Professionalism?

[jl lin]

This might help with respect to your question on specific behaviors that are categorized as "unprofessional". I believe she's one of the people who first correlated unprofessional behaviors in medical school (looking at the Dean's letter) with future medical license action by state medical boards, which is why medical schools now emphasize this a lot.

I like her presentation thus far. I have to complete the rest of it after some work. Thing is, and maybe I haven't as yet gotten to a sound covering of this in her presentation, but what devices (i.e., objective, that is, as is possible) are they employing? What will prevent a student from getting gorged by such a system if highly subjective indicators are involved in the evaluation process? I have witnessed a fair amount of unfair evaluations in healthcare in general. I have gone the extra mile not to be party to such things, but I have seen them openly occur. Yes, it may be something I have seen more in nursing. Generally, medicine has seemed more supportive with their own--but I am on the outside looking into that where I am now. And yes, there are exceptions to that, where I have been more on the inside--d/t follow-ups and inquiries. Dr. P. gives examples and ratings and ratios. But how can it be controlled in such a way that personality issues from those with more leverage don't unduly hurt those under them? People are complex, and sometimes, for whatever reason, they can decide to resent or dislike another person. That dislike can become a subjective slur against someone and their career. From what I have witnessed in nursing at least, often one problem is the lack of regularity and structure of meetings between the preceptor and preceptee . I try to go out of my way to keep this running on a timely and less subjective basis when I precept, or if I am in charge. Not all preceptors/managers do this. I also favor the use of sound prognostic indicators w/ specific definitions to the scoring. Point is, this is not done universally in healthcare, and it's a real problem.
So too, in the medical student's clinical years, I have heard students express concerns regarding the blatantly subjective evaluation processes that will continue with them after those rotations are done. This is indeed troubling; since in the evaluation process, there are two or sometimes more than two sides; ergo, professionalism is something that has to go all the way around. It can't be some one-sided expectation.

I think it's nice to try to evaluate professionalism, and clearly the examples given here should seem obvious as to why they are unprofessional. At the same time, a school or program could set this up, and what's to stop subjectivity from hurting the medical student or resident's future? Dr. P. states "2" is a pattern with regard to the professionalism form. Again, I am not clear on how they will keep this as objective as possible.

You see a bit of my concern with PL's reply, "However during pre-clinical years, professionalism basically means you don't do anything the administration doesn't want you to do. IE you don't openly ruffle feathers. Thats a 1 way ticket to punishment, regardless of how good of a student you are."
Yes. OK, so I don't find that definition as particularly striving for objectivity in evaluation.
And openly ruffle feathers would mean what? Having a respectful difference of opinion or concern?

So if a student "ruffles" someone feathers in 'some way,' and perhaps he or she is not aware of it (and it's problematic to prejudge this, b/c people mistake intentions of others all the time), does that mean, you are half-way to doom? One form written out against you! If it happens again, it follows you to residency program applications?

The person in WS's example demonstrated behavior that was just plain inconsiderate. The facts of that were presented, so that is based on objective information--unless somehow, someone else somewhere along the line is passing the buck or missed something. Seems doubtful; but I am just saying. . .

I am concerned about the potential for abuse in this professionalism grading system to which the presenter is speaking. I think I just would like to see how this will be objectively measured and processed. I can see someone with a grudge claiming disrespect to a patient, by their interpretation of tone, just b/c they firmly, but respectfully asked them to discuss things calmly. You can use a lot of therapeutic communications skills and still some patients are going to be on the wild side. Seriously. I say this, and my patients and families tend to love me and ask for me. I have seen things like this happen and get taken out of truthful context. There are plenty of potential situations where someone can try to construe something inaccurately.


I like to see the scales balanced as much as possible in life. Surely it doesn't happen as much as we'd like. But if people of science can't strive for objective systems of measurement, who can?

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[PL198]

I like her presentation thus far. I have to complete the rest of it after some work. Thing is, and maybe I haven't as yet gotten to a sound covering of this in her presentation, but what devices (i.e., objective, that is, as is possible) are they employing? What will prevent a student from getting gorged by such a system if highly subjective indicators are involved in the evaluation process? I have witnessed a fair amount of unfair evaluations in healthcare in general. I have gone the extra mile not to be party to such things, but I have seen them openly occur. Yes, it may be something I have seen more in nursing. Generally, medicine has seemed more supportive with their own--but I am on the outside looking into that where I am now. And yes, there are exceptions to that, where I have been more on the inside--d/t follow-ups and inquiries. Dr. P. gives examples and ratings and ratios. But how can it be controlled in such a way that personality issues from those with more leverage don't unduly hurt those under them? People are complex, and sometimes, for whatever reason, they can decide to resent or dislike another person. That dislike can become a subjective slur against someone and their career. From what I have witnessed in nursing at least, often one problem is the lack of regularity and structure of meetings between the preceptor and preceptee . I try to go out of my way to keep this running on a timely and less subjective basis when I precept, or if I am in charge. Not all preceptors/managers do this. I also favor the use of sound prognostic indicators w/ specific definitions to the scoring. Point is, this is not done universally in healthcare, and it's a real problem.
So too, in the medical student's clinical years, I have heard students express concerns regarding the blatantly subjective evaluation processes that will continue with them after those rotations are done. This is indeed troubling; since in the evaluation process, there are two or sometimes more than two sides; ergo, professionalism is something that has to go all the way around. It can't be some one-sided expectation.

