Benchmarking ‘adequate professionalism’ during undergraduate medical education

Background: Medical professionalism may be defined operationally as an amalgamation of behaviours, attributes and adherence to standards. Assessing professionalism is notoriously difficult, in part due to its broad and contextual nature, but also ambiguity around expectations of students within a given scenario. This study seeks to provide granular detail about what constitutes ‘adequate professionalism’ at defined milestones of undergraduate medical education in the opinion of students and teaching faculty at UK medical schools. Methods Fifteen key professionalism themes were identified from published medical regulator 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 four defined milestones of their undergraduate medical school career. Using an online survey, students and teaching faculty at UK medical schools were invited to provide their opinion as to what constituted ‘adequate professionalism’ at each milestone with respect to each theme. Results 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 one theme, while students had higher expectations than faculty for at least one 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. Conclusions This study has benchmarked ‘adequate professionalism’ for medical students at defined milestones in the undergraduate medical curriculum. This enables more detailed professionalism assessments during undergraduate studies. A number of further research questions are posed.