Abstract Objective: To determine the management of professionalism issues by foreign returned doctors who are practicing clinicians after returning from abroad. Methods: The qualitative study was conducted in tertiary care hospitals of Khyber Pakhtunkhwa province from January to August 2016. Purposive sampling technique was used to include foreign returned doctors who shared how they managed professionalism matters in context of contrasting cultures at home and abroad. The participants were interviewed in-depth, and the audio records were transcribed verbatim. The data analysis generated codes that were consolidated under categories and then themes. Results: Interviews with ten foreign returned doctors led to 20 codes that resulted in eight categories out of which four main themes were developed namely; Foreign Cultural influence that observed how their stay abroad have influenced their practice methods. Experience, showed how personal experiences of the interviewees helped forge their practice rules in Pakistan. Social Contract theme included the ways in which foreign returned doctors understood and accepted the concept of social contract in Pakistan as compared to west and how they adapted accordingly. Wise Man Approach included the help sought and received by foreign returned doctors from their senior colleagues in managing and adjusting to societal norms regarding professional behaviors in Pakistan. Conclusion: There are multiple dissimilarities between the socio-cultural aspects, practices, and knowledge of foreign returned and local medical practitioners. There exists a gap in knowledge with regards to their clinical practice between foreign returned and local doctors. Continuou....