Benchmarking "Adequate Professionalism" During Undergraduate Medical Education: An Exploratory Survey Study

Medical professionalism may be defined operationally as an amalgamation of behaviours, attributes, and adherence to standards. Assessing professionalism is challenging due to its broad and contextual nature, but also due to ambiguity around expectations of students within a given scenario. This qualitative study explores the respective opinions of students and teaching faculty at UK medical schools as to what constitutes "adequate professionalism" at defined milestones during undergraduate medical education.

Fifteen key professionalism themes were identified from published regulatory guidance. Four behavioural descriptors were written for each theme, using the lens of Miller's Pyramid to describe how a medical student might progress from "novice" to "proficient" across 4 defined milestones of their undergraduate medical school career. Using an online survey, students and faculty at UK medical schools were invited to provide their opinions as to what constituted "adequate professionalism" at each milestone, with respect to each theme.

Eight medical schools participated in the study. A total of 112 responses were received from 74 (66.1%) medical students and 38 (33.9%) faculty members. The data mapped students' journeys from "novice" to "proficient" as they transited the respective milestones of entering medical school, first patient contact, regular patient contact, and graduation. Student and faculty respondents broadly agreed about what defined "adequate professionalism" at each milestone. However, faculty expressed higher expectations than students in 1 theme, while students had higher expectations than faculty for at least 1 milestone across 10 themes. In some themes, students were expected to perform above the "most novice" descriptor at the first milestone. In other themes, students were not expected to reach the "most proficient" descriptor by the final milestone.

This study benchmarks "adequate professionalism" for medical students at defined milestones in the undergraduate medical curriculum. Its insights provide opportunities for curriculum planning, granular assessment of professionalism, and raise several further research questions.