Teaching Medical Professionalism

Professionalism is supposed to encompass the very heart of medicine. Despite—or perhaps because of—this assumption, teaching, enhancing, and generally protecting professionalism can be as complex as medicine itself and its relations to the institutions and societies that support it.

Some remarkably broad issues arise: the self-regulatory status of medicine rests on implicit and explicit agreements with society that medical professionals behave in certain ways, put patients' interests before their own, and more generally refrain from abusing the power that comes with caring for persons made vulnerable by illness. To protect professionalism, then, is to protect a crucial part of medicine's identity and its enabling conditions. But how to do this? Should it rest primarily on how students are taught? On how peer review and regulation are implemented in clinical practice? Or on how physicians try to change their contexts to facilitate more integrity?