Recommended responses to lapses in professionalism.

Background: As part of a larger project to identify appropriate responses and sanctions for lapses in professionalism by health profession students and trainees--and their teachers--we formed reference groups of medical educators to give preliminary guidance. We hope that these data will help to generate 'a greater consistency' to fitness-to-practice procedures in UK medical schools, and across the health professions, as called for by the UK Council for Healthcare Regulatory Excellence in 2009.

Methods: Having previously identified 42 forms of poor professionalism among students at the 'proto-professional' stage of undergraduate training, of which 37 could also occur in clinical teachers, we asked reference groups of UK medical educators (n=27) and from one medical school (n=35) to recommend appropriate responses by students if they observed lapses of professionalism in their teachers.

Results: There was clear congruence within and between the two reference groups on recommended responses for 90 per cent of the lapses.

Discussion: This congruence amounts to a broad range of consensus among 62 UK medical educators about whether students should ignore, challenge the individual, discuss with peers or report the lapse to a more senior person, if their teachers exhibit certain behaviours. We hope that these data will help to generate a national consensus on appropriate responses that can be used to foster a culture of 'local resolution' in which juniors feel empowered to address poor professionalism, as well as guide undergraduate fitness to practice procedures. Dissemination and validation of these findings will now be undertaken.