A Delphi study of medical professionalism in Arabian countries: The Four-Gates model

Background: Medical professionalism has been described as a set of attributes and behaviors, yet the Western frameworks of medical professionalism may not resonate with the cultural values of non-Western countries. Aim: This study aims to formulate a professionalism framework for healthcare providers as interpreted by local medical professionals in Arabian countries. Methods: A purposive sample of 17 experts from diverse disciplines participated in a Delphi study in three rounds. Consensus was identified by content analysis and by numerical analysis of responses on the basic attributes of medical professionalism in Arabian context. Results: Eight professional traits were shortlisted and coupled in four themes ( Gates): dealing with self, dealing with tasks, dealing with others and dealing with God. Self-accountability and self-motivation were interpreted from a faithful viewpoint as taqwa'' and ehtesab'', respectively, in Arabic. Discussion: The Four-Gates Model helps in better understanding of medical professionalism as grounded in the minds and culture of Arabs. The model may act as a genuine framework for teaching and learning of medical professionalism in Arab medical schools. Conclusion: The study highlights the divergent interpretation of medical professionalism between Western and Arabian contexts. The Four-Gates Model may work for faith-driven societies, but not for non-Muslims Arabs students or teachers or in institutions with humanistic values.