July 14, 2024

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Professional Aspirations < Yale School of Medicine

4 min read

Professionalism is the basis of medicine’s contract with society. It demands placing the interests of patients above those of the physician, setting and maintaining standards of competence and integrity, and providing expert advice to society on matters of health.

-Medical Professionalism in the New Millennium: A Physician Charter

Hi everyone:

Professionalism is often misunderstood as a character trait. You’re professional or you’re not. You get it or you don’t.

But professionalism is better understood as one of several competencies to master during residency training. Our professionalism allows society to trust physicians to self-regulate and act ethically and responsibly.

Residents acquire professional attitudes and behaviors just as they acquire knowledge and clinical skills. Programs are responsible for providing guidance, oversight, and feedback as trainees evolve into full professionals.

Professionalism is a challenging competency to assess. As the interns learned in our recent professionalism seminar, physicians often face dilemmas where the ”correct” action is uncertain, like the best way to respond to angry patients, medical errors, or competing personal and work obligations. By mastering core principles of professionalism, physicians position themselves to untangle such challenging dilemmas while building the trust of our patients, colleagues, and society. Here’s a partial list of professional principles, which apply to all physicians, from interns to senior faculty:

  1. Learning: Physicians can never know enough. We must read about our patients, study for boards and in-training exams, attend teaching conferences, and stay up to date on medical science.
  2. Growth: We are perpetual works in progress. We must seek out and respond to feedback, learn from our mistakes, and strive to improve ourselves throughout our careers.
  3. Appearance: As a medical student, I was expected to wear a short white lab coat, white pants, and a tie. Four decades later, we’re in scrubs, and ties are considered vectors of disease. Though styles have changed, standards of appearance have not: physicians should be well-groomed and our clothes clean and neat.
  4. Honesty: Medicine is built on a foundation of trust. Colleagues and patients depend on our truthfulness. When we don’t know a test result or can’t answer a question, we should just acknowledge it. When we sign notes, we vouch that they are accurate and do not contain outdated information from prior entries. Signing inaccurate notes hurts your precious credibility.
  5. Reliability: We must arrive on time and stay until we complete our work (and if that’s not possible, sign out to the night team). We must attend required teaching conferences, complete inbox tasks, respond to emails from program leadership, and submit duty hours and evaluations without needing reminders. We must build and nurture reputations as reliable colleagues.
  6. Teamwork: We practice in teams, collaborating with other physicians, APPs, nurses, therapists, pharmacists, and social workers. We must practice closed-loop communication and respect the contributions of others. Good teammates assist overwhelmed colleagues, expecting no favors in return.
  7. A systems perspective: We are part of a large healthcare system that requires our input to improve. That’s why we must submit patient safety reports, contribute to quality improvement efforts, and speak up when we identify errors, even when speaking up requires courage.
  8. Self-care: We must care for ourselves, not just for our own well-being but for our patients, who deserve to be cared for by healthy, well-rested physicians. We must commit to getting enough sleep, exercising, eating healthy food, and nourishing our spirits.
  9. Community: Professionals look out for struggling colleagues, who may lack the insight to help themselves and may be putting patients at risk. If you’re worried about a colleague, for example if their job performance is alarming, or if you think they may have an untreated medical problem, mental health issue, or substance use disorder, please alert program leadership so we can get them the help they need.
  10. Respect: Physicians must treat all people with respect, no matter who they are, where they come from, what they look like, or how they identify. Without exception, we must speak with compassion and sensitivity, and when we witness disrespect, we must intervene.

You are each blessed with the talent and motivation to become a skilled professional. Throughout your career, you will make mistakes, face unexpected challenges, and find yourselves in ethically and emotionally complicated situations. But the beauty and privilege of being a physician is that we are awarded the opportunity to use the professional judgment we acquire during residency and continue to refine throughout our careers.

Enjoy your Sunday, everyone. We’re on our way to New York to celebrate Francesca’s 19th birthday!

Mark

What I’m reading: American Midnight: The Great War, a Violent Peace, and Democracy’s Forgotten Crisis

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