Fred Hafferty

Mayo Clinic · Program in Professionalism and Values

In this case we meet Amanda, a medical student of Native and Latin American ethnicity who receives financial aid. Her friends are surprised by her interest in an elite residency program. They suggest, rather, that with her language skills, ethnic background, and interest in social justice, she has a responsibility to work with underserved patient p...

Within the fields of medicine and sociology, the descriptor "profession" (along with its brethren: profession, professionalization, and professionalism) has had a rich etymological history, with terms taking on different meanings at different times-sometimes trespassing into shibboleth and jargon. This etymological journey has coevolved with the ca...

Purpose: Minimal attention has been paid to what factors may predict peer nomination or how peer nominations might exhibit a clustering effect. Focusing on the homophily principle that "birds of a feather flock together," and using a social network analysis approach, the authors investigated how certain student- and/or school-based factors might p...

Professional identity formation in medical education is referenced increasingly as an object for educational reform. The authors introduce core concepts from two largely untapped literatures on identity and formation, contrasting framings on occupational preparation from within the organizational socialization literature with issues of socializatio...

Medical educators have used the hidden curriculum concept for over three decades to make visible the effects of tacit learning, including how culture, structures, and institutions influence professional identity formation. In response to calls to see more humanistic-oriented training in medicine, the authors examined how the hidden curriculum const...

Social scientists have long been interested in the impact of anatomy and the dissection experience on the professional formation of medicals students. In this chapter, we will examine the function and framing of anatomy lab and cadaver dissection as a pedagogical space (for faculty) and learning environment (for students)—and do so using the analyt...

We live in a world riddled with rules. Standards of group behavior innervate virtually every aspect of our social and work lives. Some are formal (laws); others are informal and tacit. Some appear well intentioned; others, draconian. Most arise from—and reflect— power dynamics. This can be the power of groups (how ‘‘people like us’’ see and do thin...

The stated goals – and therefore manifest functions – of Interprofessional Education (IPE) are to bring students of various health professions together to cultivate mutual understanding and respect for each occupation’s role(s) and foster a culture of collaboration and teamwork to promote more effective and efficient care. Yet, there are telling ga...

The term "professionalism" has been used in a variety of ways. In 2012, the American Board of Medical Specialties (ABMS) Standing Committee on Ethics and Professionalism undertook to develop an operational definition of professionalism that would speak to the variety of certification and maintenance-of-certification activities undertaken by ABMS an...

Aim: The aim of this review is to summarise the evidence currently available on role modelling by doctors in medical education. Methods: A systematic search of electronic databases was conducted (PubMed, Psyc- Info, Embase, Education Research Complete, Web of Knowledge, ERIC and British Education Index) from January 1990 to February 2012. Data e...

Despite an extensive literature within medical education touting the necessity in developing professionalism among future physicians, there is little evidence these ‘calls’ have thus far had an appreciable effect. Although various researchers have suggested that the hidden curriculum within medical education has a prominent role in stunting the dev...

Purpose: A medical school's mission statement (MS) is an expression of its vision and a reflection of the broader social environment in which it is embedded. The authors examine how the institutional identity of U.S. medical education is projected through the MSs of all U.S. MD-granting medical schools. In addition, the authors examine the extent...

In July 2011, the Alpha Omega Alpha Honor Medical Society sponsored a think tank of experts in the field of medical professionalism to focus on interventions and remediation strategies for those-medical students, residents, faculty, and practicing physicians-who demonstrate lapses in professional performance, particularly if the lapses are repeated...

In their comparative analysis of surgical interns and program directors, Antiel and colleagues¹ provide an important window into the anticipated impact of duty-hour regulations on resident education and patient care. Since the late 1990s (and particularly since 2003), more than 200 publications (studies, review articles, commentaries, and editorial...

Over the past 25 years, professionalism has emerged as a substantive and sustained theme, the operationalization and measurement of which has become a major concern for those involved in medical education. However, how to go about establishing the elements that constitute appropriate professionalism in order to assess them is difficult. Using a dis...

Brian Castellani on the Fast Growing Complexity Sciences and their Controversial Tangle with Social Inquiry. In this commentary piece for the Theory, Culture and Society website, Brian Castellani reflects on the fast growing complexity sciences (particularly over the last two decades) and their provocative and evolving tangle with social inquiry.

