Epistemological gaps in medical education: a bibliometric and criticalanalysis of contemporary academic discourse

Contemporary medical education is shaped by imperatives of efficiency, measurability and standardisation, often to the detriment of epistemological reflection. This study investigates how epistemological themes—critical reflection, uncertainty, epistemic justice, reflective reasoning—are represented in recent academic discourse. A bibliometric analysis was carried out on a corpus of 2,830 PubMed-indexed articles (2015–2025), followed by a qualitative interpretation of keyword co-occurrence networks generated in VOSviewer at three thresholds (≥5, ≥20, ≥40 occurrences). The analysis revealed a discursive structure dominated by themes such as “curriculum”, “clinical competence”, “simulation”, “assessment” and “students”. In contrast, terms such as “epistemic uncertainty”, “critical thinking”, “reflective practice”, “epistemic injustice”, or “bias” were absent from the central networks or completely non-existent at high thresholds. Semantic clustering indicated a systemic orientation towards a performative, technological and algorithmic vision of medical training, to the detriment of the critical, narrative and humanistic dimensions of medical knowledge. Findings indicate the existence of systemic epistemological gaps, with implications for clinical reasoning, professional uncertainty management and the integration of patient experience as epistemic knowledge. The study suggests the need for a curricular reconfiguration that integrates epistemic reflection into medical training.