I think it's nice to try to evaluate professionalism, and clearly the examples given here should seem obvious as to why they are unprofessional. At the same time, a school or program could set this up, and what's to stop subjectivity from hurting the medical student or resident's future? Dr. P. states "2" is a pattern with regard to the professionalism form. Again, I am not clear on how they will keep this as objective as possible.

You see a bit of my concern with PL's reply, "However during pre-clinical years, professionalism basically means you don't do anything the administration doesn't want you to do. IE you don't openly ruffle feathers. Thats a 1 way ticket to punishment, regardless of how good of a student you are."
Yes. OK, so I don't find that definition as particularly striving for objectivity in evaluation.
And openly ruffle feathers would mean what? Having a respectful difference of opinion or concern?

So if a student "ruffles" someone feathers in 'some way,' and perhaps he or she is not aware of it (and it's problematic to prejudge this, b/c people mistake intentions of others all the time), does that mean, you are half-way to doom? One form written out against you! If it happens again, it follows you to residency program applications?

The person in WS's example demonstrated behavior that was just plain inconsiderate. The facts of that were presented, so that is based on objective information--unless somehow, someone else somewhere along the line is passing the buck or missed something. Seems doubtful; but I am just saying. . .

I am concerned about the potential for abuse in this professionalism grading system to which the presenter is speaking. I think I just would like to see how this will be objectively measured and processed. I can see someone with a grudge claiming disrespect to a patient, by their interpretation of tone, just b/c they firmly, but respectfully asked them to discuss things calmly. You can use a lot of therapeutic communications skills and still some patients are going to be on the wild side. Seriously. I say this, and my patients and families tend to love me and ask for me. I have seen things like this happen and get taken out of truthful context. There are plenty of potential situations where someone can try to construe something inaccurately.


I like to see the scales balanced as much as possible in life. Surely it doesn't happen as much as we'd like. But if people of science can't strive for objective systems of measurement, who can?

Yeah. You don't really get to openly disagree with them. It's not fair but it's not exactly difficult to avoid inciting punishment either. Honestly it's like police officers on the highway IMO- they're really only get to get the idiots not paying attention who don't see them and slow down. Same thing, the only way you get into trouble with administrators is if you care more about expressing your opinion than graduating med school.

 

[Ismet]

I like her presentation thus far. I have to complete the rest of it after some work. Thing is, and maybe I haven't as yet gotten to a sound covering of this in her presentation, but what devices (i.e., objective, that is, as is possible) are they employing? What will prevent a student from getting gorged by such a system if highly subjective indicators are involved in the evaluation process? I have witnessed a fair amount of unfair evaluations in healthcare in general. I have gone the extra mile not to be party to such things, but I have seen them openly occur. Yes, it may be something I have seen more in nursing. Generally, medicine has seemed more supportive with their own--but I am on the outside looking into that where I am now. And yes, there are exceptions to that, where I have been more on the inside--d/t follow-ups and inquiries. Dr. P. gives examples and ratings and ratios. But how can it be controlled in such a way that personality issues from those with more leverage don't unduly hurt those under them? People are complex, and sometimes, for whatever reason, they can decide to resent or dislike another person. That dislike can become a subjective slur against someone and their career. From what I have witnessed in nursing at least, often one problem is the lack of regularity and structure of meetings between the preceptor and preceptee . I try to go out of my way to keep this running on a timely and less subjective basis when I precept, or if I am in charge. Not all preceptors/managers do this. I also favor the use of sound prognostic indicators w/ specific definitions to the scoring. Point is, this is not done universally in healthcare, and it's a real problem.
So too, in the medical student's clinical years, I have heard students express concerns regarding the blatantly subjective evaluation processes that will continue with them after those rotations are done. This is indeed troubling; since in the evaluation process, there are two or sometimes more than two sides; ergo, professionalism is something that has to go all the way around. It can't be some one-sided expectation.

I think it's nice to try to evaluate professionalism, and clearly the examples given here should seem obvious as to why they are unprofessional. At the same time, a school or program could set this up, and what's to stop subjectivity from hurting the medical student or resident's future? Dr. P. states "2" is a pattern with regard to the professionalism form. Again, I am not clear on how they will keep this as objective as possible.

You see a bit of my concern with PL's reply, "However during pre-clinical years, professionalism basically means you don't do anything the administration doesn't want you to do. IE you don't openly ruffle feathers. Thats a 1 way ticket to punishment, regardless of how good of a student you are."
Yes. OK, so I don't find that definition as particularly striving for objectivity in evaluation.
And openly ruffle feathers would mean what? Having a respectful difference of opinion or concern?

So if a student "ruffles" someone feathers in 'some way,' and perhaps he or she is not aware of it (and it's problematic to prejudge this, b/c people mistake intentions of others all the time), does that mean, you are half-way to doom? One form written out against you! If it happens again, it follows you to residency program applications?

The person in WS's example demonstrated behavior that was just plain inconsiderate. The facts of that were presented, so that is based on objective information--unless somehow, someone else somewhere along the line is passing the buck or missed something. Seems doubtful; but I am just saying. . .

I am concerned about the potential for abuse in this professionalism grading system to which the presenter is speaking. I think I just would like to see how this will be objectively measured and processed. I can see someone with a grudge claiming disrespect to a patient, by their interpretation of tone, just b/c they firmly, but respectfully asked them to discuss things calmly. You can use a lot of therapeutic communications skills and still some patients are going to be on the wild side. Seriously. I say this, and my patients and families tend to love me and ask for me. I have seen things like this happen and get taken out of truthful context. There are plenty of potential situations where someone can try to construe something inaccurately.