History is opaque. You see what comes out, not the script that produces events, the generator of history. INTRODUCTION In this chapter, we will examine issues of professions and professionalism through a particular lens, socialization theory. The fundamental assumption driving this chapter is my belief that current discussions about professionalism...

Former speaker of the US House of Representatives Thomas “Tip” O'Neill (1912-1994) is noted for saying, “All politics is local.” He could have been talking about clinical decision making and, by extension, medical education.In their comparative study of training sites and residents' attitudes about neonatal resuscitation, Janvier and colleagues1 re...

Is there a gap between what society expects and what physicians want to provide? Yes. Is this gap growing? I am not sure. Social groups have a tendency to mythologize the past, and it is not altogether clear that the public-of-old expected doctors to "be available whenever needed" and to "place the interests of patients first"—regardless. What is c...

In their Medical Education article in the October 26 issue of the Journal, Stern and Papadakis make a number of observations about professionalism and the learning environments in which medical training occurs.1 Like a growing number of medical educators, they recognize that considerable learning (some think most) takes place outside the domain of...

The rise of the corporation within health care during the 1980s and early 1990s was met by organized medicine with a deluge of editorials, articles, and books that identified a singular enemy--commercialism--and depicted it as corrosive of, and antithetical to, medical professionalism. Medicine's ire proved prognostic as scores of highly publicized...

Efforts within organized medicine over the last twenty years to reestablish an ethic of professionalism have obscured the fact that currently there are several competing clusters or types of medical professionalism, each of which represents a unique approach to medical work. Stated differently, the "professionalism" that has emerged within the acad...

Seventy-five students from five medical schools participated in structured interviews to elicit their community service history and opinions regarding the relationship of community service to the medical school admissions process and the medical school curriculum. An analysis of responses indicates that service leaders were: (a) influenced by famil...

The American Journal of Bioethics 4.2 (2004) 28-31 Delese Wear and Mark G. Kuczewski's characterization (2004) of professionalism as a "movement" is both apt (the activities taking place within organized medicine to establish professionalism as a core medical value fit the sociological definition of a "social movement") and timely (given American m...

The forces of rationality and commodification, hallmarks of the managed care revolution, may soon breach the walls of organized medical education. Whispers are beginning to circulate that the cost of educating future physicians is too high. Simultaneously, managed care companies are accusing medical education of turning out trainees unprepared to p...

The preclinical years of medical education have rich potential for preparing medical students to provide optimal end-of-life care. Most of the opportunities and settings for this education already exist in the curricula of most medical schools, although they are underutilized for this purpose. In this report The Working Group on the Pre-clinical Ye...

Throughout this century there have been many efforts to reform the medical curriculum. These efforts have largely been unsuccessful in producing fundamental changes in the training of medical students. The author challenges the traditional notion that changes to medical education are most appropriately made at the level of the curriculum, or the fo...

In October 1995, the Association of American Medical Colleges held its first Conference on Students' and Residents' Ethical and Professional Development. In a plenary session and break-out sessions, the 150 participants, representing a wide variety of medical and professional specialties and roles, discussed the factors and programs that affect med...

The organization and delivery of health care in the United States is undergoing significant social, organizational, economic, political, and cultural changes with important implications for the future of medicine as a profession. This essay will draw upon some of these changes and briefly review major sociological writings on the nature of medicine...

The authors raise questions regarding the wide-spread calls emanating from lay and medical audiences alike to intensify the formal teaching of ethics within the medical school curriculum. In particular, they challenge a prevailing belief within the culture of medicine that while it may be possible to teach information about ethics (e.g., skills in...

The depiction of physical impairments in popular culture reflects as well as shapes public attitudes towards persons with disabilities. Scholars have begun to document images of disabilities (the ‘what’) in venues such as literary fiction, motion pictures, advertisements, and television programming but there has been less attention directed toward...

The profession of medicine has changed dramatically in 75 years. Despite the commitment of individual practitioners to the highest ideals of professionalism, the profession itself has lost privilege, power, and public reputation. It has been toppled from the high moral ground of professionalism. This has happened not so much because individual clin...

