In Progress: Annual Feature: Professionalism
ELAM, CAROL L. EdD; RUDY, DAVID W. MD
Section Editor(s): ANDERSON, M. BROWNELL
Association of American Medical Colleges
UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Inquiries: Carol Elam, EdD, Assistant Dean for Admissions, University of Kentucky College of Medicine, 800 Rose Street, MN102, Lexington, KY 40536-0298.
Objective: In developing professional behaviors and attitudes, it is helpful for entering medical students to recognize their preconceived notions of physician's competencies and qualities and to monitor periodically their relative importance as they pursue their medical education. We sought to determine the competencies and qualities of physicians that medical school matriculants thought would be important in the future. We are using this information to help our medical students develop professional behaviors through curricular and self-evaluation efforts.
Description: As part of the secondary application completed by students applying to the University of Kentucky College of Medicine, students were asked to respond to the following question: “What are the competencies and qualities you feel a physician should possess for practice in the 21st century?” Responses from 91 of 95 matriculants in the 1999–2000 class (96%) were analyzed for themes by two raters. Competencies included skills and abilities; qualities described personal characteristics and attitudes. The top ten competencies for future physicians described by students were technology (keeping up with technologic advances in medicine), 63%; business (adapting to the health care system, management, finance, cost), 62%; patient advocacy (helping, counseling, and demonstrating concern for patients), 53%; lifelong learning (keeping up with developments and research), 48%; communication (talking to patients and families, listening), 47%; doctor-patient relations (establishing rapport with a patient), 41%; computers (having the ability to use the Internet and other software resources for information), 40%; team member (establishing strong working relationships with physician colleagues and other health care personnel), 21%; insurance (understanding insurance policies and relationships with payers), 16%; and government (keeping up with legislation, regulations), 14%. The top ten qualities for future physicians described by students were compassion (inclination to give aid or support and share suffering), 49%; intelligence (ability to gain and apply knowledge, grasp of field), 45%; adaptability (flexible, open-minded, willing to change), 34%; honesty and integrity (sincerity and trust-worthiness), 32%; dedication (dependable, hardworking, diligent), 29%; professionalism (seeking excellence, serving as a role model, virtuous), 25%; empathy (conveying understanding, comfort and support), 23%; strong character (inner strength, confidence, assertiveness), 19%; moral and ethical (recognizing and thinking through ethical dilemmas in modern medicine), 18%; and problem solver (ability to analyze situations objectively and make decisions), 18%.
Discussion: Although medical school interviewers regularly ask applicants what characteristics are important in future physicians, responses to the question on the secondary application about necessary competencies and qualities of physicians are not regularly discussed and considered during selection decisions as part of the admission process. Instead of using the written response to this question in making selection decisions, we forward this compiled information on student perceptions of important competencies and qualities to faculty who teach courses stressing the development of professional behaviors. The students' own perceptions of necessary physician behaviors are thus used to develop curricular experiences and self-assessment and evaluation tools.
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