I like to see the scales balanced as much as possible in life. Surely it doesn't happen as much as we'd like. But if people of science can't strive for objective systems of measurement, who can?

Nothing in evaluations is completely objective...that's the point (and the downfall). We are provided rubrics but those only go so far, there is still a subjective interpretation of what happened. It's the same for professionalism, clinical knowledge, differential diagnosis skills...you might get a great eval from one person one day and an average eval from another person the next day, all depending on the evaluator's expectations and observations. One person thinks you made a heinous error in saying a certain thing to a patient, another person might brush it off or give you verbal feedback on the matter. Yeah maybe thinks should be more consistent, but that's pretty impossible to expect when there are a multitude of scenarios where one can interpret someone as being unprofessional.

 

[DermViser]

I like her presentation thus far. I have to complete the rest of it after some work. Thing is, and maybe I haven't as yet gotten to a sound covering of this in her presentation, but what devices (i.e., objective, that is, as is possible) are they employing? What will prevent a student from getting gorged by such a system if highly subjective indicators are involved in the evaluation process? I have witnessed a fair amount of unfair evaluations in healthcare in general. I have gone the extra mile not to be party to such things, but I have seen them openly occur. Yes, it may be something I have seen more in nursing. Generally, medicine has seemed more supportive with their own--but I am on the outside looking into that where I am now. And yes, there are exceptions to that, where I have been more on the inside--d/t follow-ups and inquiries. Dr. P. gives examples and ratings and ratios. But how can it be controlled in such a way that personality issues from those with more leverage don't unduly hurt those under them? People are complex, and sometimes, for whatever reason, they can decide to resent or dislike another person. That dislike can become a subjective slur against someone and their career. From what I have witnessed in nursing at least, often one problem is the lack of regularity and structure of meetings between the preceptor and preceptee . I try to go out of my way to keep this running on a timely and less subjective basis when I precept, or if I am in charge. Not all preceptors/managers do this. I also favor the use of sound prognostic indicators w/ specific definitions to the scoring. Point is, this is not done universally in healthcare, and it's a real problem.
So too, in the medical student's clinical years, I have heard students express concerns regarding the blatantly subjective evaluation processes that will continue with them after those rotations are done. This is indeed troubling; since in the evaluation process, there are two or sometimes more than two sides; ergo, professionalism is something that has to go all the way around. It can't be some one-sided expectation.

I think it's nice to try to evaluate professionalism, and clearly the examples given here should seem obvious as to why they are unprofessional. At the same time, a school or program could set this up, and what's to stop subjectivity from hurting the medical student or resident's future? Dr. P. states "2" is a pattern with regard to the professionalism form. Again, I am not clear on how they will keep this as objective as possible.

You see a bit of my concern with PL's reply, "However during pre-clinical years, professionalism basically means you don't do anything the administration doesn't want you to do. IE you don't openly ruffle feathers. Thats a 1 way ticket to punishment, regardless of how good of a student you are."
Yes. OK, so I don't find that definition as particularly striving for objectivity in evaluation.
And openly ruffle feathers would mean what? Having a respectful difference of opinion or concern?

So if a student "ruffles" someone feathers in 'some way,' and perhaps he or she is not aware of it (and it's problematic to prejudge this, b/c people mistake intentions of others all the time), does that mean, you are half-way to doom? One form written out against you! If it happens again, it follows you to residency program applications?

The person in WS's example demonstrated behavior that was just plain inconsiderate. The facts of that were presented, so that is based on objective information--unless somehow, someone else somewhere along the line is passing the buck or missed something. Seems doubtful; but I am just saying. . .

I am concerned about the potential for abuse in this professionalism grading system to which the presenter is speaking. I think I just would like to see how this will be objectively measured and processed. I can see someone with a grudge claiming disrespect to a patient, by their interpretation of tone, just b/c they firmly, but respectfully asked them to discuss things calmly. You can use a lot of therapeutic communications skills and still some patients are going to be on the wild side. Seriously. I say this, and my patients and families tend to love me and ask for me. I have seen things like this happen and get taken out of truthful context. There are plenty of potential situations where someone can try to construe something inaccurately.

I like to see the scales balanced as much as possible in life. Surely it doesn't happen as much as we'd like. But if people of science can't strive for objective systems of measurement, who can?

I think the video is actually worth watching in full, as she does mention what behaviors are considered to be unprofessional or not as well as how the evaluations at UCSF measure professionalism on an objective scale. Not that I agree with, but at least you have a better idea of what they mean by it. So a student is evaluated on different professionalism competencies: altruism, integrity, honesty, etc. If there is a major professionalism lapse, usually then the intern/resident/attending can fill out a professionalism concern form: http://meded.ucsf.edu/sites/meded.u...edical-education/physicianshipeval-med3-4.pdf

On the actual clerkship evaluation there are certain professionalism competencies that a student has to meet where it's usually a yes or no that you met the competency. If you fail professionalism overall, then you fail the rotation and likely either have to repeat the rotation or undergo some type of remediation. You are correct, there is a possibility that it can be abused, in which a student is labeled as unprofessional by an intern/resident bc they are not liked. That being said, it's not as likely bc a big process is put into place that starts and the last thing a resident wants to be involved in is that, when they have to actually work - so lying about a student that way is protected against somewhat, as that person will likely be called in to explain what happened as that student will likely appeal.

