The College of Medicine statement on professionalism (2005)
There are several documents that delineate the expectations of society, the profession and the college with respect to the ethics and professionalism of medical doctors. Three such documents are replicated below.
Note that breaches of professionalism that are egregious and/or refractory to correction may, in themselves and at the discretion of the Undergraduate Medical Education Committee, constitute sufficient grounds for removal from the program, regardless of performance in other aspects of the curriculum.
“Not everything that can be measured is important, and not everything that is important can be measured.” (Albert Einstein)
The College of Medicine statement on professionalism (2005)
We, as teachers, learners and educational support personnel of the College of Medicine, University of Saskatchewan have a responsibility to ourselves as individuals, to each other, and to patients and society as a whole, to understand and exhibit the highest standards of personal, interpersonal, and public professionalism.
- As individuals, we commit to demonstrating the personal characteristics necessary for moral function within the medical profession and the university community, and as representatives of these occupations within society as a whole. Such characteristics will include but are not limited to humility, respect for others, and self-care.
- As caregivers, colleagues and coworkers, we will demonstrate professional interpersonal behaviour in all settings, guided by the values of integrity, accountability, and responsibility.
- As medical professionals, learners, and educational support personnel interacting in the public domain, we will strive to fulfill all reasonable health-related societal expectations, demonstrating at all times compassion, reliability, honesty, respect, and an appropriate level of competence. We will seek to promote the public good and understand the principles of good stewardship. We will adhere to the Codes of Ethics of our professions and occupations.
We consider these to be important standards describing the expectations we have of ourselves and of each other, and will treat any significant divergence as a serious threat to the mission and values of the College of Medicine.
The College of Medicine’s Guiding Principles of Professionalism
Respect for others
Professionals demonstrate consideration and respect for others including patients, their families and support persons, colleagues, classmates, teachers, other professionals and the public.
- We don't allow our conduct to negatively impact on others' learning or clinical activities
- We don't discriminate against others on the basis of such grounds as age, race, colour, ancestry, place of origin, ethnicity, political beliefs, religion, marital status, family status, physical or mental disability, sex, sexual orientation or gender identity
- We demonstrate respect for the dignity and rights of patients and their families or support persons, taking into account their diversities, both in their presence and in discussion with other members of the health care team
- We accept and promote patient autonomy in decision--‐making, and when the patient lacks capacity, we consult with and appropriately take direction from surrogate decision--‐makers
- We respect the personal boundaries of others and refrain from making unwanted or inappropriate romantic or sexual overtures towards others
- We communicate respectfully with others both verbally and in writing
- We respect the privacy and confidentiality of those to whom we owe that duty
Honesty and integrity
Professionals demonstrate adherence to the highest standards of personal, professional and academic honesty and integrity.
- We communicate truthfully with others verbally and in writing
- We don't falsify documents or records
- We acknowledge and manage conflicts of interest appropriately, avoiding conflicts of interest, real or apparent, whenever there is potential detriment to others
- We admit and disclose errors
- We make accurate records of conversations, histories, physical findings and other information pertinent to patient care
- We don't engage in plagiarism, nor do we give or receive assistance during an examination or in completion of an assignment unless such is expressly permitted
- We conduct research in an ethical manner, analyzing and reporting results accurately and fairly
- We credit the ideas and work of others appropriately and fairly
Compassion and empathy
Professionals demonstrate compassion and empathy for those in distress and especially for patients, their families and support persons.
- We demonstrate effective listening
- We are aware of and respectful of others' differences and respond appropriately to their needs
- We show compassion and provide support for patients, their families and support persons dealing with illness and/or dying and death
Duty and responsibility
Professionals acknowledge their duties to patients, their profession and society and accept the responsibilities that flow from these duties.
