Medical professionalism in the new millennium: are there intercultural differences? Brief report and commentary

We hypothesized that differences in premedical and medical indoctrination might lead to demonstrable differences in notions of medical professionalism among U.S. medical schoolgraduates (USMG) and international medical graduates (IMG). We used the previously validated Barry Challenges to Professionalism questionnaire to query applicants to our Medicine residency. Two hundred sixty-six of 1,476 applicants responded; 57 were USMG and 188 IMG were non-U.S. citizens. There were no significant differences in responses based on gender or medical school background (comparing USMG vs IMG). Graduates of U.S. and Canadian schools were more likely than those of Indian schools to answer correctly three of 10 questions. We use the results of this ostensibly "negative" study to comment on the foundations for the hypothesis and logistic difficulty of studying the question.