As far as evaluations, you have to realize that they are all subjective and not objective like multiple choice exams (regardless whether professionalism is there or not). It's in MS-3/MS-4 and thru out residency each month. It's what everyone who hasn't gone to medical school has had to deal with since they entered the workforce directly after college or a masters. As far as people of science striving for objective systems of measurement, realize that medicine is as much an art as it is a science. You can't just have medical knowledge and be a doctor, you have to have other traits.

 

[redpanda]

Specific professionalism issues seen in my program:
1. Texting with the sounds on constantly in the middle of inpatient psych rounds
2. Telling off a faculty member in front of the entire class
3. Posting things to the class fb page bemoaning the burden of having an unrelated very chill class the morning prior to an exam. "Let's boycott!"
4. Asking for time off in core clinical rotations for things which are clearly unreasonable (birthday parties, sibling's play, residency interview - already informed of the policy of no-time-for-interviews long prior)

 

[DermViser]

Definitely not the case.

I've actually found that med students are quite fond of tossing the "unprofessional" grenade. Pretty much anytime our GME committee has to discuss negative evals, etc, its because of this.

I meant as far as actual consequences for the intern/resident/attending getting fired. Of course students will lob the unprofessionalism charge bc their feelings got hurt.

 

[NontradCA]

You hit on the exact reason why MS-1s/MS-2s aren't allowed on the wards just yet. They are utterly useless in terms of knowledge base and they haven't even finished their physical diagnosis course. A social worker who plns for disposition is more useful than they are.

Who gives a ****. I don't feel bad for the hospital one bit, considering when I'm an attending they'll skim all the money. I don't consider it a privilege to pay 40 grand into a system that treats you like dirt. In fact, I am not even paying a dime and still do not feel "lucky".

 

[DermViser]

Who gives a ****. I don't feel bad for the hospital one bit, considering when I'm an attending they'll skim all the money. I don't consider it a privilege to pay 40 grand into a system that treats you like dirt. In fact, I am not even paying a dime and still do not feel "lucky".

What are you talking about and what does that have to do with my post you responded to?

 

[Wordead]

Specific professionalism issues seen in my program:
1. Texting with the sounds on constantly in the middle of inpatient psych rounds
2. Telling off a faculty member in front of the entire class
3. Posting things to the class fb page bemoaning the burden of having an unrelated very chill class the morning prior to an exam. "Let's boycott!"
4. Asking for time off in core clinical rotations for things which are clearly unreasonable (birthday parties, sibling's play, residency interview - already informed of the policy of no-time-for-interviews long prior)

For #4, what are you supposed to do if you have interviews? Or is this for people who are delayed, because you shouldnt be interviewing during your core rotations.

 

[Ismet]

For #4, what are you supposed to do if you have interviews? Or is this for people who are delayed, because you shouldnt be interviewing during your core rotations.

At our school we have until the October block of 4th year to finish our core rotations. I don't know much about timing of interviews yet, but can there be interviews in mid-late oct?

 

[maxxor]

At our school we have until the October block of 4th year to finish our core rotations. I don't know much about timing of interviews yet, but can there be interviews in mid-late oct?

When I was interviewing, my first interview was 10/25.

 

[redpanda]

For #4, what are you supposed to do if you have interviews? Or is this for people who are delayed, because you shouldnt be interviewing during your core rotations.

The people who have a core rotation as late as November-December have managed to put off taking said core rotation in lieu of electives, aways, etc. Yes, there are mid-October interviews, but if you know that your field tends to do a lot of interviews then, it behooves you to make a schedule which will clearly permit time away for interviews.

 

[Wordead]

The people who have a core rotation as late as November-December have managed to put off taking said core rotation in lieu of electives, aways, etc. Yes, there are mid-October interviews, but if you know that your field tends to do a lot of interviews then, it behooves you to make a schedule which will clearly permit time away for interviews.

I didn't even know you could do aways without finishing cores. All of mine had the requirement that you finish them first.

Finishing cores in October seems really late, but I guess thats the variance in school schedules.

 

[redpanda]

I didn't even know you could do aways without finishing cores. All of mine had the requirement that you finish them first.

Finishing cores in October seems really late, but I guess thats the variance in school schedules.

It is late given that MS3 starts at the beginning of May for us.

 

[Wordead]

It is late given that MS3 starts at the beginning of May for us.

M3 didnt start until july for us.....how long are your rotations? Odd.

 

[Ismet]

M3 didnt start until july for us.....how long are your rotations? Odd.

We have a couple core rotations that many other schools don't have. I'm on a core right now that is ophtho, ENT, peds ED, and adult ED. We also have a 2 month rotation for ambulatory adult and pediatric medicine. Plus many (all??) people take at least one research month during MS3, and people take electives due to scheduling issues or general interest. At this point I have to push obgyn to early next fall.

 

[Wordead]

We have a couple core rotations that many other schools don't have. I'm on a core right now that is ophtho, ENT, peds ED, and adult ED. We also have a 2 month rotation for ambulatory adult and pediatric medicine. Plus many (all??) people take at least one research month during MS3, and people take electives due to scheduling issues or general interest. At this point I have to push obgyn to early next fall.

That sounds pretty awesome in that it allows you to explore potential interests outside of standard core rotations. But interfering with your students' interviews sucks.