- We attend to patients' best interests and well--‐being as the first priority
- We work cooperatively with others for the benefit of our patients and contribute to a healthy working environment for all
- We make equitable and prudent use of health care resources under our control
- We are responsible to society for matters relating to public health
- We recognize and adhere appropriately to policies, codes, guidelines and laws that govern us and our work
- We participate in the process of self--‐regulation of the profession
- We address misconduct, incompetence or behaviours that put patients or others at risk
- We share resources and expertise, and assume responsibility for our portion of a fairly distributed workload; where issues of fair distribution arise, we act most immediately in the patient's best interests, and seek to resolve issues of fairness through appropriate channels
- We respond in an appropriate, non--‐judgmental and non--‐demeaning manner when our expertise is sought
- We don't take advantage of colleagues, learners, patients, their families or support persons or others for emotional, financial, sexual or other personal purposes, and we conduct research and educational activities with these groups only with appropriate informed consent
- We fulfill commitments, meet deadlines and are punctual particularly where these behaviours have significant impact on others; where we're unable to do so, we communicate appropriately to mitigate any negative impacts
- We engage in lifelong learning, maintain clinical competence and strive for continuous quality improvement
- We take appropriate and necessary responsibility for our personal health and well--‐being
- We recognize our own limitations and seek assistance appropriately
- We display dress, behaviour and demeanor in the educational and healthcare setting in keeping with appropriate pedagogical, clinical or safety standards
Used with Permission Dalhousie University Faculty of Medicine “Dalhousie Medical School Professionalism Committee Professionalism Policy”.The complete College of Medicine Procedures for Concerns with Medical Student Professional Behaviour and related documents can be found at:
Canadian Medical Association Code of Ethics
(Update 2004; reviewed March 2015)
This Code has been prepared by the Canadian Medical Association as an ethical guide for Canadian physicians, including residents, and medical students. Its focus is the core activities of medicine – such as health promotion, advocacy, disease prevention, diagnosis, treatment, rehabilitation, palliation, education and research. It is based on the fundamental principles and values of medical ethics, especially compassion, beneficence, non-maleficence, respect for persons, justice and accountability. The Code, together with CMA policies on specific topics, constitutes a compilation of guidelines that can provide a common ethical framework for Canadian physicians.
Physicians should be aware of the legal and regulatory requirements that govern medical practice in their jurisdictions.
Physicians may experience tension between different ethical principles, between ethical and legal or regulatory requirements, or between their own ethical convictions and the demands of other parties. Training in ethical analysis and decision-making during undergraduate, postgraduate and continuing medical education is recommended for physicians to develop their knowledge, skills and attitudes needed to deal with these conflicts. Consultation with colleagues, regulatory authorities, ethicists, ethics committees or others who have relevant expertise is also recommended
1. Consider first the well-being of the patient.
2. Practise the profession of medicine in a manner that treats the patient with dignity and as a person worthy of respect.
3. Provide for appropriate care for your patient, even when cure is no longer possible, including physical comfort and spiritual and psychosocial support.
4. Consider the well-being of society in matters affecting health.
5. Practise the art and science of medicine competently, with integrity and without impairment.
6. Engage in lifelong learning to maintain and improve your professional knowledge, skills and attitudes.
7. Resist any influence or interference that could undermine your professional integrity.
8. Contribute to the development of the medical profession, whether through clinical practice, research, teaching, administration or advocating on behalf of the profession or the public.
9. Refuse to participate in or support practices that violate basic human rights.
10. Promote and maintain your own health and well-being.
Responsibilities to the Patient
11. Recognize and disclose conflicts of interest that arise in the course of your professional duties and activities, and resolve them in the best interest of patients.
12. Inform your patient when your personal values would influence the recommendation or practice of any medical procedure that the patient needs or wants.
13. Do not exploit patients for personal advantage.
14. Take all reasonable steps to prevent harm to patients; should harm occur, disclose it to the patient.
15. Recognize your limitations and, when indicated, recommend or seek additional opinions and services.
16. In determining professional fees to patients for non-insured services, consider both the nature of the service provided and the ability of the patient to pay, and be prepared to discuss the fee with the patient.
Initiating and Dissolving a Patient-Physician Relationship
17. In providing medical service, do not discriminate against any patient on such grounds as age, gender, marital status, medical condition, national or ethnic origin, physical or mental disability, political affiliation, race, religion, sexual orientation, or socioeconomic status. This does not abrogate the physician’s right to refuse to accept a patient for legitimate reasons.
18. Provide whatever appropriate assistance you can to any person with an urgent need for medical care.
19. Having accepted professional responsibility for a patient, continue to provide services until they are no longer required or wanted; until another suitable physician has assumed responsibility for the patient; or until the patient has been given reasonable notice that you intend to terminate the relationship.
20. Limit treatment of yourself or members of your immediate family to minor or emergency services and only when another physician is not readily available; there should be no fee for such treatment.
Communication, Decision Making and Consent
21. Provide your patients with the information they need to make informed decisions about their medical care, and answer their questions to the best of your ability.
22. Make every reasonable effort to communicate with your patients in such a way that information exchanged is understood.
23. Recommend only those diagnostic and therapeutic services that you consider to be beneficial to your patient or to others. If a service is recommended for the benefit of others, as for example in matters of public health, inform your patient of this fact and proceed only with explicit informed consent or where required by law.
24. Respect the right of a competent patient to accept or reject any medical care recommended.
25. Recognize the need to balance the developing competency of minors and the role of families in medical decision-making. Respect the autonomy of those minors who are authorized to consent to treatment.
26. Respect your patient's reasonable request for a second opinion from a physician of the patient's choice.
27. Ascertain wherever possible and recognize your patient's wishes about the initiation, continuation or cessation of life-sustaining treatment.
