Kanza Ateeque ( 4th Year MBBS Student, Dow University of Health Sciences, Karachi. )
Maira Jamal ( Department of Pediatrics, Hamdard University Hospital, Karachi. )
Bushra Zafar Sayeed ( Emergency Department, Rafa-e-Aam Medical Centre, Karachi, Pakistan. )
Madam, Professionalism and ethical boundaries are the basis of the healthcare system's foundation, especially in the doctor - patient relationship.1 The last 20 years have seen a rise in world-wide concern for integrating professionalism in training and assessment; an example being the American Association of Medical Colleges and related American institutions having marked professionalism as a core competency to be indoctrinated in undergraduate and graduate medical education.2
According to the Royal College of Physicians (RCP), medical professionalism is: "A set of values, behaviours, and relationships that underpins the trust the public has in doctors".3 Medical students and professionals should demonstrate respect, compassion, and integrity. Primarily they should be required to be receptive to the patient and societal requirements and needs; hence they must supersede self-interest.4
Codes of ethics booklet issued by the Pakistan Medical Council states that it should be made a regular part of medical curriculum with a strong focus on the development and improvement of the quality of patient care. Furthermore, the enhancement of professional performance is anticipated through recognising and analysing ethical aspects and advancing interpersonal and communication skills with the patient.5 The fundamental principles of professionalism include, firstly, patient welfare followed by patient autonomy, i.e. appropriate awareness and confidence that could enable them to make their own decisions. Thirdly, it embodies social justice i.e., equitable provision of health care resources and advocates against age, gender, religious and socio-economic prejudice.6
Strong regard for humanism, ethicality and diligence are vital qualities on the basis of which acceptance into medical school should be judged.7 However, West CP et al.7 have highlighted numerous studies demonstrating a deterioration in inculcating professionalism, empathy and humanism over the course of academic and clinical training.7 Professional development of students and trainees can be adequately achieved by a curriculum designed in such a way to overlook educational milestones for medical ethics and their subsequent assessment. Students should be trained in a manner to be competent enough to identify and resolve the common ethical issues they encounter.5
The development of professional conducts begins with the student's entry into medical college.7 Emphasis on teaching through workshops, seminars, role models and mentorship programmes may help with this process. Consolidating professionalism and academic training is beneficial for both medical institutions and society as this would allow the masses to have more confidence in the medical profession providing means for advancement in affordable, high quality and safer clinical services.2
Disclaimer: None to declare.
Conflict of Interest: None to declare.
Funding Disclosure: None to declare.
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2. Brennan MD. The role of professionalism in clinical practice, medical education, biomedical research and health care administration. J Transl Int Med 2016;4:64-5. doi: 10.1515/jtim-2016-0017.
3. Ray S. Role model. BMJ 2010;340:c1572. doi:10.1136/bmj.c1572
4. Lewis B. Medical Professionals and the Discourse of Professionalism: Teaching Implications. In: Wear D, Aultman JM, eds. Professionalism in Medicine: Critical Perspectives, 1st ed. New York, USA: Springer, 2006; pp 149-61. Doi: 10.1007/0-387-32727-4
5. Pakistan Medical and Dental Council. Code of Ethics of Practice for Medical and Dental Practitioners. [Online] 2011 [Cited 2022 April 01]. Available from URL: http://www.pmdc.org.pk
6. ABIM Foundation, ACP-ASIM Foundation, European Federation of Internal Medicine. Medical professionalism in the new millennium: a physician charter. Ann Intern Med 2002;136:243-6. doi: 10.7326/0003-4819-136-3-200202050-00012.
7. West CP, Shanafelt TD. The influence of personal and environmental factors on professionalism in medical education. BMC Med Educ 2007;7:29. doi: 10.1186/1472-6920-7-29.