Professionalism deficits among medical students: Models of identification and intervention

Objective: This study compares the instruments and interventions utilized to identify and remediate unprofessional behaviors in medical students across U. S. psychiatry clerkships. Methods: A 20-item questionnaire was distributed to 120 psychiatry clerkship directors and directors of medical student education, in the U. S., inquiring into the procedures utilized for identifying, monitoring, and remediating unprofessional behaviors among medical students during their psychiatry clerkship. Results: Fifty seven (47.5%) clerkship directors responded to the questionnaire. Professionalism is evaluated by 96% of the clerkships with the most frequent goals being to provide feedback to students and to specifically identify problematic behaviors. Seventy percent of the clerkships identify one to three students per year with unprofessional behaviors that warrant intervention. The majority (86%) of the respondents note that unprofessional behaviors may impede the advancement of students during their medical education. A recommendation for a mental health evaluation occurs in at least 76% of cases. Dismissal from medical school for unprofessional behaviors is most likely recommended based on the severity and/or repetitiveness of the acts. Conclusions: There is concordance among clerkship directors regarding the importance of identifying unprofessional behaviors among medical students although there exists a range of modalities for monitoring, remediating, and disciplining such behaviors.