Professionalism is key to a successful medical career. Obviously, you're not going to develop a strong practice if you can't establish a reputation for trustworthiness. More importantly, you can't convince patients to follow your advice unless they are absolutely convinced that you are the expert. They must respect you; they must have faith in your diagnosis; they must believe in you. All of that requires professionalism.
It should come as no surprise, then, to learn that medical schools place a premium on this quality in their students. They teach professionalism as a fundamental characteristic of a good physician, and they hold students responsible for any lapses in professionalism. What does that mean? It means if you don't have an innate natural sense of professionalism and can't find a way to master the principles of professionalism, you could very well find yourself dismissed and looking for another career.
Not all communities are created the same, though, nor are all definitions of "professionalism" equal. What qualifies as "professional" in the States, for instance, is considerably different from how that term is conceptualized in the Caribbean. That can sometimes create problems in how medical schools treat students their students.
If you've experienced unfair treatment because of your background, it's important you know that you have rights as a med student. Your school can't simply dismiss you with some vague explanation that you made a mistake. It's their responsibility to train you. They must use fair methods of evaluation. And any time they're considering dismissing you, you're entitled to due process.
Of course, it's no easy task taking on a medical school. You're used to seeing your instructors as authority figures and to doing everything school administrators tell you to. If you're taking on your school, though, you don't have to do it alone. If you're struggling to meet your school's professionalism expectations, Joseph D. Lento and his Education Law Team can help. They know what you're going through, they know how medical schools operate, and they are ready to do whatever it takes to make sure you graduate and go on to a successful career.
Defining Professionalism
Just what is "professionalism" in the medical health community, and how does that definition translate in Caribbean nations?
Medical Professionalism in the New Millennium: A Physician's Charter was created in 2002 and has since been adopted and endorsed by over 100 medical organizations recognized in North America and the Caribbean. It sets forth three specific principles that are meant to guide med students in the development of their own professionalism:
- The Primacy of Patient Welfare: "Altruism" is the key word in this principle. A physician's goal must always be the patient's welfare, and no other concern—not the market, not administrative requirements, not societal pressures—should ever be placed above that goal.
- Patient Autonomy: Patients must have control over decisions about their own health. This means doctors must be honest with their patients and give them the ability to make an informed decision about their own care.
- Social Justice: Physicians must also maintain a commitment to social justice, particularly when it comes to medical care. Race, gender, religion, socioeconomic status, and any other social category cannot be allowed to interfere with how care is distributed.
This charter and its principles have been an important influence on the evolution of medical school curricula in the two decades since it was written. Today's schools teach professionalism in the classroom, and they expect students to live up to these three principles.
It is worth noting, though, that while Caribbean doctors and medical students generally practice these elements of professionalism, they aren't always as skilled in articulating them. As one study on students in Trinidad and Tobago put it, "students' attitudes toward professionalism are generally positive, though in some cases attitudes and knowledge do not line up with current definitions of professionalism." As a result, professionalism can sometimes be a source of tension between schools and their students as students grapple with how these principles should govern their personal behavior.
Expectations of Professionalism
Principles are important, but in a practical sense, how do those principles translate into a concrete set of expectations for medical students? In their 2002 Journal of the American Medical Association article, "Defining and Assessing Professional Competence," Epstein and Hunbert write, "
"Professional competence is the habitual and judicial use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and the community being served."
In translating this definition into a teaching curriculum, author Lynn Kirk focuses on four specific categories of expectations for med students.
- Responsibility
- Following through on assigned tasks
- Arriving on time
- Accepting blame for failure
- Maturity
- Making no inappropriate demands
- Refraining from abuse and criticism in times of stress
- Listening well
- Communication Skills
- Using a tone that is not hostile, derogatory, or sarcastic
- Communicating in a way that is neither loud nor disruptive
- Making a commitment to patient confidentiality
- Exercising patience
- Respect
- Remaining sensitive to physical and emotional needs
- Avoiding bias and any sort of discriminatory attitude
You can expect your school to hold you accountable for all four of these categories. The Ross University School of Medicine, for instance, focuses on objectives like patient care, interpersonal and communication skills, professionalism, and personal and professional development. Of course, you are a student, not a licensed physician, and schools generally recognize that you are still learning how to put these behaviors into practice. Egregious mistakes, though, can bring serious consequences.
In addition, you can never be sure when a particular instructor or administrator will try to hold you accountable to unreasonable standards. Some schools, for instance, insist that your "professionalism" extend to your personal behaviors outside of the classroom. You can even be sanctioned for behavior that takes place off campus. Participate in a bar fight or get pulled over for a DUI, and you could be dismissed from your program. The Code of Ethics at the St. James School of Medicine, for instance, includes "Respect for Property and Laws," while the Saba University School of Medicine's regulations note that "violations of the laws of Saba" will lead to disciplinary action.
This is why it is so important to have strong legal representation from Joseph D. Lento and his Education Law Team so you can be sure that your rights will be respected no matter what.
Evaluating Professionalism
Again, while you have the responsibility to develop your own professionalism as a med student, there should also be clear guidelines in place for how you do that. Instructors should be teaching these principles—not simply expecting you to come in knowing them—and there should be clear methods of evaluation and feedback.
