Navigating Professional Code of Conduct Among Undergraduate Dental Students in Pakistan: A Qualitative Study

Professionalism in dentistry extends beyond technical competence to include accountability, respect for patients and colleagues, non-maleficence, informed consent, communication, fairness, and conduct consistent with professional standards. In Pakistan, these expectations are shaped by international bioethical principles, national professional regulation, and local social and religious contexts.

To explore undergraduate dental students' experiences of, or observations of, events they perceived as unethical or inconsistent with professional conduct during clinical/workplace learning, and to understand the forms and meanings of these experiences.

A qualitative narrative inquiry was conducted over 6 months (November 2020-April 2021) at two dental colleges in Peshawar, Pakistan, one public and one private. Purposive sampling was used to recruit clinically exposed undergraduate dental students. Fifty students were approached and 37 participated in semi-structured interviews. Data were analyzed using Template Analysis. The report follows the COREQ framework and makes the analytic, reflexive, and trustworthiness procedures explicit.

Participants had a mean age of 20.9 ± 1.96 years (range 17-25); 29 (78.4%) were female and 8 (21.6%) male. Four interconnected themes were identified: unprofessionalism, harassment, poor communication, and discrimination. The accounts included concerns about infection control, empathy, accountability for clinical error, dishonesty, physical/verbal/emotional harassment, inadequate instruction, failures of informed consent, abuse of power, victimization, and targeting.

Students' accounts point primarily to breaches of professional conduct and to tensions between formal ethical expectations and the hidden curriculum of clinical learning. Professionalism education should therefore be embedded longitudinally in dental curricula and reinforced through faculty role-modeling, safe reporting pathways, supervised clinical practice, and context-sensitive ethical reasoning that can hold universal duties together with legitimate cultural and religious considerations.