Practical Professionalism in Medicine

Doctors in training are exposed to pressures and distractions to which they do not always respond appropriately, and individuals and institutions can struggle to deal effectively with difficulties when they arise. This book exposes the myths surrounding medical professionalism and strips it of pretensions or exclusivity, making a complex subject accessible and easy to comprehend. It promotes best practice for dealing with unprofessional behaviours amongst doctors-in-training. Divided into two main sections, this workbook first explores topics such as what constitutes professionalism, how it might best be taught and assessed, the interactions between professionalism, ethics and legal frameworks, international trends in medical education in relation to professionalism and implications for public policy. The second section presents 29 international case studies based on real life, explores issues and makes practical recommendations. Medical educators and students will appreciate the common format with key discussion points for each case and international health and social care professionals will welcome inspiration from the candid, sincere exploration of the topic.

Edited by ROGER WORTHINGTON Independent Researcher, Policy Advisor and Medical Ethicist and RICHARD HAYS Dean, Faculty of Health Sciences and Medicine Bond University, Queensland, Australia Roger P Worthington MA, PhD, FAcadMed is an independent researcher, policy advisor and medical ethicist. Based in London, he holds honorary faculty positions at Yale University, Connecticut, and Bond University, Queensland, schools of medicine. He teaches ethics and professionalism to junior doctors in the NHS (UK) and is former subject lead on healthcare ethics and law at Keele University School of Medicine, England. He is a consultant advisor on workforce development at the Ministry of Health, New Zealand, and a former advisor on standards, ethics and education at the General Medical Council (UK). Richard B Hays MBBS, PhD, MD, FRACGP is Dean of the Faculty of Health Sciences and Medicine at Bond University, Queensland, Australia. As a clinician, he works part- time as a general practitioner; his main academic interests are in curriculum and assessment design, programme evaluation and accreditation, and the measurement of professionalism. He lectures on these issues around the world and has ongoing quality assurance and advisory responsibilities with the medical regulator in the United Kingdom and in Australia. He has been instrumental in the establishment of new medical schools in Australia, Asia, Canada and Europe, including at Keele University in the United Kingdom.

Foreword. Preface. About the editors. List of contributors. Acknowledgements. Part One: Background and analysis. Introduction. Why a new book on professionalism, and how did it come about? What does the book aim to achieve? How is the book organised (and why)? Responding to unprofessional behaviors is often difficult - why? Teaching and assessing professionalism - a useful exercise or a waste of time? References. Professionalism. The concept. Professionalism and public policy. Professionalism and patient care. Ethics v. professionalism. Progression and fitness to practice. Teaching professionalism. Assessing professionalism. Summary. References. Ethical analysis of professional issues in practice. Introduction. Justice. Responsibility. Rights. References. International trends in medical education: professionalism in context. Introduction. Why has professionalism assumed increased importance? Generational change. Other societal changes. Globalisation of medical education. Cultural issues. National jurisdictional issues. Selecting for professionalism. Conclusion. References. Public policy and the patient: professionalism and regulation - a UK perspective. Professional regulation. Professionalism and medical education. Public policy. Workforce planning. Professionalism and revalidation. Unprofessional behaviours and fitness to practice, or progress. References. Part Two: Case studies. Introduction. UK/USA. Australia/New Zealand. Postscript. Reflections on the cases. Developing processes and procedures to guide the development of sound professionalism in learners. Case summaries. Index

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