28. Respect the intentions of an incompetent patient as they were expressed (e.g., through a valid advance directive or proxy designation) before the patient became incompetent.
29. When the intentions of an incompetent patient are unknown and when no formal mechanism for making treatment decisions is in place, render such treatment as you believe to be in accordance with the patient's values or, if these are unknown, the patient's best interests.
30. Be considerate of the patient's family and significant others and cooperate with them in the patient's interest.
Privacy and Confidentiality
31. Protect the personal health information of your patients.
32. Provide information reasonable in the circumstances to patients about the reasons for the collection, use and disclosure of their personal health information.
33. Be aware of your patient’s rights with respect to the collection, use, disclosure and access to their personal health information; ensure that such information is recorded accurately.
34. Avoid public discussions or comments about patients that could reasonably be seen as revealing confidential or identifying information.
35. Disclose your patients' personal health information to third parties only with their consent, or as provided for by law, such as when the maintenance of confidentiality would result in a significant risk of substantial harm to others or, in the case of incompetent patients, to the patients themselves. In such cases take all reasonable steps to inform the patients that the usual requirements for confidentiality will be breached.
36. When acting on behalf of a third party, take reasonable steps to ensure that the patient understands the nature and extent of your responsibility to the third party.
37. Upon a patient’s request, provide the patient or a third party with a copy of his or her medical record, unless there is a compelling reason to believe that information contained in the record will result in substantial harm to the patient or others.
38. Ensure that any research in which you participate is evaluated both scientifically and ethically and is approved by a research ethics board that meets current standards of practice.
39. Inform the potential research subject, or proxy, about the purpose of the study, its source of funding, the nature and relative probability of harms and benefits, and the nature of your participation including any compensation.
40. Before proceeding with the study, obtain the informed consent of the subject, or proxy, and advise prospective subjects that they have the right to decline or withdraw from the study at any time, without prejudice to their ongoing care.
Responsibilities to Society
41. Recognize that community, society and the environment are important factors in the health of individual patients.
42. Recognize affecting the health or well-being of the community and the need for testimony at judicial proceedings.
43. Recognize the responsibility of physicians to promote equitable access to health care resources.
44. Use health care resources prudently.
45. Recognize a responsibility to give generally held opinions of the profession when interpreting scientific knowledge to the public; when presenting an opinion that is contrary to the generally held opinion of the profession, so indicate.
Responsibilities to the Profession
46. Recognize that the self-regulation of the profession is a privilege and that each physician has a continuing responsibility to merit this privilege and to support its institutions.
47. Be willing to teach and learn from medical students, residents, other colleagues and other health professionals.
48. Avoid impugning the reputation of colleagues for personal motives; however, report to the appropriate authority any unprofessional conduct by colleagues.
49. Be willing to participate in peer review of other physicians and to undergo review by your peers. Enter into associations, contracts and agreements only if you can maintain your professional integrity and safeguard the interests of your patients.
50. Avoid promoting, as a member of the medical profession, any service (except your own) or product for personal gain.
51. Do not keep secret from colleagues the diagnostic or therapeutic agents and procedures that you employ.
52. Collaborate with other physicians and health professionals in the care of patients and the functioning and improvement of health services. Treat your colleagues with dignity and as persons worthy of respect.
Responsibilities to Oneself
53. Seek help from colleagues and appropriately qualified professionals for personal problems that might adversely affect your service to patients, society or the profession.
54. Protect and enhance your own health and well-being by identifying those stress factors in your professional and personal lives that can be managed by developing and practising appropriate coping strategies.
Student Oath of Commitment
(As declared by students during their White Coat Ceremony at the beginning of Year 1)
As I begin my training as a physician at the University of Saskatchewan, College of Medicine I pledge the following:
I promise to earn the trust and respect of my teachers and to return them in kind, for only through mutual trust and respect can we learn the skills required of a physician.
I will adhere to the standards of professionalism as specified by the college, such that my conduct upholds and reflects the high calling of my profession.
I will accept responsibility for those medical duties that I feel prepared for; I will hold back when I am not prepared; and I will seek the experience that I need to prepare myself.
I will strive to preserve the dignity, the humanity and the privacy of all my patients, and through my openness and kindness I will seek to earn their trust in turn.
I will treat my patients and my colleagues as my fellow beings and never discriminate against them for their differences; and I will ask that they do the same for me.
I will value the knowledge, and the wisdom of the physicians who have preceded me; I will add to this legacy what I am able, and I will pass it on to those who come after me.
As my skills and my knowledge grow so too will my awareness of my limitations and my errors; I will strive to recognize and understand my weaknesses;
And I promise never to put an end to my studying and learning that I might improve myself every day of my practice, in all the years to come.
(Modified from the University of Kansas School of Medicine Oath of Commitment.)
(Modified from the University of Kansas School of Medicine Oath of Commitment.)