Author	A.P. Berlin
Author	K. Riley
Abstract	This practitioner research is the story of what happens when we take an important, but heterogeneous idea, and turn it into a mandatory standard. It explores how public engagement and patient involvement are framed and enacted in UK medical education, in the context of evolving regulatory requirements and diversity of medical schools. Four case studies are presented - three medical schools with different missions, and the regulator (the General Medical Council, GMC). Interview transcripts with school leaders and GMC officers were analysed applying two approaches, informed by symbolic interactionism and social epistemology: boundary object theory and frame analysis. The study shows that public engagement is a diffuse, plastic concept acting at organisational and individual levels with many features of a boundary object. This conclusion is further supported by its institutionalisation as a regulatory standard (in Tomorrow's Doctors 2009). The study sheds light on ideas of professional and organisational identity formation and on boundary agents - those working across intra, and extra organisational boundaries. Through frame analysis, the case studies provide an insight into the socio-political, moral and pedagogical dimensions of involving patients and the public in medical education as viewed by educators and regulators, and how these ideas are affected by the use of knowledge, values and authority on one hand, and regulation on the other. Medical school leaders frame public engagement and patient involvement with reference to their local higher education and healthcare context, and their knowledge community. Variations in framing encompass individual, person-centred, and collective, socially-oriented dimensions. New regulatory standards for medical education and training were published in January 2016 - a re-framing of professional and regulatory priorities. This study helps us understand how such standards in professional education evolve and provides a framework for investigating and analysing their intended and untoward effects at individual, organisational and institutional levels.