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Irresponsible in med school—in trouble as a doctor
Dec. 21,
2005
Courtesy the University of California, San Francisco
and World Science staff
Medical students with records of irresponsible behavior
later became doctors who got in trouble for alleged misconduct much more often
than their peers, a study has found.
Researchers studied records of 235 doctors who had been penalized by their state medical boards for alleged negligence, use of drugs or alcohol, unprofessional conduct or criminal convictions.
These physicians were three times more likely than others to have shown “unprofessional behavior” while in medical school, the researchers found.
The researchers counted a range of activities as unprofessional behaviors during
the school years. Among these, the worst risk factors for later disciplinary actions were irresponsibility in attendance or patient care, they
said. Students with records of such problems
were nearly nine times more likely than their colleagues to be disciplined as practicing doctors.
The study, by Maxine A. Papadakis of the University of San California, San Francisco, and colleagues, is published in the December 22 issue of the
New England Journal of Medicine.
Unprofessional behavior in medical school was a stronger risk factor for later disciplinary action by state boards than more traditional measures of academic success, such as performance on the admission tests and early medical school grades, the researchers found.
Papadakis said the study doesn’t predict the future behavior of current medical
students, but “we have at least established a risk factor for disciplinary action against practicing physicians.”
This is the first national study linking medical school performance with later disciplinary action, and therefore with a potential threat to patient safety, Papadakis said. “These data support the growing movement to make the demonstration of professional behavior a requirement for graduation from medical school in the United States,” she
added.
The study included 235 graduates since 1970 of three medical schools who were disciplined by one of 40 state medical boards between 1990 and 2003.
The schools were the University of California, San Francisco School of Medicine; University of Michigan Medical School in Ann Arbor; and Jefferson Medical College of Thomas Jefferson University in Philadelphia.
These graduates were compared with 469 control physicians of the same medical schools and graduation years.
“Professionalism can and must be taught in medical school,” wrote the study authors.
“We want to identify people who have trouble in this domain as early as possible,” Papadakis added. “We all grow up, and most of us become more professional as we mature. However, for the rare student who cannot demonstrate professional behavior, we need to think long and hard about whether he or she should graduate from medical school.”
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