 

[Ismet]

That sounds pretty awesome in that it allows you to explore potential interests outside of standard core rotations. But interfering with your students' interviews sucks.

Yeah I'm loving the ED and I know a few classmates who are now looking at ophtho and ENT based on this rotation. But since it's an unconventional core, many people end up pushing it to 4th year.

 

[DermViser]

We have a couple core rotations that many other schools don't have. I'm on a core right now that is ophtho, ENT, peds ED, and adult ED. We also have a 2 month rotation for ambulatory adult and pediatric medicine. Plus many (all??) people take at least one research month during MS3, and people take electives due to scheduling issues or general interest. At this point I have to push obgyn to early next fall.

Good decision.

 

[redpanda]

That sounds pretty awesome in that it allows you to explore potential interests outside of standard core rotations. But interfering with your students' interviews sucks.

Well, you know, quite frankly, when it's been spelled out for you that you can't be absent during core rotations for interviews, it's your own darn problem when you've had at least 16 months (May 20XX-Sept 20XX+1) to get them all done (12 months to finish) and you're not done yet.

 

[group_theory]

Examples of unprofessionalism:

When you are presenting a patient on rounds in front of the entire team, try not to answer the phone while presenting unless it is an absolute emergency (and not just a call from your gf wanting to say hi), and if you do answer, try to tell her you're busy or in the middle of something, and not continue the conversation as if we're not there. The rest of the team (including the attending, who also happens to be the clerkship director), will go "WTF!?!?!" When the team decides to skip your patient and continue rounding, don't shout out loud "hey, we're not done with my patient yet". People tend to frown on that behavior (including the associate dean of student affairs who wanted a word with the student).

If the attending makes time in the afternoon to sit down with the medical students on service to go over topics and teach, try not to skip it. If the attending ask you why you skipped the lecture, saying "oh, I already know this subject so I figure I didn't have to go" will not go over well.

If your team is extremely busy with multiple admissions, discharges, and sick patients needing attention (one of which is actually your patient), spending the afternoon in the call room playing games on your iPhone is not a good idea since you are theoretically part of the "team". The excuse "well, no one came to get me" usually doesn't hold well.

 

[jl lin]

I appreciate what everyone has added here. Thing is, just b/c striving for objectivity is difficult, doesn't mean it's completely impossible. Limiting the darker side of human reactivity and responses in a system of evaluation is a great start. It means stepping outside of one's own personal biases and looking for the facts--not merely someone's interpretation of the facts. If someone truly has a pattern of unprofessional behavior, in time, it will become evident. Someone's career shouldn't be unduly injured or trashed b/c of other people's issues or personal biases--even if those people aren't aware that their biases or personal insecurity issues exist.

It's about stepping back and outside of yourself. It's kind of like how everyone wants to believe they aren't in any way racists or biased re: people, whose lives are different from them, or whose lifestyles are such that they can't relate to or understand them. Truly fair-minded, professional people will periodically evaluate the fact that they have been influenced by certain biases. We all need to be honest with ourselves, b/c we can't positively influence, direct, or be helpful to others if we don't do the personal due diligence of evaluating that we may not be quite as open-minded as we think we are.

Ultimately, my point is about tightening up the systems of evaluation in such a way that personal biases or personal quirks, irritations, or insecurities are limited in the evaluation process. The more subjective the system of evaluation, the less reliable and helpful--in fact, I'd say, the more hurtful those systems are to others and the organizations that employ them.

It shouldn't matter if I feel like you would be the kind of person I'd sit down and have a glass of wine with or not. I shouldn't be a matter of me not understanding your particular personality, which is different from mine. It shouldn't be about how you were treated like dirt during your training, so, hey, it's part of the process, so suck it up. When these kinds of things somehow are part of an evaluation process, they are toxic, destructive, unproductive, and ultimately, they can lead to litigation issues. So bypass that kind of thing by structuring evaluations systems that are as objective as possible--meaning--dealing with the facts and steering clear of individual or collective perceptions of facts, which can be tainted and turned in a way that is not relevant to the truth or the facts of the individual cases.

You see, it may be just as much or even more so about proper training of those in a position to teach, influence, and instruct--whether they are more senior med students, residents, attending physicians, or administrators--as it is about marking out professionalism as a requirement of graduation or advancement into residency or even a particular practice. It's a two-way street, not a one-way street. Even good leaders in military programs know this. Any excellent teacher/professor knows this.

 

[PL198]

I don't get the texting with the ringer on thing. As always, when I mention these things, they aren't single occurrences b/c I understand everyone makes mistakes. There are multiple people in my class that have had their phone go off 5+ times in lecture. I seriously don't know if there's hearing loss at play or they're just so stupid they can't recognize that your phone going off during a lecture isn't a normal behavior.

 

[DermViser]

My school was actually very nervous about the idea of putting these on youtube. This was back in 2006 or so though. I think they've gotten over it.

Esp. when it can attract applicants to show what a "fun" time the students are having.

 

[DermViser]

Examples of unprofessionalism:

When you are presenting a patient on rounds in front of the entire team, try not to answer the phone while presenting unless it is an absolute emergency (and not just a call from your gf wanting to say hi), and if you do answer, try to tell her you're busy or in the middle of something, and not continue the conversation as if we're not there. The rest of the team (including the attending, who also happens to be the clerkship director), will go "WTF!?!?!" When the team decides to skip your patient and continue rounding, don't shout out loud "hey, we're not done with my patient yet". People tend to frown on that behavior (including the associate dean of student affairs who wanted a word with the student).

