By Heidi Choe, OMS-II
A simple ubiquitous concept that is differently interpreted and understood by each individual, while applicable to almost any field of work. A theme that especially resonates with us as future osteopathic physicians entering a profession that gives us insight into the most sensitive aspects of a person’s private issues and the ability to use our hands to treat and heal. For us at NYCOM, professionalism is a concept so essential to our medical education that our school has incorporated “Pride and Professionalism” into its main tenets to instill in all its students. Since our first day of orientation, we are exposed to these values –- written in bold on the banner on the stage and in our face with skits put on by 2nd year students—and familiarized with constantly during our education here. Beyond our school, professionalism has been implemented by the ACGME as a general competency deemed applicable to every specialty that need to be imparted during residency or fellowship, and later followed by the creation of a professionalism charter that has been adopted by many major physician organizations.
Seeing how highly regarded this value is in both our school and in the medical community, I decided to delve more into the root of professionalism-what it actually means and its implications for us as future physicians. The word professionalism, in general, is understood as the conduct, aims, or qualities that characterize or mark a profession or a professional person. This broad definition may hold true for most, but for us as aspiring medical practitioners, professionalism holds a deeper meaning and more rigid expectations we need to uphold to. One of the most applicable definitions to our profession I found in my search was:
“Professional competence is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and community being served.”
—Epstein and Hundert (1)
It may seem like a lofty goal to practice all these aspects every day, but our profession is to heal and we need to apply this to each patient encounter for the well being of those who entrust their health to our care. However, it is not easy to attain this ideal level of professionalism. Examples of some challenges are given by Dr. Lynne M. Kirk(2) including negative role models from popular T.V. shows like Grey’s Anatomy, House, and Scrubs where the physician characters model unprofessional behavior, and the difficulty for medical educators to give students feedback on values, which tend to imply flaws in character and may be more difficult to address or accept.
Another important and familiar topic she raised was the seemingly inevitable changes that occur in students as they progress through medical school. She wrote that students enter medical school with idealism, with a commitment to being good doctors, taking good care of patients, and being successful in the profession. Yet, they can begin to lose that idealism early on and develop a sense of cynicism. Other examples include students’ tendency to detach from patients, more than is needed to maintain professional responsibility; their loss of reflection and a turning to rote actions based on expectations about what a physician in a particular specialty is supposed to do; their acceptance of hierarchy; and their identification with specialty-based modes of being a physician.
In spite of these challenges and the many discouraging moments that will stand in our paths, we need to keep in mind the nature of the profession we chose and the responsibilities that come with it. In our shared commitment to better the health of our patients we should strive to hold onto the idealism of the pre-med student, the factual knowledge of the medical student, and the clinical proficiency of the practiced physician to truly become respectable professionals in our field.
Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA 2002;287(2):226–235.
Kirk LM. Professionalism in medicine: definitions and considerations for teaching. Proc (Bayl Univ Med Cent) 2007;20:13–16.