Teaching professionalism in undergraduate medical education

Context There is a growing consensus among medical educators that to promot e the professional development of medical students, schools of medicine sho uld provide explicit learning experiences in professionalism. Objective To determine whether and how schools of medicine were teaching pr ofessionalism in the 1998-1999 academic year. Design, Setting, and Participants A 2-stage survey was sent to 125 US medic al schools in the fall of 1998. A total of 116 (92.3%) responded to the fir st stage of the survey. The second survey led to a qualitative analysis of curriculum materials submitted by 41 schools. Main Outcome Measures Presence or absence of learning experiences (didactic or experiential) in undergraduate medical curriculum explicitly intended t o promote professionalism in medical students, with curriculum evaluation b ased on 4 attributes commonly recognized as essential to professionalism: s ubordination of one's self-interests, adherence to high ethical and moral s tandards, response to societal needs, and demonstration of evincible core h umanistic values. Results Of the 116 responding medical schools, 104 (89.7%) reported that th ey offer some formal instruction related to professionalism. Fewer schools have explicit methods for assessing professional behaviors (n = 64 [55.2%]) or conduct targeted faculty development programs (n = 39 [33.6%]). Schools use diverse strategies to promote professionalism, ranging from an isolate d white-coat ceremony or other orientation experience (n = 71 [78.9%]) to a n integrated sequence of courses over multiple years of the curriculum (n = 25 [27.8%]), Of the 41 schools that provided curriculum materials, 27 (65. 9%) addressed subordinating self-interests; 31 (75.6%), adhering to high et hical and moral standards; 17 (41.5%), responding to societal needs; and 22 (53.7%), evincing core humanistic values. Conclusions Our results suggest that the teaching of professionalism in und ergraduate medical education varies widely. Although most medical schools i n the United States now address this important topic in some manner, the st rategies used to teach professionalism may not always be adequate.