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Obstetrics & Gynecology:
Graduate Education

PROFESSIONALISM IN OBSTETRICS‐GYNECOLOGY RESIDENCY EDUCATION: THE VIEW OF PROGRAM DIRECTORS

Fries, Melissa H.

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Abstract

Objective: To define the qualities of professionalism emphasized in obstetrics-gynecology residencies and identify existing means of evaluating them.

Methods: A survey, designed to assess the importance of professionalism in residency programs and what means are utilized for its development, was sent to all 270 obstetrics-gynecology residency program directors in the United States.

Results: Two hundred thirteen surveys were returned (79%). Ninety-seven percent of all respondents indicated that they thought the development of professionalism was necessary for training obstetrics-gynecology residents, and 84.3% thought that formal educational training time should be devoted to this development. Over 85% endorsed faculty examples and mentoring as their methods of teaching professionalism. Respondents ranked honesty; accountability to patients, colleagues, and society; respect for patients; integrity; and excellence as the most important qualities of professionalism. Almost 79% believed those qualities were as important and as necessary as qualities of skill and knowledge in residency training. Almost 80% of respondents thought that the establishment of formal professionalism guidelines would be valuable in their training programs.

Conclusion: A critical quality in resident education is professionalism, which receives emphasis in training programs largely through faculty example and mentoring. The variability inherent in such methods might be reduced by residencywide guidelines for uniform application of standards and to avoid arbitrariness in enforcement.

Frequently, residency program directors are required to address concerns about residents that are unrelated to diagnostic skills or surgical abilities. Issues such as dishonesty in recording clinical findings, lack of respect to patients and staff, or frank negligence of patient care cause great anxiety about the nature of resident professionalism and occupy hours of discussion in faculty meetings about their management and need for improvement. Much of this discussion stems from a frustration that professionalism is not inherent in residents—“isn't that supposed to be taught in medical schools?”—and a sense of hopelessness about teaching it—“if a resident isn't honest by this time of his life, we certainly can't make him honest.” Program directors face a dilemma when problem residents do not believe they can be held accountable for deficiency in professional qualities when “they were never explained” to them and “faculty members behave like that all the time.”

Because professional qualities are often considered intrinsic in students seeking to become doctors, little attention in residency programs might be placed on determining if they are present, although those behaviors are vital for future interactions with patients, peers, committees, and hospitals. This research effort was designed to ascertain whether professionalism is believed to be important in obstetrics-gynecology residency programs, and if so, what qualities are most critical and how are they evaluated and fostered.

© 2000 The American College of Obstetricians and Gynecologists

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