If the attending makes time in the afternoon to sit down with the medical students on service to go over topics and teach, try not to skip it. If the attending ask you why you skipped the lecture, saying "oh, I already know this subject so I figure I didn't have to go" will not go over well.

If your team is extremely busy with multiple admissions, discharges, and sick patients needing attention (one of which is actually your patient), spending the afternoon in the call room playing games on your iPhone is not a good idea since you are theoretically part of the "team". The excuse "well, no one came to get me" usually doesn't hold well.

Amazing the **** students will pull and have absolutely no qualms about it.

 

[Psai]

every time i think i'm doing poorly, i think of all these anecdotes and feel a little better about myself

 

[W19]

Professionalism in med school is a way of 'them' telling you 'we own you for the next 4 years'...

 

[maxxor]

This thread makes me laugh. I remember applying to medical school, and Duke's secondary had a question that went something like "Describe what Professionalism means to you".

I'd love to see some of these anecdotes turned in to 500 word essay responses.

 

[DermViser]

This thread makes me laugh. I remember applying to medical school, and Duke's secondary had a question that went something like "Describe what Professionalism means to you". I'd love to see some of these anecdotes turned in to 500 word essay responses.

If many medical students don't even know what professionalism means, then I have no hope for premeds knowing what it means.

 

[DermViser]

Professionalism in med school is a way of 'them' telling you 'we own you for the next 4 years'...

You and EMDO2018 are so much alike.

 

[Ismet]

Professionalism in med school is a way of 'them' telling you 'we own you for the next 4 years'...

Uhh...no?

Most of the professionalism concerns that have been listed in this thread by other med students and physicians are not silly expectations. They're expectations of being a professional adult who will be taking care of patients on their own in a relatively short amount of time.

Professionalism doesn't stop with med school either.

 

[DermViser]

Uhh...no?

Most of the professionalism concerns that have been listed in this thread by other med students and physicians are not silly expectations. They're expectations of being a professional adult who will be taking care of patients on their own in a relatively short amount of time.

Professionalism doesn't stop with med school either.

Thank you. The "professionalism" competency extends thru residency and even as an attending (thru your state medical board - which can revoke your license). I believe he may be referring to the abuse of the "unprofessionalism" label.

 

[W19]

You and EMDO2018 are so much alike.

Really! I couldn't care less about stuff such as race, social class etc... that EMDO2018 usually talks about here... Maybe I am like him in another aspect...

 

[W19]

Thank you. The "professionalism" competency extends thru residency and even as an attending (thru your state medical board - which can revoke your license). I believe he may be referring to the abuse of the "unprofessionalism" label.

That was what I was referring to... It seem like they use that word to make it easy for them to throw the book at you even for minor infraction(s).

 

[DermViser]

Really! I could careless about stuff such as race, social class etc... that EMDO2018 usually talks about here... Maybe I am like him in another aspect...

I was talking about in another aspects.

That was what I was referring to... It seem like they use that word to make it easy for them to throw the book at you even for minor infraction(s).

Depends on the medical school. It's supposed to be set of behaviors consistent with the expectations for being an adult and a future physician, but like everything else in medical education it morphs into something way beyond what it was originally intended.

 

[Kaustikos]

Specific professionalism issues seen in my program:
1. Texting with the sounds on constantly in the middle of inpatient psych rounds
2. Telling off a faculty member in front of the entire class
3. Posting things to the class fb page bemoaning the burden of having an unrelated very chill class the morning prior to an exam. "Let's boycott!"
4. Asking for time off in core clinical rotations for things which are clearly unreasonable (birthday parties, sibling's play, residency interview - already informed of the policy of no-time-for-interviews long prior)

1 isn't unprofessional - it's just annoying and stupid. You should be banned from leaving your house if you do that.
2 n 3 - agreed
4 - No, I disagree. There will come a time in October/November/December where interviews will happen and you have to do a core rotation at this time. Having no-time-for-interviews during "core" rotations is something I just find ridiculous because even staff members seem to understand the ridiculous nature of it all. "No, you can't go to an interview because it's a "core" rotation". As opposed to "electives"? Give me a break. My school has that policy (which is why I put off those core rotations for spring) but you're telling me I can't miss a day of radiology because it's a "core" rotation? Come on

Come on....

Who gives a ****. I don't feel bad for the hospital one bit, considering when I'm an attending they'll skim all the money. I don't consider it a privilege to pay 40 grand into a system that treats you like dirt. In fact, I am not even paying a dime and still do not feel "lucky".

I wouldn't want to be in the hospital as a 1st/2nd year all the time. I mean, the times I was there helped me "learn" things, but it was all a joke and waste of time for everyone involved.

Examples of unprofessionalism:

When you are presenting a patient on rounds in front of the entire team, try not to answer the phone while presenting unless it is an absolute emergency (and not just a call from your gf wanting to say hi), and if you do answer, try to tell her you're busy or in the middle of something, and not continue the conversation as if we're not there. The rest of the team (including the attending, who also happens to be the clerkship director), will go "WTF!?!?!" When the team decides to skip your patient and continue rounding, don't shout out loud "hey, we're not done with my patient yet". People tend to frown on that behavior (including the associate dean of student affairs who wanted a word with the student).

