Academic Psychiatry

, Volume 29, Issue 3, pp 301–309 | Cite as

Becoming a Good Doctor: Perceived Need for Ethics Training Focused on Practical and Professional Development Topics

  • Laura W. RobertsEmail author
  • Teddy D. Warner
  • Katherine A. Green Hammond
  • Cynthia M. A. Geppert
  • Thomas Heinrich
Original Article



Ethics training has become a core component of medical student and resident education. Curricula have been developed without the benefit of data regarding the views of physicians-in-training on the need for ethics instruction that focuses on practical issues and professional development topics.


A written survey was sent to all medical students and PGY1-3 residents at the University of New Mexico School of Medicine. The survey consisted of eight demographic questions and 124 content questions in 10 domains. Responses to a set of 24 items related to ethically important dilemmas, which may occur in the training period and subsequent professional practice, are reported. Items were each rated on a 9-point scale addressing the level of educational attention needed compared to the amount currently provided.


Survey respondents included 200 medical students (65% response) and 136 residents (58% response). Trainees, regardless of level of training or clinical discipline, perceived a need for more academic attention directed at practical ethical and professional dilemmas present during training and the practice of medicine. Women expressed a desire for more education directed at both training-based and practice-based ethical dilemmas when compared to men. A simple progression of interest in ethics topics related to level of medical training was not found. Residents in diverse clinical specialties differed in perceived ethics educational needs. Psychiatry residents reported a need for enhanced education directed toward training-stage ethics problems.


This study documents the importance placed on ethics education directed at practical real-world dilemmas and ethically important professional developmental issues by physicians-in-training. Academic medicine may be better able to fulfill its responsibilities in teaching ethics and professionalism and in serving its trainees by paying greater attention to these topics in undergraduate and graduate medical curricula.


