Professionalism

[QuebecMD1]

0

[LittleDaisy]

I don't understand that you will have red flags in professionalism marked on your MSPR? or in your clerkship evaluation?

I think that it is still possible to match, you just have to show to the selection committee that you have improved and learnt from your mistakes.

Also, be willing and humble to talk about your professionalism issues during interviews!

How many students per cohort get flagged because of this? What happens when you try to match? Is matching impossible?

[QuebecMD1]

MSPR. (Does UdM have a section for this? Do they separate into minor vs major?)

 

Do you know anyone who got marked and how it went for him?

[LittleDaisy]

No I don't know anyone with professionalism issues on their MSPR I am so sorry..

Which med school is this? Could you talk to your school's guidance counsellor or vice-dean, to perhaps remove those comments?

It depends on what you are interested in applying to, if something competitive, then back-up 

Sorry that I can't help further!

MSPR. (Does UdM have a section for this? Do they separate into minor vs major?)

 

Do you know anyone who got marked and how it went for him?

[hkmedic]

This is a broad question, and of course I can understand if you are not willing to divulge into specifics, but however it can really vary depending on the nature and severity of the professionalism issue(s).

[rmorelan]

This is a broad question, and of course I can understand if you are not willing to divulge into specifics, but however it can really vary depending on the nature and severity of the professionalism issue(s).

 

and how widely the event is known 

[rmorelan]

Dal would flag people as "unprofessional" if they did an elective at Dal but set it up on their own (i.e. not through the AFMC system). I know someone who did this and interviewed at dal for a competitive specialty, ultimately matching for that specialty. 

-GP

 

p.s. I would consider this to be a "light" unprofessional letter/complaint

 

yeah that is a slap on the wrist for being annoying. I am not sure that even sounds all that unprofessional to me (you have to balance your interests vs the fields). 

 

the cases of unprofessionalism I have been involved with back in student leadership were in an entirely different league. Some easily could have been careers ending.

[QuebecMD1]

yeah that is a slap on the wrist for being annoying. I am not sure that even sounds all that unprofessional to me (you have to balance your interests vs the fields). 

 

the cases of unprofessionalism I have been involved with back in student leadership were in an entirely different league. Some easily could have been careers ending.

Do you know the number of students (%) with professionalism flags in the MSPR? I'm trying to get a sense of how common and hushed this is by students. 

[rmorelan]

Do you know the number of students (%) with professionalism flags in the MSPR? I'm trying to get a sense of how common and hushed this is by students. 

 

very rare for the big stuff - maybe in a large program one or two examples a year. That is purely from my own experience with it of course. 

 

I don't think it is a big surprise that often the underlying reason is a combination of the work load, stress, and usually a mental disorder - like depression. Most of the time they crop up in clerkship which truly for most is the first time they have real professional responsibilities. 

 

they won't always show up in a MSPR either of course - dealing with unprofessionalism is one of the most complex student interaction with their school you have have. Each case is different and there is a lot of thought that goes into it. 

[QuebecMD1]

Because this is all relative, when you say big stuff, can you give a made-up example?

 

Did your school identify "minor" issues like the one goingplaid mentionned? What about the prevalence of these in the MSPR?

 

[hamham]

Because this is all relative, when you say big stuff, can you give a made-up example?

 

Did your school identify "minor" issues like the one goingplaid mentionned? What about the prevalence of these in the MSPR?

 

 

At my school, both "minor" and "major" professionalism issues may be noted on the MSPR. Ultimately, the decision to flag one for professionalism issues is one made by the faculty.

 

Examples of "relatively minor" issues: Does not respond to pages on multiple occasions when on call, showing up late for work without a valid reason, does not listen to or act on feedback provided.

 

Examples of "relatively major issues": Cheating on an exam, engaging in inappropriate behaviours with patients, failure to recognize self-limitations and acting beyond limits of one's competency.

 

Note that the lists are non-exhaustive. Hope this helps.  

[NLengr]

Dal would flag people as "unprofessional" if they did an elective at Dal but set it up on their own (i.e. not through the AFMC system). I know someone who did this and interviewed at dal for a competitive specialty, ultimately matching for that specialty.

-GP

 

p.s. I would consider this to be a "light" unprofessional letter/complaint

I'd consider that BS. Just typical university idiocy.

 

I don't know what it's like now for setting up electives at Dal but when I went through the lady who was supposed to set up your elective if you were from outside Dal was completely and utterly useless. Literally the most useless employee I have ever encountered in my entire life. She never picked up the phone or returned emails. I'm pretty sure her voicemail actually said don't leave a message because I will not call you back. The only way to set an elective up was to talk to the program directly. It was impossible otherwise.

[ralk]

I'd consider that BS. Just typical university idiocy.

 

I don't know what it's like now for setting up electives at Dal but when I went through the lady who was supposed to set up your elective if you were from outside Dal was completely and utterly useless. Literally the most useless employee I have ever encountered in my entire life. She never picked up the phone or returned emails. I'm pretty sure her voicemail actually said don't leave a message because I will not call you back. The only way to set an elective up was to talk to the program directly. It was impossible otherwise.

