Mapping the intellectual structure of medical education research from 174,729 publications (2000–2025): a bibliometric study

Purpose: Medical education research has expanded rapidly, yet no study has comprehensively mapped its intellectual structure across publications with available reference data. We conducted a reference co-citation analysis to identify the foundational works, intellectual communities, and structural trends within this subset of publications.Methods: We analyzed 174,729 medical education publications with reference data, representing 28.1% of 622,407 records from four bibliographic databases for 2000–2025. After deduplicating reference identifiers, we constructed a co-citation network of 7,203 frequently cited references, applied Louvain community detection, tracked the citation trajectories of 15 key theoretical frameworks, and examined structural evolution across four time periods using size-invariant network metrics.Results: The co-citation network was organized into 13 major intellectual communities, the largest of which were Learning Theory and Qualitative Methods, Assessment and Competency-Based Education, and Simulation and Patient Safety. Theoretical frameworks exhibited three trajectory patterns: sustained growth, peak-then-decline, and rapid policy-contemporaneous rise. Cross-community connectivity declined over 25 years, as reflected by a decrease in intercommunity edge fraction from 25% to 17% and an increase in modularity from 0.71 to 0.78; these trends were confirmed in uniform downsampling and multiseed analyses.Conclusion: Among medical education publications with available reference data, the knowledge structure was organized into distinct intellectual communities that showed progressive specialization. These findings provide an empirical foundation for promoting integrative scholarship and informing curriculum design for medical education scholars.