Medical Student Academic Psychiatry Ethic Education Psychiatry Resident Training Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Drane JF: Becoming a Good Doctor: The Place of Virtue and Character in Medical Ethics. Kansas City, MO, Sheed & Ward, 1988Google Scholar
  2. 2.
    Wallace AG: Educating tomorrow’s doctors: the thing that really matters is that we care. Acad Med 1997; 72: 253–258PubMedCrossRefGoogle Scholar
  3. 3.
    Inui TS: Flag in the Wind: Educating for Professionalism in Medicine. Association of American Medical Colleges, 2003Google Scholar
  4. 4.
    Feudtner C, Christakis DA: Making the rounds: the ethical development of medical students in the context of clinical rotations. Hastings Cent Rep 1994; 24: 6–12PubMedCrossRefGoogle Scholar
  5. 5.
    Ginsburg S, Regehr G, Lingard L: The disavowed curriculum: understanding student’s reasoning in professionally challenging situations. J Gen Intern Med 2003; 18: 1015–1022PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Bryant JH: Educating tomorrow’s doctors. World Health Forum 1993; 14(3): 217–230; discussion 231–252PubMedGoogle Scholar
  7. 7.
    Farnsworth WE: Training physicians to be doctors-teachers and healers, problem-solvers and decision-makers. J Am Osteopath Assoc 1991; 91: 1005–1018PubMedGoogle Scholar
  8. 8.
    Robins LS, Braddock CH, Fryer-Edwards KA: Using the American Board of Internal Medicine’s “Elements of Professionalism” for undergraduate ethics education. Acad Med 2002; 77: 523–531PubMedCrossRefGoogle Scholar
  9. 9.
    Miles SH, Lane LW, Bickel J, et al: Medical ethics education: coming of age. Acad Med 1989; 64: 705–714PubMedCrossRefGoogle Scholar
  10. 10.
    Culver CM, Clouser KD, Gert B, et al: Basic curricular goals in medical ethics. N Engl J Med 1985; 312: 253–256PubMedCrossRefGoogle Scholar
  11. 11.
    DuBois JM, Burkemper J: Ethics education in US medical schools: a study of syllabi. Acad Med 2002; 77: 432–437PubMedCrossRefGoogle Scholar
  12. 12.
    Christakis DA, Feudtner C: Ethics in a short white coat: the ethical dilemmas that medical students confront. Acad Med 1993; 68: 249–254PubMedCrossRefGoogle Scholar
  13. 13.
    Braunack-Mayer AJ: What makes a problem an ethical problem? an empirical perspective on the nature of ethical problems in general practice. J Med Ethics 2001; 27: 98–103PubMedCrossRefGoogle Scholar
  14. 14.
    Hundert EM, Douglas-Steele D, Bickel J: Context in medical education: the informal ethics curriculum. Med Educ 1996; 30: 353–364PubMedCrossRefGoogle Scholar
  15. 15.
    Hafferty FW, Franks R: The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med 1994; 69: 861–871PubMedCrossRefGoogle Scholar
  16. 16.
    Geppert CM: The last physician? “The parable of the last physician”. Pharos 1997; 60: 15–20PubMedGoogle Scholar
  17. 17.
    Adams D: Generation gripe: young doctors less dedicated, hardworking?, Am Med News. 2004Google Scholar
  18. 18.
    Patenaude J, Niyonsenga T, Fafard D: Changes in the components of moral reasoning during students’ medical education: a pilot study. Med Educ 2003; 37: 822–829PubMedCrossRefGoogle Scholar
  19. 19.
    Roberts LW: Sequential assessment of medical student competence with respect to professional attitudes, values, and ethics. subcommittee on professional attitudes and values, student progress assessment. Acad Med 1997; 72: 428–429PubMedCrossRefGoogle Scholar
  20. 20.
    Accreditation Council for Graduate Medical Education: ACGME Outcome Project: General Competencies. 1999; 2000 (Dec 30, 2000)Google Scholar
  21. 21.
    Lehmann LS, Kasoff WS, Koch P, Federman DD: A survey of medical ethics education at US and Canadian medical schools. Acad Med 2004; 79: 682–689PubMedCrossRefGoogle Scholar
  22. 22.
    Bickel J, Ruffin A: Gender-associated differences in matriculating and graduating medical students. Acad Med 1995; 70: 552–559PubMedCrossRefGoogle Scholar
  23. 23.
    Shapiro J, Miller R: How medical students think about ethical issues. Acad Med 1994; 69: 591–593PubMedCrossRefGoogle Scholar
  24. 24.
    Eldridge JJ, Gluck JP: Gender differences in attitudes toward animal research. Ethics Behav 1996; 6: 239–256PubMedCrossRefGoogle Scholar
  25. 25.
    Moffic HS, Coverdale J, Bayer T: Ethics education for psychiatry. J Clin Ethics 1991; 2: 161–166PubMedGoogle Scholar
  26. 26.
    Nunnally JC, Bernstein IH: Pychometric Theory. New York, McGraw-Hill, 1994Google Scholar
  27. 27.
    Brownell AK, Cote L: Senior residents’ views on the meaning of professionalism and how they learn about it. Acad Med 2001; 76: 734–737PubMedCrossRefGoogle Scholar
  28. 28.
    Roberts L, Teresita. M, Lyketsos C, et al: What and how psychiatry residents at ten training programs wish to learn ethics. Acad Psychiatry 1996; 20: 131–143Google Scholar
  29. 29.
    Hojat M, Gonnella JS, Xu G: Gender comparisons of young physicians’ perceptions of their medical education, professional life, and practice: a follow-up study of Jefferson Medical College graduates. Acad Med 1995; 70: 305–312PubMedCrossRefGoogle Scholar
  30. 30.
    Wertz DC: Is there a “women’s ethic” in genetics: a 37-nation survey of providers. J Am Med Womens Assoc 1997; 52: 3338Google Scholar
  31. 31.
    Diekema DS, Shugerman RP: An ethics curriculum for the pediatric residency program: confronting barriers to implementation. Arch Pediatr Adolesc Med 1997; 151: 609–614PubMedCrossRefGoogle Scholar
  32. 32.
    Leach DC: The ACGME competencies: substance or form? accreditation council for graduate medical education. J Am Coll Surg 2001; 192: 396–398PubMedCrossRefGoogle Scholar

Copyright information

© Academic Psychiatry 2005

Authors and Affiliations

  • Laura W. Roberts
    • 1
    Email author
  • Teddy D. Warner
    • 2
  • Katherine A. Green Hammond
    • 2
  • Cynthia M. A. Geppert
    • 3
  • Thomas Heinrich
    • 1
  1. 1.Department of Psychiatry and Behavioral MedicineMedical College of WisconsinMilwaukeeUSA
  2. 2.Department of Family and Community MedicineUniversity of New Mexico School of MedicineAlbuquerqueUSA
  3. 3.Department of PsychiatryUniversity of New Mexico School of MedicineAlbuquerqueUSA

Personalised recommendations