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On Professionalism Lapses

November 12, 2022
by Mark David Siegel

Hi everyone,

One morning during my third year of medical school, I arrived late to an ENT lecture. The department chair, clearly offended, sat me down in the front row of the conference room so I could absorb the humiliating stares of those seated behind me. He’d teach me not to be late. As if I didn’t know.

The chair was oblivious to my struggles and didn’t know I’d awoken that morning exhausted and febrile, barely able to dress, let alone leave the apartment. I had mono but still felt compelled to attend conference when I belonged in bed.

A hallmark of professionalism is doing the right thing without having to be told. We arrive on time and tell the truth. We’re polite and dependable. We complete tasks promptly, dress neatly, study, maintain our skills, and admit mistakes. At the start of our careers, we learn what’s expected of us, and we strive to uphold these ideals.

But we all fail sometimes, not just residents but faculty too. Some fall behind on chart documentation. Others let their inboxes pile up. Some vent in workrooms. Some fail to submit duty hours, attend meetings, or respond to emails. None of these lapses are acceptable, but they can happen to anyone.

Sometimes I must remind you about professional expectations as I did a couple of times last week. It’s my job. Over the past year, I’ve reminded you about the hazards of copying and pasting and the importance of submitting peer evaluations on time. Sometimes we’ve had to meet with people individually to discuss their challenges, especially when problems persist.

In the wider world, we hear about scandalous breaches, from plagiarized papers to Medicare fraud, but that’s not what’s happening here. Few of us lapse intentionally, and most of us do the right thing most of the time. No one gets it right all the time.

Professionalism lapses rarely occur for lack of trying. There’s typically a backstory: overwork, fatigue, stress, illness, anxiety, burnout, depression, ADHD, feeling overwhelmed. The point of identifying professionalism lapses is not to humiliate but to prompt reflection.

In this community, we’re committed to high ideals, and we support one another when we fail. When the APDs, Chiefs, and I discuss professionalism lapses, our first instinct is to troubleshoot. In that same spirit, if a colleague lapses, please don’t condemn them; ask if they’re okay. If you’re struggling yourself, don’t carry the burden alone. Ask for help.

We’ve come far since my days as a student when professionalism lapses were met with punishment and humiliation. That’s no way to teach, then or now. In this community, we’ve replaced condemnation with curiosity and humiliation with caring. Please consider these principles when professionalism lapses occur. Let’s lift each other up so we can all reach the lofty expectations we set for ourselves.

Enjoy your Sunday, everyone.


Submitted by Mark David Siegel on November 15, 2022