Young Medical Doctors’ Perspectives on Professionalism: A Qualitative Study Conducted in Public Hospitals in Pakistan

Abstract

Background: Professionalism is amongst the major dimensions indicating the competence of medical doctors. A decline in professionalism affects the overall outcome of healthcare services. This study explores the patterns of declining professionalism among young medical doctors in Pakistan.Methods: A qualitative study based on in-depth interviews was conducted with 60 young medical doctors aged less than 40 years who were employed at various levels from house officer to consultant specialist in public tertiary hospitals in Pakistan. The respondents were identified through a multistage maximum heterogeneity sampling strategy. A semi-structured interview guide was developed based on a previous extensive literature review. Written consent was obtained from the hospitals and study participants. Thematic content analysis was applied to analyse the data. Results: The data analysis revealed a rigidity of opinions, inflexibility blocking the acceptance of contrasting perspectives, and perceived superiority over all other professions and over patients. The belief that patients know nothing was common among all participants. Similarly, doctors believed that there is no need to include a professionalism and humanity course in the medical school curriculum. The majority of respondents thought that social science topics are irrelevant to medicine and are common-sense things that they already know. The doctors recognised high professionalism in themselves, while reporting unprofessional behaviour demonstrated by their colleagues. The reported characteristics include using social media applications during duty hours, ridiculing patients, substance use such as cigarettes in the office, referrals of complicated cases to other hospitals, freeing up beds before holidays and inappropriate salaries. Conclusions: It seems that professionalism has declined among young doctors, and this should be immediately addressed by policymakers. The lack of training about ethics and healthcare service delivery, and a lack of performance monitoring and evaluation mechanisms at public hospitals are the major factors contributing to declining professionalism. There is a need to revisit the curriculum taught to medical students in order to strengthen professionalism.