The Professionalism Disconnect: Do Entering Residents Identify Yet Participate in Unprofessional Behaviors?

Perceptions of professional behavior may vary by individual, medical specialty, demographic group and institution. In order to understand these differences, Duke University Hospital and Vidant Medical Center/East Carolina University surveyed entering PGY1 residents about their perception of professionalism of 46 specific behaviors related to training and patient care. A majority of responders rated all 46 specified behaviors as unprofessional, and a majority had either observed or participated in each behavior. For all 46 behaviors, a greater percentage of women rated the behaviors as unprofessional. Respondents indicated the most important professionalism issues relevant to medical practice include: respect for colleagues/patients, relationships with pharmaceutical companies, balancing home/work life, and admitting mistakes. Defining professionalism in measurable terms as is assessed in this survey is a challenge yet critical in order for it to be taught and assessed. Recognition of the differences by gender and institution should allow for tailored teaching and assessment of professionalism so that it is most meaningful.