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J Surg Educ. 2017 Oct 27. pii: S1931-7204(17)30511-1. doi: 10.1016/j.jsurg.2017.09.033. [Epub ahead of print]

Professionalism: A Core Competency, but What Does it Mean? A Survey of Surgery Residents.

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General Surgery, William Beaumont Army Medical Center, El Paso, Texas. Electronic address:
General Surgery, William Beaumont Army Medical Center, El Paso, Texas.
General Surgery, Louisiana State University, Health Sciences Center, New Orleans, Louisiana.
General Surgery, Texas Tech University Health Sciences Center, El Paso, Texas.



Professionalism is 1 of the 6 core competencies of the Accreditation Council of Graduate Medical Education. Despite its obvious importance, it is poorly defined in the literature and an understanding of its meaning has not been evaluated on surgical trainees. The American College of Surgeons (ACS) has previously published tenets of surgical professionalism. However, surgery residents may not share similar views on professionalism as those of the ACS.


Surgical residents of all levels at 2 surgery residencies located in the same city were interviewed regarding their personal definitions, thoughts, and experiences regarding professionalism during their training. They were then queried regarding 20 points of professionalism as outlined by the ACS tenets of professionalism.


The study utilized the surgery residencies at William Beaumont Army Medical Center and Texas Tech University Health Science Center in El Paso, Texas.


All general surgery residents at each program were invited to participate in the study. Eighteen residents volunteered to take the survey and be interviewed.


The definitions of professionalism centered on clinical competence. Surgery residents conveyed experiences with both professional and unprofessional behavior. Seven of the 20 ACS tenets of professionalism were unanimously agreed upon. There were key differences between resident definitions and those as outlined by the ACS. The least agreed upon ACS tenets of professionalism include professionalism education, public education, and public health.


Surgical trainees express personal experiences in both professional and unprofessional behavior. Their definitions of professionalism are not as expansive as those of the ACS and seem to focus on patient and colleague interaction. Due to the lack of congruency, a tailored curriculum for professionalism based upon ACS tenets appears warranted.


Professionalism; education; ethics; professionalism; surgeon behavior; surgical residents

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