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Revitalizing Professionalism & Professional Integrity

Over the past years, medical journals and the popular press alike have commented on “an erosion of medical professionalism” and “faltering public trust in physicians.” In this new age of powerful commercial forces in health care, AMSA’s national leadership has chosen to make “revitalizing professionalism” a central focus of student action. The resources below are meant to encourage students to redefine the professional code and find their own sense of meaning and commitment in their professional oath. Provided are some guiding principles for students and physicians relevant to practicing ethical and compassionate medicine.

1. AMSA’s Model Oath for the New Professional
   Putting the ‘Hip’ back in Hippocratic. Update your school’s oath.
2. AMSA’s Just Medicine Campaign
   Help remove the influences of pharmaceutical advertising from the practice of medicine.
3. Address your school’s curriculum on professionalism. Approach your Dean and faculty to discuss this important gap in medical education and make sure your existing curriculum deals with important issues like the physician’s responsibility to public health, the need to avoid conflicts of interest with managed care and the pharmaceutical industry, the physician’s role in addressing health disparities and advocating for health care justice and social justice.

In addition to the resources provided here, you can organize your own course. Funded by a grant from the Medicine as a ProfessionHealth Activist Courses for medical students. These courses are designed to train medical students to consider roles as physician advocates and activists and to examine important issues in health care and medical education today.

Professionalism in the 21st Century

As the current climate of our health care system changes, we are bombarded with talk of professionalism and its importance in shaping the public’s perception of today’s physicians. Yet it seems that few people have a concrete understanding of what professionalism means. How do we transform the current culture of medicine from one of monetary and power struggles to one of compassion and exceptional medical care? It is our goal to create a new generation of physicians who serve as professional role models for future physicians. We hope that the following excerpts and survey will help us address our part in the effort to increase awareness of the need for professionalism and to create an environment that fosters professionalism in medical education.

What is Professionalism?

“Professionalism is the enactment of the values and ideals of individuals who are called, as physicians, to serve individuals and populations whose care is entrusted to them, prioritizing the interests of those they serve above their own.” AAMC Professionalism Task Force

The 1998 AAMC Study on Professionalism in which 116 medical schools responded, showed:

• 89.7% offered some formal instruction related to professionalism
• 78.9% addressed professionalism through orientation, often a “white-coat” ceremony
• 60% incorporated professionalism as a component of multiple courses
• 28.9% taught professionalism in one course or an integrated sequence of courses
• 33.6% offered professionalism faculty development programs

While almost 90% of medical student receive some instruction in professionalism, many medical students still feel inadequately prepared when professional conflicts occur. In an attempt to create some common understanding of professionalism, the ABIM in association with several other organizations created a Charter on Medical Professionalism.

Why Is Professionalism Important?

Samuel Shem, author of The House of God, in speaking on attitudes towards students and residents, states that for students who are “searching for connection, compassion, mutuality, shared power, and process, the role models are few, with characters who are antithetical to these qualities lurking everywhere in the teaching hospital environment.” In our current environment, it becomes a challenge to stay human, and it often becomes even difficult to find appropriate role models.

It has been shown in study after study that medical students are more cynical at the end of their clinical years than when they started school. Dr. Jordan Cohen, former President of the AAMC, stated that “we have tended to assume that the good people we admit to medical school will remain good no matter what kind of behavior we visit on them or parade in front of them. All of the evidence points the other way.” Because he felt the need to “convert our learning environments from crucibles of cynicism into cradles of professionalism,” he created a Compact Between Teachers and Learners of Medicine.