Journal of Bioethical Inquiry

, Volume 9, Issue 2, pp 135–147 | Cite as

Competing Duties

Medical Educators, Underperforming Students, and Social Accountability
  • Thalia Arawi
  • Philip M. RosoffEmail author
Original Research


Over the last 80 years, a major goal of medical educators has been to improve the quality of applicants to medical school and, hence, the resulting doctors. To do this, academic standards have been progressively strengthened. The Medical College Admission Test (MCAT) in the United States and the undergraduate science grade point average (GPA) have long been correlated with success in medical school, and graduation rates have been close to 100 percent for many years. Recent studies have noted that some doctors having difficulties in practice were found to have had similar problems while in school. In this essay, we present a brief historical account of attitudes and approaches to admissions requirements, then discuss basic broad areas of accomplishment in clinical practice: academic mastery, clinical acumen, and professionalism. We then review data that suggest that lack of competency can often be detected very early in a student’s career and may or may not be immune to remediation efforts. We end with a recommendation for a course of action that upholds and fulfills the profession’s social responsibility. This will be a moral argument, defending an aggressive but equitable approach to maintaining both public accountability and trust.


Medical education Professionalism Professional competency 


Competing Interests

The authors have no competing interests with reference to this manuscript.

Funding Support

No external funding was used for this manuscript.


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© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  1. 1.Salim El-Hoss Bioethics and Professionalism Program, Faculty of MedicineAmerican University of BeirutBeirutLebanon
  2. 2.Trent Center for Bioethics, Humanities and History of Medicine, Departments of Pediatrics and MedicineDuke University Medical CenterDurhamUSA

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