes offers a more inclusive, culturally sensitive, and resilient approach to PIF in today's complex medical landscape.