Deconstructing Professionalism​

Abstract

The notion of professionalism informs policy-making at all levels of medical practice, from national organizations and licensing boards to hospital disciplinary committees. The creation of policies to promote professionalism, however, is made all the more complex in the context of undergraduate medical education, where the notion of professionalism not only acts to govern behavior, but also to shape the professional identity of physicians-in-training. Given the importance of such policies, our goal here is to characterize, both descriptively and prescriptively, how the notion of professionalism manifests in the policies governing undergraduate medical education. First, we present a review of the professionalism policies currently in effect at Indiana University School of Medicine (IUSM). Following this review, we turn to argue that these policies suffer from two significant shortcomings: (i) the frequent use of circular definitions, giving rise to considerable ambiguity, and (ii) pronounced conflict between policies which seek justice and policies which maintain institutional power structures. We conclude that these conceptual inadequacies represent significant barriers which can both hinder the professional growth of medical students and hamper their ability to navigate their professional obligations, and we offer a number of recommendations for refining and reforming these policies.