If the attending makes time in the afternoon to sit down with the medical students on service to go over topics and teach, try not to skip it. If the attending ask you why you skipped the lecture, saying "oh, I already know this subject so I figure I didn't have to go" will not go over well.

If your team is extremely busy with multiple admissions, discharges, and sick patients needing attention (one of which is actually your patient), spending the afternoon in the call room playing games on your iPhone is not a good idea since you are theoretically part of the "team". The excuse "well, no one came to get me" usually doesn't hold well.

First one is hilarious. It's rude/unprofessional, but hilarious that people can be THAT oblivious.

Three - I think it can be hit/miss. There can be times where you're not there because no one informed you/told you about what's happening and you're just there. It happens. As medical students; we're an afterthought during those situations. The only way we "survive" is by communication between ourselves. Having group texts/texting each other about things is a MUST. Which is why I've rarely given my pager number to staff but instead used texting. Nowadays most staff prefer texting since it's usually simple things like "We're rounding at 7am instead of 6:30" or "We're gonna start rounding in 30 minutes". I actually appreciate that more than always having to follow the residents every damn second when I actually have things to do myself.



Also - be proud that I didn't share anything this time

 

[Awared]

Not answering course surveys is considered unprofessional

 

[jw3600]

Uhh...no?

Most of the professionalism concerns that have been listed in this thread by other med students and physicians are not silly expectations. They're expectations of being a professional adult who will be taking care of patients on their own in a relatively short amount of time.

Professionalism doesn't stop with med school either.

There is some degree of truth to this in the first 2 years. Mainly because students are not in a true professional environment (if they had significant time in one, I'm sure there would be plenty of examples). There is definitely some of the authoritative whip cracking to people who voice their opinion (even if valid) as DV has alluded to, that is defended with the "professionalism" card. I think it becomes a much more clear concept in clinical years, residency, and actual practice settings.

 

[jw3600]

Examples of unprofessionalism:

When you are presenting a patient on rounds in front of the entire team, try not to answer the phone while presenting unless it is an absolute emergency (and not just a call from your gf wanting to say hi), and if you do answer, try to tell her you're busy or in the middle of something, and not continue the conversation as if we're not there. The rest of the team (including the attending, who also happens to be the clerkship director), will go "WTF!?!?!" When the team decides to skip your patient and continue rounding, don't shout out loud "hey, we're not done with my patient yet". People tend to frown on that behavior (including the associate dean of student affairs who wanted a word with the student).

If the attending makes time in the afternoon to sit down with the medical students on service to go over topics and teach, try not to skip it. If the attending ask you why you skipped the lecture, saying "oh, I already know this subject so I figure I didn't have to go" will not go over well.

If your team is extremely busy with multiple admissions, discharges, and sick patients needing attention (one of which is actually your patient), spending the afternoon in the call room playing games on your iPhone is not a good idea since you are theoretically part of the "team". The excuse "well, no one came to get me" usually doesn't hold well.

Great examples. Thanks for posting.

 

[DermViser]

Not answering course surveys is considered unprofessional

You mean course evaluations. Believe it or not, it is bc apparently filling out course evaluations was one of the biggest indicators during med school whether that person would be professional (or not) in medical school by faculty:

@ 31:09

 

[PL198]

You mean course evaluations. Believe it or not, it is bc apparently filling out course evaluations was the biggest indicator during med school whether that person would be professional/unprofessional in medical school:

@ 31:09

lol insta-check "Agree with this statement" = I'm professional. cash

 

[redpanda]

4 - No, I disagree. There will come a time in October/November/December where interviews will happen and you have to do a core rotation at this time. Having no-time-for-interviews during "core" rotations is something I just find ridiculous because even staff members seem to understand the ridiculous nature of it all. "No, you can't go to an interview because it's a "core" rotation". As opposed to "electives"? Give me a break. My school has that policy (which is why I put off those core rotations for spring) but you're telling me I can't miss a day of radiology because it's a "core" rotation? Come on

Come on....

Maybe in your program, there are reasons why one would be doing a core rotation that late and don't involve de-prioritizing it to the bottom of the list and maybe the policy of "no time off for interviews in core rotations" is poor, but the point is that there comes a time when asking for special dispensation which is clearly in contrast to the official policy just because an individual's priorities don't line up with the school's is a problem. Again, 12 months of core rotations and at least 16 months to make it happen without the possibility of an interview interfering with scheduling. It's plenty of leeway comply with policy.

 

[DermViser]

lol insta-check "Agree with this statement" = I'm professional. cash

I should have added that the example he uses was when evaluations weren't mandatory to fill out. You could either do them or not - it was your choice. So the ones who VOLUNTARILY filled out a course evaluation anyways, apparently were less likely to be violators of professionalism by faculty.

 

[DermViser]

Maybe in your program, there are reasons why one would be doing a core rotation that late and don't involve de-prioritizing it to the bottom of the list and maybe the policy of "no time off for interviews in core rotations" is poor, but the point is that there comes a time when asking for special dispensation which is clearly in contrast to the official policy just because an individual's priorities don't line up with the school's is a problem. Again, 12 months of core rotations and at least 16 months to make it happen without the possibility of an interview interfering with scheduling. It's plenty of leeway comply with policy.

It can possibly be the case if you have to put off a 2 month rotation from third year and move it to 4th year, and you still have to do electives before that for the specialty you actually want to do. Not all med schools have this hard and fast rule of no interview days off at all no matter what.

