School of Integrated Social Sciences, University of Lahore, Lahore, Pakistan.
Department of Sociology, International Islamic University, Islamabad, Pakistan.
BMC Health Serv Res. 2020 Sep 10;20(1):847. doi: 10.1186/s12913-020-05681-w.
Professionalism is amongst the major dimensions determining the competence of medical doctors. Poor professionalism affects the overall outcome of healthcare services. This study explores the perspectives of young medical doctors on professionalism in Pakistan.
A qualitative study based on in-depth interviews was conducted with 60 young medical doctors, aged less than 40 years, who had studied medicine in Pakistani universities, were Pakistani nationals, and were employed at various hierarchical levels, from house officer to consultant specialist, in public tertiary hospitals in Pakistan. The respondents were identified through a multistage maximum heterogeneity sampling strategy. A semi-structured interview guide was developed based on a previous extensive literature review. Written consent was obtained from the hospitals and study participants. Qualitative thematic analysis was applied to analyse the data.
The data analysis revealed that rigidity of opinions, unacceptability of contrasting perspectives, false pride, and perceived superiority over other professions and patients were major components of poor medical professionalism. Most of the young doctors believed that there is no need to include professionalism and humanity course modules in the medical curriculum, because topics related to social sciences are deemed irrelevant to medicine and judged to be common sense. The doctors recognised good professionalism in themselves, while reporting unprofessional behaviour demonstrated by their colleagues and paramedics. Other factors contributing to poor medical professionalism included the use of social media applications during duty hours, ridiculing patients, substance use such as smoking cigarettes in the office, referrals of complicated cases to other hospitals, freeing up beds before holidays, lack of cooperation from paramedical staff, and inadequate role models.
Poor medical professionalism among young doctors needs to be addressed by policymakers. There is a need to revisit the medical curriculum to strengthen professionalism. It is essential to develop the qualities of tolerance, teachability, and acceptance in doctors in order to facilitate interprofessional collaborations and avoid medical errors.
专业精神是决定医生能力的主要维度之一。专业精神不佳会影响医疗服务的整体效果。本研究探讨了巴基斯坦年轻医生对专业精神的看法。
本研究采用基于深度访谈的定性研究方法，对 60 名年龄在 40 岁以下、在巴基斯坦大学学习医学、具有巴基斯坦国籍、在巴基斯坦公立三级医院担任从住院医师到顾问专家等不同层级的年轻医生进行了访谈。通过多阶段最大异质性抽样策略确定受访者。根据先前广泛的文献综述制定了半结构化访谈指南。从医院和研究参与者处获得了书面同意。采用定性主题分析方法对数据进行分析。
数据分析显示，观点僵化、无法接受相反观点、虚假的自豪感以及对其他职业和患者的优越感，是医学专业精神不佳的主要组成部分。大多数年轻医生认为，没有必要在医学课程中增加专业精神和人文课程模块，因为社会科学相关主题被认为与医学无关，被认为是常识。医生们认为自己有良好的专业精神，但也报告了同事和医务人员的不专业行为。导致医学专业精神不佳的其他因素包括在工作时间使用社交媒体应用程序、嘲笑患者、在办公室吸烟等物质滥用行为、将复杂病例转介到其他医院、在假期前腾出床位、缺乏辅助医务人员的合作以及缺乏适当的榜样。
政策制定者需要解决年轻医生中存在的医学专业精神不佳问题。需要重新审视医学课程，以加强专业精神。培养医生的宽容、可教性和接受性等素质至关重要，以促进专业间合作并避免医疗错误。
