Ontological perspectives in higher education and particularly in professional education and development have focused attention on the question of the learner's being and becoming rather than on the epistemological concern of what and how they know. This study considers the formation of the professional self in the light of the requirements for professional practice. It raises the question of agency in relation to this formational process and considers the implications of the autonomy paradox which arises from the simultaneous influence of the sovereign self and the external authority of the profession on the formation of the professional self. This study considers a structural perspective on both of these matters and concludes with implications for professional education and development derived from constructive developmental theory and the notion of subject-object transformation.