 

[jw3600]

lol insta-check "Agree with this statement" = I'm professional. cash

Haha. Let's just say my course evaluations were ONE HUNDRED PERCENT indicative of how I really felt about each course and professor. *end sarcasm*

That guy in the video looks like the CEO of Dundler Mifflin.

 

[DermViser]

Haha. Let's just say my course evaluations were ONE HUNDRED PERCENT indicative of how I really felt about each course and professor. *end sarcasm*

That guy in the video looks like the CEO of Dundler Mifflin.

Apparently he's hired at Mt. Sinai as the Professor of Medicine and Vice-Chair of Professionalism: http://icahn.mssm.edu/static_files/MSSM/Files/Departments/Medicine/2009 AR.pdf, and has even written a book: http://books.google.com/books/about/Measuring_Medical_Professionalism.html?id=GUA23tGPDaYC

You can bet he makes a ****-load of money for his current position.

 

[DermViser]

Haha. Let's just say my course evaluations were ONE HUNDRED PERCENT indicative of how I really felt about each course and professor. *end sarcasm*

I tended to not be as nice in my course evaluations (putting it very mildly). They were anonymized (only check was to see that you filled one out and submitted online), so we were all free to say whatever we wanted.

 

[Kaustikos]

Maybe in your program, there are reasons why one would be doing a core rotation that late and don't involve de-prioritizing it to the bottom of the list and maybe the policy of "no time off for interviews in core rotations" is poor, but the point is that there comes a time when asking for special dispensation which is clearly in contrast to the official policy just because an individual's priorities don't line up with the school's is a problem. Again, 12 months of core rotations and at least 16 months to make it happen without the possibility of an interview interfering with scheduling. It's plenty of leeway comply with policy.

And I still disagree. Given the limited time given to us to do interviews and the fact that we're at the mercy of going to any interview invites we get, it seems rather neglectful and ignorant to make these rules at this point in time. If the person scheduled things themselves and put that core during interview season and was like "oops" then I can see where you can argue otherwise, but I know that we don't always get the schedule we want and sometimes **** happens. Sometimes you're ultimately stuck doing a core rotation during interview season. I've yet to see these people doing core rotations during that time and the staff they round with having an issue... but god forbid the admins catch it and it's doomsday with the 'unprofessional' demeanor and "You don't choose your schedule as a doctor how can you expect it to be okay now" as if we schedule interviews on a daily basis for our careers without any concern to our priorities.
I'm not saying it's okay to do 15 interviews/month.. I'm saying it's not unprofessional to take a day off to do so. In the end; I'd take a hit on professionalism to go on an interview. In the end; I'd fork the cash over and go to a "doctor" and get a "note" saying I was sick so I could do so. Is that unprofessional? Maybe. But I won't for a second let school try to restrict me from doing the right thing when we ultimately aren't physicians yet. We're trying to become one. And to corner us with these threats about "missing a day" for interviews just plays into the admins power trips and lack of understanding/empathy on the part of students. ESPECIALLY now when residency spots aren't exactly being handed out so freely.
So, if you say it's conduct that can be punished because they "broke the rules", fine. That's fine. But it's not unprofessional. And people do it all the time... even in our careers. Breaking the rule doesn't automatically make you a bad person. When you find out a loved one is going to the ER/Surgery and might not make it; tell me how wrong you are to get in your car and get there asap "breaking the speed limit" to get there? Yes, I broke the rule. Now call me unprofessional.

 

[PL198]

And I still disagree. Given the limited time given to us to do interviews and the fact that we're at the mercy of going to any interview invites we get, it seems rather neglectful and ignorant to make these rules at this point in time. If the person scheduled things themselves and put that core during interview season and was like "oops" then I can see where you can argue otherwise, but I know that we don't always get the schedule we want and sometimes **** happens. Sometimes you're ultimately stuck doing a core rotation during interview season. I've yet to see these people doing core rotations during that time and the staff they round with having an issue... but god forbid the admins catch it and it's doomsday with the 'unprofessional' demeanor and "You don't choose your schedule as a doctor how can you expect it to be okay now" as if we schedule interviews on a daily basis for our careers without any concern to our priorities.
I'm not saying it's okay to do 15 interviews/month.. I'm saying it's not unprofessional to take a day off to do so. In the end; I'd take a hit on professionalism to go on an interview. In the end; I'd fork the cash over and go to a "doctor" and get a "note" saying I was sick so I could do so. Is that unprofessional? Maybe. But I won't for a second let school try to restrict me from doing the right thing when we ultimately aren't physicians yet. We're trying to become one. And to corner us with these threats about "missing a day" for interviews just plays into the admins power trips and lack of understanding/empathy on the part of students. ESPECIALLY now when residency spots aren't exactly being handed out so freely.
So, if you say it's conduct that can be punished because they "broke the rules", fine. That's fine. But it's not unprofessional. And people do it all the time... even in our careers. Breaking the rule doesn't automatically make you a bad person. When you find out a loved one is going to the ER/Surgery and might not make it; tell me how wrong you are to get in your car and get there asap "breaking the speed limit" to get there? Yes, I broke the rule. Now call me unprofessional.

get that note from your gf/fiance/wife, would be poetically funny

 

[maxxor]

get that note from your gf/fiance/wife, would be poetically funny

Kaustikos was under my care from xx/xx/xxxx to xx/xx/xxxx and may return to work on yy/yy/yyyy.

Signed,
FancyMyLotus