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Students who need disciplining often need it again as doctors

Unprofessional behavior in medical school was a stronger predictor of disciplinary action down the road than measures such as poor grades.

By Damon Adams, amednews staff. Feb. 6, 2006.

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New research supports what some educators and medical board leaders suspected: Medical students who misbehaved became physicians who misbehaved.

In fact, the study found that physicians disciplined by state medical boards were three times more likely to have behaved unprofessionally in medical school than their colleagues.

The national rate of disciplinary action among the approximately 725,000 practicing U.S. physicians is 0.3%, according to the study in the Dec. 22, 2005, New England Journal of Medicine. But students at three medical schools who were irresponsible in areas such as patient care or attendance were about eight times more likely than colleagues to be disciplined after they became practicing physicians.

Among the violations medical boards disciplined these doctors for: drug abuse, unprofessional conduct, negligence and inappropriate prescribing. And most physicians who were disciplined committed multiple violations.

Unless professionalism is stressed more in medical school, the trend is not likely to change, medical leaders said.

"Professionalism should be interwoven into everything. It's not enough to have one lecture on it in the introduction to medical school," said lead study author Maxine Papadakis, MD, professor of clinical medicine at University of California, San Francisco, School of Medicine, and associate dean of student affairs.

Dr. Papadakis and fellow researchers studied 235 graduates of three medical schools who were disciplined by state medical boards between 1990 and 2003. The doctors were compared with 469 classmates who had not been disciplined by boards. The subjects graduated from the University of Michigan Medical School in Ann Arbor, Mich.; Jefferson Medical College of Thomas Jefferson University in Philadelphia and UCSF.