Professionalism as inspiration and discernment in educating medical students and trainees

We propose that the various meanings of ‘professionalism’ in the literature can usefully be grouped as 1) professionalism denoting ‘excellence in medical practice’ and 2) professionalism as it relates to ‘meeting certain standards.’ These groupings lead to two complementary pedagogical goals and teaching strategies in terms of inspiration and discernment. These strategies address both the need for an aspirational goal, and for achievable standards in attaining clinical competence, understanding of ethics, and skills in communication. Achieving these standards then provides a base for the eventual expression of professionalism which is understood in terms of virtues—such as excellence, humanism, accountability and altruism. Some of the implications for medicine as a profession are discussed if it is to claim these virtues in professional practice. We suggest that disciplinary issues be dealt with separately from teaching programmes as they relate (in most cases) to a small proportion of students and clinicians who have difficulty in maintaining required standards of professionalism. We illustrate this approach to teaching professionalism by reference to a programme at the Yong Lin Loo School of Medicine in the National University of Singapore.