- Evaluation: Evaluation is crucial in any educational setting, particularly in medical school, where it helps to give students a sense of how they are doing in mastering material and principles. It is important your school provide a range of different types of evaluation. While some of this evaluation should come from instructors and supervisors, a single opinion of your performance is not enough to establish definitively whether or not you are mastering the material and meeting expectations. The school should also set up evaluations from your peers and colleagues, from patients, and from other medical professionals you work with, such as nurses.
- Feedback: Evaluation offers a clear measure of whether or not you are learning and executing the principles of professionalism, but in and of itself is not enough to ensure you will improve. For that, the school must offer you constructive feedback. This feedback should be directly tied to the evaluation. It should also provide clear suggestions for improvement.
You should receive evaluation and feedback at regular intervals. Typically, the expectations will grow as you work your way through your program.
Med schools also provide summary evaluations. Often, these come at the end of a course or the end of a rotation, but you'll also receive cumulative summaries as you near the end of your program, such as the MSPE (Medical School Performance Evaluation). It's important your school recognize the difference between periodic and summary evaluations. That is, periodic evaluations should offer an honest assessment of your performance. However, if your performance improves as a result of feedback, the summary assessment should reflect where you are at the end of the course, not the struggles you may have had throughout.
Again, if you feel your school is using unfair standards to judge you or that it is providing you with summary evaluations that don't reflect your actual progress, you may need to contact Joseph D. Lento and his Team to find out what they can do to help.
What Can Go Wrong?
Of course, if you continue to struggle after instruction, evaluation, and feedback, you are subject to consequences. A medical school's job is to train you, and it can't do that without the ability to assign sanctions when you aren't learning.
Usually, egregious and repeated mistakes are handled through a school committee. Different schools use different labels for this committee—Committee on Professionalism, Committee on Academic Promotion—but they generally consist of instructors and attending physicians, school or hospital administrators, other health care personnel, and sometimes a medical student or two.
The good news is this process affords you some due process rights. No single individual has the power to decide what happens to you, and you have the opportunity to explain your side of the story. You may be allowed to bring an attorney with you to proceedings, and even if you aren't, you have the right to consult someone from the Joseph D. Lento Law Firm as you prepare to present your case. A Lento Law Firm professional can help you gather evidence, coach you on what to say, even help you draft documents and put together presentation materials. Most importantly, they can ensure that you are treated fairly and afforded all the rights you deserve.
Ultimately, the school's committee does have the power to institute sanctions. At American University of the Caribbean School of Medicine, for instance, the Administrative Review Committee is authorized to sanction students with
- Written warnings
- Financial restitution
- Non-academic probation
- Loss of privileges
- Suspension
- Dismissal
Dismissal usually means the end of your medical career. Few medical schools are willing to take a chance to admit a student who has already been expelled from another program.
Any sanction, though, is serious and can have consequences for your career. Medical schools, as you might expect, keep careful records on their students, among these the MSPE (Medical Student Performance Evaluation). Any notes on unprofessional behavior in your file will necessarily follow you when you go up for licensure and when you're talking to hiring committees.
Here again, you cannot prevent a medical school from censuring you if it finds you guilty of misbehavior. However, you are a student rather than a licensed, practicing physician. As such, you should be entitled to learn from your mistakes. If you believe your medical school has made unfair notations in your permanent file, you have the right to challenge its actions. Joseph D. Lento and his Education Law Team have helped hundreds of medical students get the justice they deserve, and they can help you to do the same.
Your Rights
From your first day in medical school, you have some important rights, and you should insist on them.
- A right to clear expectations: Your school should let you know exactly what it expects of you in terms of professional behavior, and you should never be held accountable for any behavior you don't know about up-front.
- A right to a list of rights: Just as important, your school should let you know on day one just what rights you have as a student. At a minimum, you should be given a list of your rights any time you are subject to disciplinary action.
- The right to be treated as a student: You are a student, not a professional, and should be treated as such. This doesn't mean you can ignore the school's mandate to act in a professional manner, but it does mean you should be given the opportunity to fail and to learn from your mistakes.
- Evaluations should be fair: Again, the expectations of your behavior should match your experience, and evaluations should take your level of experience into account.
- You should know the consequences: Sanctions should never be arbitrary. You should know in advance what will happen to you if you act unprofessionally.
- You must be allowed due process: Your school should never be able to summarily dismiss you without giving you a chance to defend yourself.
Finally, keep in mind that as a student in the Caribbean, you may be used to a different culture than that which governs your medical school. You have the right to a period of adjustment.
If you feel you've been denied any of these rights, you may have a case for challenging a sanction that's been assigned to you. If you have any questions, Joseph D. Lento and his Education Law Team can talk you through your situation and help you decide on the best course of action
Fighting for Your Future
You've invested a lot of time and money to get to this point, to say nothing of all the blood, sweat, and tears. Don't let all of that go to waste simply because of a mistake or a misunderstanding.
The Lento Law Firm was built on helping students just like you defend themselves from unfair treatment. Joseph D. Lento and his Team know how the medical school system works. They know who to talk to and what to say. Most importantly, though, they're on your side and ready to fight for your future.
To find out more about exactly what Joseph D. Lento and his Team can do for you, contact the Lento Law Firm today at 888-555-3686, or use our automated online form.
