Re-thinking Practice

A significant gap persists between general practitioners (GPs) and hospital-based specialists, rooted not only in divergent professional languages and specialized skills, but also in different epistemologies and narrative frameworks through which patient experience is interpreted and communicated. This fragmentation hinders the management of multimorbidity and chronic diseases, undermining the patient-centered care pathways and marginalizing patient experience.

This project, based in Pavia, Italy, proposes an integrated approach to medical education and interprofessional communication aimed at developing an institutional protocol. It aims to reconnect these professional groups by co-designing a multi-channel communication intervention, including standardized referral/discharge templates, joint case discussions, and shared digital platforms for clinical updates. Central to this intervention is the integration of narrative medicine, which serves as a "boundary object" to enhance mutual recognition, enable the negotiation of patient stories, and align the technical focus of specialists with the holistic and longitudinal approach of GPs.

The study adopts a participatory action-research framework, grounded in the theories of interprofessional communication and co-production in healthcare. Moving beyond a "deficit model" of communication, this bottom-up governance approach actively involves GPs, specialists, policymakers, and patients in the co-design of an integrative ecosystem. The methodology follows a mixed-methods design to analyse stakeholder needs, perceptions, communicative and narrative skills, and how patient narratives are constructed: a qualitative phase based on focus groups will inform the development of questionnaires. Preliminary findings will be presented.

This project contributes to medical humanities by offering a potentially transferable model for integrating healthcare practice across European regional systems.

What happens when a humanistic researcher enters a randomized controlled trial (RCT) as a process evaluator, and can reflections on this dual position contribute to the future of medical humanities?

This presentation proposes "the embedded humanist" as a figure from which the future of medical humanities may be thought or inspired — a position that emerges when humanistic questions are brought into the process evaluations of clinical trials. The presentation draws on my own experiences as a humanistic process evaluator in MindShift — an RCT in which a co-created virtual reality intervention exposes clinicians to patients' perspectives on antipsychotic deprescribing. The hypothesis is that this kind of embodied perspective-taking may open a crack in biomedical authority and thereby strengthen shared decision-making in antipsychotic deprescribing.

The process evaluation is an integral part of the MindShift RCT frame, yet an inquiry whose humanistic and philosophical questions — about ambivalence, interpretation, and subjectivity — sit uneasily within this frame already shaped by a particular research economy: the RCT as global gold standard, digital health as political vision. The presentation engages this friction as a methodological object and argues that reflection on different positions within the research process — here specifically, the embedded humanist's dual belonging to evidentiary logic and interpretive tradition — is not merely a methodological virtue, but a condition for the renewal of the field. The presentation shares concrete experiences from this work and proposes that making these dilemmas visible as interdisciplinary collaboration unfolds is one way of thinking critical medical humanities from inside medical frameworks.

Medical training abroad has become a key alternative for Indian aspirants who are excluded by the country's highly competitive medical education system, with non-Anglophone medical education playing a key pathway. However, existing accounts of such mobility are largely framed within the push-pull models, overlooking how medical identities are actively produced and entangled within social, digital, and material processes. Thus, with this paper, we address this gap and examine how medical professional trajectories are shaped through interconnected digital and institutional processes by using the dual framework of “Algorithmic Aura” and “Institutional Unmaking”.

Drawing on the frame analysis of digital recruitment media (websites/ YouTube) and interviews with Foreign medical graduates interning in India, the study firstly analyses the Algorithmic Aura, the socio-technical production of a “global doctor” identity, curated through digital imaginaries. The narrative aestheticises cross-border education with the discourse of affordability and global recognition, emphasising the elusive dream of a white coat.

However, return to Indian clinical field marks a site of “Institutional Unmaking”. With narrative inquiry acquired from interns, the data highlights epistemic frictions as international training collides with the nationalistic gatekeeping of the Foreign Medical Graduate Examination and the hierarchical positioning of Indian clinical settings. We argue that the transition from a digitally made global student to a materially made local intern exposes the fragile materiality of professional identity.

Thus, by focusing on the unmaking of doctors at the intersection of digital dreamscapes and clinical practice, this paper demonstrates how medical subjectivities are reshaped through encounters with regulatory frameworks and institutional hierarchies. We try to highlight the uneven and contingent revaluation of transnational medical credentials within the Indian healthcare field.