Responding to unprofessional behaviours.

Background: Medical educators sometimes have to respond to inappropriate behaviours from doctors in training that have the potential to endanger their future careers and affect the safety and well-being of their patients. The authors led workshops at international meetings using case-based discussion and plenary wrap-ups to reinforce and share the learning outcomes. This paper summarises key points of difference and common themes about how to manage challenging professional behaviours presented by doctors in training that may be of value to tutors and clinical educators.

Context: Although the problems encountered had elements in common, experiences varied between countries, schools and programmes as regards processes, procedures and thresholds for launching an investigation. Whereas variations are not unexpected it is important to consider the context and background against which decisions are made. Appropriate responses must take account of professional, legal and ethical guidelines, where they exist.

Implications: Major inconsistencies in hearings and investigations may not be in anyone's best interests: fairness is core to most notions of justice, whether from the perspective of a doctor in training, clinical educator or member of the public. Therefore, schools and programmes need to take this into account when reviewing processes and procedures. Although the career of a doctor in training is important, it is not the only consideration. If systems fail the public has a right to be concerned, and striving to ensure that medical students graduate to become safe, professional doctors is something of concern to all clinical educators.