Frequently Asked Questions
The general principles that underpin a definition of medical professionalism include that: physicians subordinate their own interests to the interests of others, physicians adhere to high ethical and moral standards, physicians respond to societal needs and their behaviors reflect a social contract with the communities served, physicians evince core humanistic values, including honesty and integrity, caring and compassion, altruism and empathy, respect for others, and trustworthiness, physicians exercise accountability for themselves and for their colleagues, physicians demonstrate a continuing commitment to excellence, physicians exhibit a commitment to scholarship and to advancing their field, physicians deal with high levels of complexity and uncertainty and physicians reflect upon their actions and decisions.
Professionalism specifically includes: the ability to communicate, accountability, altruism, appearance, decency, demeanor, duty, excellence, following through with recommendations made to patients, honesty, honor, integrity, judgement, knowledge, language (appropriate), not impugning the reputation of others, putting the patient first, reporting colleagues’ errors, service (devotion to a lifetime of), skills and telling the truth.
The general principles underpinning the definition were adapted from: Swick HM: Toward a Definition of Medical Professionalism. Academic Medicine 75:612-616, 2000
Specific aspects regarding profession were adapted from:
- Project Professionalism. American Board of Internal Medicine, Philadelphia, Penn 1997.
- Report on Professionalism in Undergraduate Medical Education, Faculty of Medicine, University of Toronto, May 2000, Ian Johnson, Chair.
- Oral and written communications with faculty members at the School of Medicine, University of Maryland, Baltimore and elsewhere (JHU, UC, D, University of Colorado, UNM, USIS).
Unprofessional Behavior includes: abuse of power in interactions with patients or colleagues, bias and sexual harassment, breach of confidentiality, arrogance, cheating, greed, misrepresentation of credentials and certifications or education and training, impairment, lack of conscientiousness, lying, conflicts of interest, self-referral, acceptance of gifts, over-utilization of services, collaboration with industry, compromising the principles of clinical investigation.
Humanism, includes caring for patients’ needs and psychosocial aspects, compassion and empathy.
Yes. Different experts and different schools of medicine use different definitions. We’ve used the broadest definition for Professionalism and a narrower one for Humanism or Medical Humanism, but there’s no one way.
It has responsibility for implementing a program of improving professionalism among the School of Medicine’s faculty and students. This program begins with the admissions process and culminates in what we expect to be recognition of each student and faculty members’ professionalism.
It is shorthand for Humanism, Ethics, Life-long Learning, Physicians subordinating themselves to their patients, Ethical behavior, Research subjects, Sensitivity to age, culture, disability, diversity and gender - Professionalism, Respect for Patients, Families and Colleagues, Other (Death and Dying, Impairment, Sexual and Aggressive Behavior and Physician/Industry relationships).
I would suggest that first you talk over what you observed or experienced with someone you respect on the faculty or in Students Affairs or the Professionalism Project. From that discussion it may be clearer whether to pursue: (1) talking with the individual him or herself, (2) talking with the individual's superior (course director, residency training director, division or department chair, Dean, etc.), (3) filling out a critical event form for serious unprofessional acts or (4) going to the Feedback Loop on the Professionalsm website for other problems.
No one. The peer-to-peer site on Medscope linked to the Professionalism page is accessible only to the students. That is what the student group who advised Dr. Talbott recommended and that's how Tracy Ijams set it up. When a student evaluates another student - that's it - only the student being evaluated will see it - it will not be shared with faculty or staff. There is no written record, no written copy - there's just the stored data accessible only to the evaluated student - and which will be periodically cleaned out by Tracy.
Often persons simply do not realize how they are coming across to others. We hope that the Peer-to-Peer evaluation opportunity on Medscope linked to our website will be a useful first step. At other schools it has been shown that a talk with the student by the Dean of Student Affairs about what was observed solves 92% of the problems and this would be another step. If pointing it out doesn't help, another form of remediation may be recommended, usually by the Academic Advancement Committee, such as being assigned a mentor, faculty advisor or the repeat of a course or rotation. In cases of serious violations, such as critical events, though, it could mean consideration by the Judicial Board and/or Dean and possible dismissal.
John A. Talbott, M.D., Director of the Project
University of Maryland School of Medicine
Department of Psychiatry
701 West Pratt Street, Room 322
Baltimore, MD, 21201 U.S.A.
The answer to this question is as mysterious as that told in the parable of the loaves and fishes and as unknowable as the process of making sausages.
It is an ever evolving work-in-progress that will take many years.