Yeah, that hasn't changed. At all.

[rmorelan]

At my school, both "minor" and "major" professionalism issues may be noted on the MSPR. Ultimately, the decision to flag one for professionalism issues is one made by the faculty.

 

Examples of "relatively minor" issues: Does not respond to pages on multiple occasions when on call, showing up late for work without a valid reason, does not listen to or act on feedback provided.

 

Examples of "relatively major issues": Cheating on an exam, engaging in inappropriate behaviours with patients, failure to recognize self-limitations and acting beyond limits of one's competency.

 

Note that the lists are non-exhaustive. Hope this helps.  

 

sounds about right - I will add saying/recording in the chart doing something you didn't do, failing to protect personal medical information about patients including posting things on social media, access medical information you don't have a valid medical reason to access (still not exhaustive)....there are a wide range of things

 

again part of this is truly issues in personality or training and part is the environment. Those character flaws are more likely to manifest in the stresses of exam times or clerkship (I will say that simply objectively it is hard to convey to people that haven't done something like clerkship the kind of sleep deprivation that goes on - and how it is worse in residency. In that background things can pop up you don't expect. For that reason EVERYONE has to be on their guard for this sort of stuff).

[bentobox1234]

Wouldn't the home school go out of its way to hide professionalism issues from the student's MSPR so that they can play hot potato with them come CaRMS time (and have an internal flag on their file), so that they match to another school for postgrad and not theirs?

[rmorelan]

Wouldn't the home school go out of its way to hide professionalism issues from the student's MSPR so that they can play hot potato with them come CaRMS time (and have an internal flag on their file), so that they match to another school for postgrad and not theirs?

 

No. 

 

(ha)

 

you are focusing on the MSPR - let's be clear, the sort of stuff I was talking about would lead to expulsion. In my experience the schools can be rather aggressive about removing the problem. They will dispose of a problem student rather than harm the profession or the school - they feel it is their duty to do so. They take it personally and often for good reason. The students involved naturally respond with every means they have to remain enrolled and to graduate (imagine being 150-200K in debit with no med school degree and no other clear path to move forward. Explain that to your family etc). Sometimes the students win and go on to regular postgrad training (which in my experience is a relatively rare outcome), sometimes the school wins and they are expelled, and often some form of a middle group happens where the student is delayed in terms of graduation, goes through extra training, and there multiple red flags that results causing the student limited post grad options (often quite limited - medicine is a very small universe, word gets around). I guess my point is if you are unprofessional once you have to think you will be again - and no school wants that to happen (if for no other reason than the news headline - Dr. ABC graduate from medical school X is charged with....)

 

This is the one way you can actually mess up in the process - the one way the dream can turn into a nightmare. We have to be so careful at making sure it doesn't happen and noticing when our colleagues are at risk. 

[QuebecMD1]

No. 

 

(ha)

 

you are focusing on the MSPR - let's be clear, the sort of stuff I was talking about would lead to expulsion. In my experience the schools can be rather aggressive about removing the problem. They will dispose of a problem student rather than harm the profession or the school - they feel it is their duty to do so. They take it personally and often for good reason. The students involved naturally respond with every means they have to remain enrolled and to graduate (imagine being 150-200K in debit with no med school degree and no other clear path to move forward. Explain that to your family etc). Sometimes the students win and go on to regular postgrad training (which in my experience is a relatively rare outcome), sometimes the school wins and they are expelled, and often some form of a middle group happens where the student is delayed in terms of graduation, goes through extra training, and there multiple red flags that results causing the student limited post grad options (often quite limited - medicine is a very small universe, word gets around). I guess my point is if you are unprofessional once you have to think you will be again - and no school wants that to happen (if for no other reason than the news headline - Dr. ABC graduate from medical school X is charged with....)

 

This is the one way you can actually mess up in the process - the one way the dream can turn into a nightmare. We have to be so careful at making sure it doesn't happen and noticing when our colleagues are at risk. 

"aggressive about removing the problem"

 

By problem, do you mean something so disastrous that it will directly lead to expulsion or one of the "relatively major" issues cited above?

 

Or do these (saying/recording in the chart doing something you didn't do, failing to protect personal medical information about patients including posting things on social media, access medical information you don't have a valid medical reason to access) lead to automatic expulsion?

 

If someone has an idea of the % of students with minor professionalism issues on the MSPR at their school, please PM.

 

     

[rmorelan]

"aggressive about removing the problem"

 

By problem, do you mean something so disastrous that it will directly lead to expulsion or one of the "relatively major" issues cited above?

 

Or do these (saying/recording in the chart doing something you didn't do, failing to protect personal medical information about patients including posting things on social media, access medical information you don't have a valid medical reason to access) lead to automatic expulsion?

