Medical students' attitudes to professionalism: an opportunity for the GP tutor?

Using a novel tool based on General Medical Council (GMC) standards, this cross-sectional survey aimed to assess UK medical students' professional attitudes at different stages of the curriculum, and to investigate the influence of the hidden curriculum on these attitudes through exposure to unprofessional behaviour during the medical course.

An anonymous online questionnaire was developed, reflecting core professional competences outlined in Good Medical Practice. First, third and fifth year students received Section 1: 'Attitudes to professionalism'; third and fifth year students also received Section 2: 'Exposure to unprofessional behaviour'. 'Professionalism score' (Section 1) and 'Exposure score' (Section 2) were analysed using ANOVA. Thematic analysis was used to analyse free text.

Response rate was 50.8% (363/714). Female (F=18.24, p < 0.001) and first year students (F=12.22, p < 0.001) had significantly higher Professionalism scores. Professionalism scores for male students showed a significant stepwise decline from first year to fifth year. Fifth year students had significantly higher Exposure scores (F=23.4, p < 0.001). Qualitative themes included bullying, lack of accountability and sexism.

Sensitivity to professionalism, as defined by the GMC, was higher and exposure to unprofessional behaviour lower in first year compared to fifth year. Addressing the hidden curriculum is crucial to protect professional development; GP teachers should be aware of these findings and are ideally placed to provide mentorship and support to medical students.