Overview

Being a professional is one of the key attributes of being a physician. In order to assist students in their development as future professionals, the program provides abundant instruction and feedback, both formal and informal, about professionalism. Information about the program’s formal professionalism instruction is summarized in this Calendar under the Ethics & Professionalism theme. This section focuses on the assessment of students’ professional behaviour as well as how critical professionalism incidents are defined and addressed.

The MD Program’s Guidelines for the Assessment of Student Professionalism are informed by the University of Toronto’s Standards of Professional Practice Behaviour for all Health Professional Students and the MD Program’s competency framework.

Assessment of student professionalism takes place through competency-based professionalism assessments, which is summarized below.

Professionalism incidents that require immediate action are addressed through critical incident reports, also summarized below.

Suspected breaches of academic integrity are addressed in accordance with the MD Program’s Academic Integrity Guidelines, which are informed by the University of Toronto’s Code of Behaviour on Academic Matters.

Professionalism Assessment

In selected teaching and learning settings where teachers are in a position to make meaningful observations about students’ professional behaviour, including small group settings and clinical learning environments, supervising teachers complete competency-based student professionalism assessment forms. This assessment exercise provides an opportunity for teachers to indicate both strengths and areas for improvement with respect to professionalism. It also allows the program to monitor whether individual students are exhibiting a pattern of unprofessional behaviour, possibly across multiple courses or multiple learning contexts.

The assessment of demonstrated professional behaviours form is organized according to six professionalism domains. Each domain includes criteria that reflect specific behaviours that characterize the respective domain, as follows:

Interactions with Patients and Essential Care Partners

• Uses effective verbal and non-verbal communication
• Shows respect for patients' time, space, and person (e.g., appropriate draping)
• Takes time to comfort the patient
• Navigates difficult or complex situations with empathy and sensitivity to the patient's lived experience
• Demonstrates respect for donated tissues/cadavers
• Establishes and maintains appropriate boundaries

Reliability and Responsibilities

• Fulfills obligations in a timely manner
• Manages transitions of care effectively
• Informs supervisor/colleagues when tasks are incomplete, mistakes or medical errors are made, or when faced with a conflict of interest
• Manages lateness or absence in accordance with policy/expectations
• Arrives prepared for work, including maintaining an acceptable standard of appearance and hygiene (e.g., scrubs for OR)
• Actively participates in patient care activities and learning activities (e.g., rounds, family meeting, CBL/HSR/Seminar, etc.)
• Fulfills call duties and academic responsibilities (e.g, attending rounds, seminars, classes)
• Timely completion of MD Program and hospital registration requirements

Growth and Adaptability

• Accepts and provides constructive feedback
• Incorporates feedback by demonstrating changes in behaviour 
• Recognizes own limits and seeks appropriate help
• Appropriately responds to unanticipated changes in schedules, clinical responsibilities, and other work/learning activities
• Understands the importance of reconciling self-care and care for patients. Consults with others when challenges arise

Relationships with Colleagues

• Maintains appropriate boundaries
• Balances the needs of the learner and the group/team (e.g., group work, leaving early)
• Collaborates effectively with team members (including physician colleagues, other health providers, other clinic/hospital staff, and patients/families/essential care partners)
• Communicates effectively with Temerty Faculty of Medicine staff/faculty
• Contributes to a psychologically and culturally safe learning environment
• Demonstrates awareness and support for peers-in-need

Upholding Student and Professional Codes of Conduct

• Accurately represents qualifications
• Uses appropriate language with patients, colleagues, and other staff
• Acts with honesty and integrity
• Employs effective conflict navigation strategies
• Respects confidentiality, privacy, and data stewardship
• Engages responsibility with social media and observes policies surrounding its use
• Promotes equity, diversity, and inclusion (e.g., race, gender, religion, sexual orientation, etc.)
• Uses appropriate strategies to access and identify supports and pathways to respond to unprofessional behaviour and unethical behaviours

Recognize and Respond to Ethical Issues

• Recognizes when ethical issues in patient care arise and responds appropriately, including asking for additional support as needed
• Communicates effectively when differences in personal and professional values arise (e.g., termination of pregnancy, medical assistance in dying)
• Applies ethical reasoning skills where appropriate

Teachers are asked to rank students from 1 to 5, with 5 being the highest score, for each of the six professionalism domains. The assessment of each domain is based on the criteria applicable to the student’s learning activity. Teachers have the option of indicating if they were not in a position to assess one or more of the professionalism domains. Teachers are required to provide comments regarding any scores of 1 or 2, including those that are based on a critical incident (which is described in more detail below).

Professionalism Standards of Achievement

Satisfactory professionalism competency is a requirement to achieve credit in every course, and assessment of professionalism competency is included in every course. Satisfactory professionalism competency is also required to progress from one year level to the next and to graduate from the program, in accordance with the MD Program’s Standards for Grading and Promotion for Foundations and Clerkship.

Procedural details regarding the student professionalism check-in process and student in professionalism difficulty review process are provided in the MD Program’s Guidelines for the Assessment of Student Professionalism.

Sample Professionalism Forms and Resources

• MD Program Student Professionalism Check-in Process (PDF)
• Assessment of Demonstrated Professional Behaviours
• Professionalism Check-In Reporting Form
• Student in Professionalism Difficulty Reporting Form
• Critical Incident Report Form