Developing professional values and behaviours is essential to maintaining public trust in doctors and ensuring safe, effective patient care. However, this new research suggests that there are significant issues with how professionalism is defined and applied in medical schools.

This UK-wide study draws on responses from 2,573 medical students across the UK, alongside analysis of information obtained from medical schools through FOI (Freedom of Information) requests.

Key findings

• While most students report being familiar with professionalism guidance and almost three in five believe it is taught well (58.6%), only just over one third believe their medical school would address a professionalism concern fairly (36.2%).
• Students frequently describe ‘professionalism’ as a broad and loosely defined concept that can be used to enforce compliance with administrative processes, such as attendance, rather than to support meaningful professional development.
• The survey found that nearly half (45.3%) of students would feel uncomfortable raising concerns within their medical school, while 40.0% said the same about speaking up on clinical placement.
• Students described a culture in which raising concerns could be labelled as unprofessional, creating barriers to reporting issues, including those related to patient safety.
• Over one third of respondents had been labelled ‘unprofessional’ at least once (36.0%), with most of these students believing that the judgement against them was unfair (71.2%).
• Data collected through FOI requests from medical schools indicates significant variation in how professionalism standards are applied between institutions. This inconsistency suggests that students may be treated very differently depending on where they study.

Our recommendations

In response to these findings, the BMA is calling for a reset in how professionalism is understood and applied in medical education. Key recommendations include:

• The GMC should make the management of student professionalism a core component of quality assurance for UK medical schools.
• Medical schools should record, monitor, and publish data on low-level professionalism concerns and fitness to practise investigations.
• Medical schools should design proportionate and flexible attendance and leave policies that recognise students as adult learners with responsibilities and lives outside of medicine.
• Points-based professionalism systems must not be used.
• Medical schools must foster a culture where students always feel safe to speak up and raise concerns.
• Medical schools should recognise that lawful political expression and activism are not, in themselves, incompatible with professional conduct.
• Medical schools should ensure their FTP processes have consistent and robust sanctioning guidelines for cases of serious failings of professional behaviour. These must be sufficient to deter this behaviour from taking place.  

The BMA believes professionalism should support students to develop into confident, reflective and responsible doctors. To achieve this, professionalism processes must be fair, transparent and trusted by the students they are intended to serve.

What the BMA is doing

We are working proactively to highlight these issues with key stakeholders. We have discussed this issue with the GMC and presented the data to the education leads at every UK medical school. 

Our initial discussions have been productive, and we are working to ensure all the recommendations are implemented. 

Our local representatives are also addressing these issues with their medical schools. Get in touch with your rep, share our campaign and discuss it with your colleagues.