Intended for healthcare professionals

Education And Debate

Professionalism must be taught

BMJ 1997; 315 doi: (Published 20 December 1997) Cite this as: BMJ 1997;315:1674
  1. Sylvia R Cruess, associate professor of medicinea,
  2. Richard L Cruess, professor of surgerya
  1. a Centre for Medical Education, McGill University, 1110 Pine Avenue West, Montreal, Quebec, Canada H3A 1A3
  1. Correspondence to: Dr Sylvia R Cruess


The subject of professionalism is often referred to in the medical literature, but the word itself is rarely defined—and it is assumed that physicians understand what it means to be a professional and use this understanding as they make decisions in their private and professional lives. Though this may have been true in the past, the lack of literature dealing with professionalism available to the average doctor is striking. When this is coupled with the absence of relevant material in the curriculum of most medical schools, it is understandable why, in a rapidly changing world, doctors may not have a clear understanding of what the public expects from its professionals.

Summary points

Professional status is not an inherent right, but is granted by society

Its maintenance depends on the public's belief that professionals are trustworthy

To remain trustworthy, professionals must meet the obligations expected by society

The substance of professionalism should be taught at all levels of medical education as part of the profession's response to changing societal expectations

The General Medical Council's approach to professionalism and self regulation is a response to the rapidly changing relation of all professions to society and is designed to allow medicine to meet new societal demands and expectations. Dealing with problems having to do with doctors' performance and attitudes, Irvine presented the subject in the overall context of professionalism in the modern world.1 2 He emphasised the importance of independence (which some call “autonomy”) and stated that it depended on the three pillars of expertise, ethics, and service. He then linked the concept of an independent profession, as granted by the state, to self regulation. As have almost all observers of the present scene,3 Irvine emphasised the importance of trust to the relationship between patient and doctor and the profession and society. In …

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