Literary inquiry and professional development in medicine: against abstractions

The professional development discourse currently circulating in academic medicine owes much to the work of the American Board of Internal Medicine (ABIM) and their Project Professionalism. They identify the elements of altruism, duty, excellence, honor and integrity, accountability, and respect for others as forming the basis of professional development. While an admirable effort, Project Professionalism remains primarily an abstract set of attitudes and behaviors with a number of vignettes that are of limited use to medical educators attempting to foster the development of professionalism in medical students. This paper outlines an approach to professional development grounded in medical narratives written by physicians, including memoirs, essays, and poetry, that may help students grapple with the challenges of medicine that involve those very elements put forth by ABIM. An argument is made that literature may be a superior medium for engagement with these elements because of its ability to evoke discomfort and vulnerability in ways the case report does not.