This article, based on field research of a cohort of students enrolled in an innovative medical school, traces the transformation of idealism among student doctors. Our findings show that loss of idealism goes beyond a temporary diversion caused by situational demands of medical school. Rather it is inherent in the very demands of professionalization. We begin by describing students' changing perceptions of the importance of psychosocial issues in medicine. In their need to strive for competence, students turn off their emotional reactions to patients. Equally important is the students' perception of the medical profession's expectation of affective neutrality toward patients. We conclude that loss of idealism must be understood in the context of a symbolic-moral drama wherein professionalization is conceptualized as a process of differentiation and alienation from lay society and of elevation to a position of detachment and control.
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