Background: As medical education develops into a varied and well-developed field of research, the issue of quality research anchored in or generating theory has gained increasing importance. Medical education researchers have been criticized of not connecting their work to relevant theory. This paper set out to analyse how researchers can connect to theory in medical education. The goal of this paper is to provide an accessible framework for those entering medical education research, regarding how theory may become an integral part of one's work. Methods: Fifteen purposefully selected researchers in medical education were asked to nominate papers they considered influential in medical education. Through this process 41 papers were identified and included in the study. Results: The papers were analysed with thematic content analysis, which resulted in three approaches to the use of theory: as close-up exploration; as a specific perspective; and as an overview. The approaches are exemplified by quotes from the papers included in our dataset and further illuminated by a metaphoric story. Conclusions: We conclude by pointing at the importance of making explicit how theory is used in medical education as a way to collaboratively take responsibility for the quality of medical education research.