Baylor College of Medicine medical students will receive new specialized training and education on professionalism as part of a recent grant the institution received from the Institute on Medicine as a Profession and the Josiah Macy Jr. Foundation.

"For most of the last century, professionalism was rarely taught in medical school, rather, professionalism was assumed without students having a clear understanding of expected behaviors," said Dr. Anne Gill, associate professor of pediatrics and medical ethics at BCM and principal investigator on the project. "Over the past 20 years, there has been more emphasis on professionalism in medical education, culminating with the 2002 publication of the Physician’s Charter on Medical Professionalism. In keeping with the principles of the charter, we believe that by providing better resources, outlining clear expectations, clinical experiences and guided reflection, we can help the students become exemplary medical professionals."

Professionalism threaded throughout training BCM was one of five institutions across the country who received this grant. A total of 75 applied to participate in this prestigious program.

"Traditionally, most medical schools have special events at the beginning of the first year that highlight professionalism, such as a white coat ceremony," said Gill. "With the new grant, professionalism training will be threaded throughout the four-year program."

Gill explained the new curriculum would include.

First year

"Our first-year students make a clinical ethics visit with one of our faculty members," said Gill. "This continues to allow the student to learn from the faculty member about the ethical concerns, but new interventions will challenge the student to problem solve issues related to social justice, resource allocation, physician advocacy, and patient interests.

Second year

As second-year students begin their clinical rotations, they will be asked to document in their online portfolio patient encounters related to discrimination in health care delivery, the equitable distribution of resources and patient advocacy. The students will then meet with their mentors to debrief these encounters and other examples of the hidden curriculum to contextualize and draw meaning from the experiences.

Third year

At the beginning of the third-year, BCM students will attend a workshop during the Longitudinal Ambulatory Care Experience (LACE) course.

"After a didactic session on ethics and professionalism, we will invite faculty from the ethics course, and the mentors to work with the students in small groups," said Gill. "Students will again share experiences during their training to identify boundaries between unacceptable, acceptable, and exemplary professional behavior. And at the end of the third-year, students will be tested using a standardized patient with health care concerns that should trigger physician advocacy for the patient."

Fourth year

As fourth-year medical students prepare for their residency, this new training will bring the students together in small groups to focus on issues related to promoting a just distribution of finite resources in clinical practice. The students will reflect upon clinical encounters where they witnessed wasteful utilization of resources or non evidenced-based medicine. Students will be asked how these events could be prevented or how they will respond in the future.

Commitment to highest standards

"We are very excited about this award and the new training it will provide our students," said Gill. "Receiving this grant acknowledges BCM’s commitment to training physicians to the highest standards of professional practice. It also moves us forward as leaders in medical professionalism education."

In addition to Gill, Dr. Beth Nelson, Dr. Cayla Teal, Dr. Joey Fisher, Dr. Rebecca Yarrison and Shewanna Manning will lead this new initiative.

The new training will begin with the 2011–2012 academic year. BCM will receive $50,000 over a two-year period.