 

If someone has an idea of the % of students with minor professionalism issues on the MSPR at their school, please PM.

 

     

 

well at most schools there is quite a process in expulsion so nothing is really automatic. That being said all of those things you mention would automatically invoke disciplinary action and could very likely result in explusion. this isn't even just even in the sphere of the medical school - lying about something you did could seriously harm a patient even as a medical student (you claim for example you checked for allergies - you didn't - and now someone orders for them a medication....), the hospital as strict rules about patient information - you break those rules and they could ban you from the hospital (now you cannot complete your degree), the college will now directly punish medical students for social media related infractions...

 

You can see why the schools won't stop talking about all of this stuff. I remember sitting there going well of course you don't do XYZ - that is so obvious. And yet it happens.  

[Organomegaly]

well at most schools there is quite a process in expulsion so nothing is really automatic. That being said all of those things you mention would automatically invoke disciplinary action and could very likely result in explusion. this isn't even just even in the sphere of the medical school - lying about something you did could seriously harm a patient even as a medical student (you claim for example you checked for allergies - you didn't - and now someone orders for them a medication....), the hospital as strict rules about patient information - you break those rules and they could ban you from the hospital (now you cannot complete your degree), 

 

 

 

can't count the number of times I've noticed other services leaving their patient lists where they shouldn't be. I've seen doctors walking around with patient stickers plastered on their white coats. the standards are theoretically quite high but in practice I find it is implemented shoddily. 

[NLengr]

well at most schools there is quite a process in expulsion so nothing is really automatic. That being said all of those things you mention would automatically invoke disciplinary action and could very likely result in explusion. this isn't even just even in the sphere of the medical school - lying about something you did could seriously harm a patient even as a medical student (you claim for example you checked for allergies - you didn't - and now someone orders for them a medication....), the hospital as strict rules about patient information - you break those rules and they could ban you from the hospital (now you cannot complete your degree), the college will now directly punish medical students for social media related infractions...

 

You can see why the schools won't stop talking about all of this stuff. I remember sitting there going well of course you don't do XYZ - that is so obvious. And yet it happens.

CPSO: Don't sleep with your patients

CPSO magazine every month: Multiple people being disciplined for sleeping with patients.

[rmorelan]

can't count the number of times I've noticed other services leaving their patient lists where they shouldn't be. I've seen doctors walking around with patient stickers plastered on their white coats. the standards are theoretically quite high but in practice I find it is implemented shoddily. 

 

depends on how many times something actually got leaked out (all that swiss cheese model stuff ha - if you are sloppy in many places you likely will get eventually burned. Still we are sloppy for sure). Ottawa for instance is in big time hot water with that sort of thing which caused the higher ups to come down on security like a ton of bricks.

 

I know of one centre where a resident left a patient list in the food court at the local mall. That was not a fun experience for the resident I hear. 

[Organomegaly]

depends on how many times something actually got leaked out (all that swiss cheese model stuff ha - if you are sloppy in many places are you likely will get eventually burned. Still we are sloppy for sure). Ottawa for instance is in big time hot water with that sort of thing which caused the higher ups to come down on security like a ton of bricks.

 

I know of one centre where a resident left a patient list in the food court at the local mall. That was not a fun experience for the resident I hear. 

 

wow. that would be so disastrous.

 

I'm very paranoid about those lists. I had a nurse send me a page to pick up a census when I left it on a table in the nursing station (so not even a public or easily accessible place). learned my lesson and now I destroy the lists as soon as I'm done using them. otherwise they're in my front pocket or in my white coat. 

 

I find the huge reliance on paper on the wards to be quite archaic in general. 

[NLengr]

wow. that would be so disastrous.

 

I'm very paranoid about those lists. I had a nurse send me a page to pick up a census when I left it on a table in the nursing station (so not even a public or easily accessible place). learned my lesson and now I destroy the lists as soon as I'm done using them. otherwise they're in my front pocket or in my white coat.

 

I find the huge reliance on paper on the wards to be quite archaic in general.

The problem with the iPad or computer based systems is they tend to be slow and cumbersome. For medicine they might be fine due to the slow pace but for surgical specialties they're a pain in the ass.

 

If someone designed an efficient EMR with easy and quick input ability I'd be all over it. But I've never seen one.

[NLengr]

depends on how many times something actually got leaked out (all that swiss cheese model stuff ha - if you are sloppy and many places are you likely will get eventually burned. Still we are sloppy for sure). Ottawa for instance is in big time hot water with that sort of thing which caused the higher ups to come down on security like a ton of bricks.

 

I know of one centre were a resident left a patient list in the food court at the local mall. That was not a fun experience for the resident I hear.

Never underestimate how fast a university or health authority will throw you under the bus.

[rmorelan]

CPSO: Don't sleep with your patients

CPSO magazine every month: Multiple people being disciplined for sleeping with patients.

 

yes, every single time. 

 

and each time you read them and go - how can you be so stupid(?) Yet each month there are fresh examples.