There is a growing consensus among medical educators that to promote
the professional development of medical students, schools of medicine should
provide explicit learning experiences in professionalism.
To determine whether and how schools of medicine were teaching professionalism
in the 1998-1999 academic year.
Design, Setting, and Participants
A 2-stage survey was sent to 125 US medical schools in the fall of 1998.
A total of 116 (92.3%) responded to the first stage of the survey. The second
survey led to a qualitative analysis of curriculum materials submitted by
Main Outcome Measures
Presence or absence of learning experiences (didactic or experiential)
in undergraduate medical curriculum explicitly intended to promote professionalism
in medical students, with curriculum evaluation based on 4 attributes commonly
recognized as essential to professionalism: subordination of one's self-interests,
adherence to high ethical and moral standards, response to societal needs,
and demonstration of evincible core humanistic values.
Of the 116 responding medical schools, 104 (89.7%) reported that they
offer some formal instruction related to professionalism. Fewer schools have
explicit methods for assessing professional behaviors (n=64 [55.2%]) or conduct
targeted faculty development programs (n=39 [33.6%]). Schools use diverse
strategies to promote professionalism, ranging from an isolated white-coat
ceremony or other orientation experience (n=71 [78.9%]) to an integrated sequence
of courses over multiple years of the curriculum (n=25 [27.8%]). Of the 41
schools that provided curriculum materials, 27 (65.9%) addressed subordinating
self-interests; 31 (75.6%), adhering to high ethical and moral standards;
17 (41.5%), responding to societal needs; and 22 (53.7%), evincing core humanistic
Our results suggest that the teaching of professionalism in undergraduate
medical education varies widely. Although most medical schools in the United
States now address this important topic in some manner, the strategies used
to teach professionalism may not always be adequate.