The basic science years of medical training have long been dominated by an exam-based and memorization-oriented lecture format. This paper describes the use of a game show format designed to engage students in an active process of exploring their own group-based images, fears, and stereotypes about what it means to be a physician. The article exami...

The directors of family practice residencies were surveyed to measure the effect on family practice of the multitude of recent changes in medical organization and practice. The survey achieved a response rate of 80% (N = 306) and revealed that 90% of program directors were generally optimistic about the current status and future vigor of the specia...

Cadaver stories are narratives describing "jokes" played by medical student protagonists on unsuspecting and emotionally vulnerable victims. In these stories, medical students physically (and thus symbolically) manipulate whole cadavers or certain cadaver parts–often extremities or sexual organs–for the dual purpose of shocking their intended victi...

All students at the University of Minnesota, Duluth, School of Medicine responded to a 65-item questionnaire about their perceptions of changes facing medicine, the future of family practice, and career choices. Three different orientations toward family practice were identified--"stayers," "defectors," and "potential defectors." Students who had a...

The widespread perception that medicine is undergoing significant changes in its social position and professional status is of sociological importance not only for understanding medicine's own construction of reality, but also for assessing a general sociological theory of the profession. How a profession maintains its status is reflected in the wa...

A retrospective review of 949 cases of pelvic laparotomy without an indwelling catheter was conducted. Contrary to traditional beliefs, this study found that the use of an indwelling catheter was not necessary to assure either adequate exposure during operation or satisfactory voiding in the postoperative period. Various prophylactic steps included...

This paper utilizes a social constructionist perspective to examine the widespread belief among physicians during the early 1980s that an oversupply of doctors was either present or imminent. It was found that the timing and growth of physician beliefs in a "physician glut" during this period could not be adequately explained by net increases in th...

Ninety-six first- and second-year students (97 percent) at the University of Minnesota, Duluth, School of Medicine responded to a questionnaire on their career choices and their perceptions of changes in the organization and financing of medical care. Their responses indicated a great deal of student concern regarding the future of medical practice...

This study examined the impact of a community-based, totally decentralized training program on the likelihood that graduates would establish their first practice within predefined and limited geographic regions. We found that when students in a physician assistant/nurse practitioner program received their preclinical and terminal training (precepto...

It is the premise of this paper that certain instructional interventions in the medical school behavioral science curriculum will eventually improve the health care received by elderly patients. Four content areas for such intervention are reviewed: patient adherence to medication regimens, risk and management of psychosocial stress, responses to c...

To improve the geographic distribution of physician assistants and nurse practitioners in California, the Primary Care Associate Program established five community-based training sites in outlying areas while continuing to operate its core program within the San Francisco Bay Area. To evaluate this effort, the authors prospectively compared the emp...

Long-term effects of a seminar on aging and health for first-year medical students were assessed prior to graduation from medical school. Seminar students held more positive attitudes toward the elderly than did classmates in a control group. Analysis of questionnaire responses suggests that seminar students perceived contacts with elderly patients...

A community-based educational network was established to improve the deployment of physician's assistants away from the original site of training in California's San Francisco Bay Area. The philosophy underlying the program decentralization, lessons learned during its implementation, and outcomes of the decentralization are discussed. The graduates...

A community-based educational network was established to improve the deployment of physician's assistants away from the original site of training in California's San Francisco Bay Area. The philosophy underlying the program decentralization, lessons learned during its implementation, and outcomes of the decentralization are discussed. The graduates...

To the Editor.— The article "Where Have All The Doctors Gone" by Newhouse and colleagues (1982; 247:2392) and its predecessor article1 represent a major and formidable statement regarding the applicability of "trickle-down" or "smaller slice" models to explain physician manpower distribution.2 Such prominence at a time when other market-forces the...

A seminar on aging and health was developed for first-year medical students. Students' attitudes toward the elderly were assessed before and one year after the seminar. Students who elected the seminar were initially less favorable toward the elderly than were their classmates. One year after the seminar the same students held significantly more fa...

A seminar on aging and health was developed for first-year medical students. Students' attitudes toward the elderly were assessed before and one year after the seminar. Students who elected the seminar were initially less favorable toward the elderly than were their classmates. One year after the seminar the same students held significantly more fa...