Today's highlight from the @Acgme IM Milestones 2.0 is about "PROF1 Professional Behavior" and addressing the historical context bias including racial and gender discrimination in professionalism assessment.

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https://acgme.org/Portals/0/PDFs/Milestones/InternalMedicineSupplementalGuide.pdf?ver=2020-12-02-124831-067

#IMMilestones2 #meded #Assessment

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I think Professionalism as a concept is useful because it describes the unique responsibilities we hold as physicians in relationship to our patients. As medical professionals we have a deep responsibility to ensure the lives and wellbeing of the patients we care for.

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However, at times due to power structures, systemic racism, and sexism within medicine, the concept of "professionalism" has been used for harmful effects on the careers of minoritized trainees.

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This came to the forefront when during the course of the the Milestones workgroup writing and revision period we witnessed, as did the nation, the murders of George Floyd, Breonna Taylor as well as the healthcare inequities exacerbated by the COVID-19 pandemic.

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The ongoing advocacy, demonstrations, protests, writings, publications, public discourse of learners and faculty to end discrimination in medical education all had a major impact on the work. So, I'd like to highlight a section from the Supplemental Guide on PROF1.

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My hope is that if there is ever a question or situation regarding professionalism assessment, a learner who has been made a victim of discrimination can point to these official ACGME documents that clearly state what professionalism should *not* be used to assess.

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What matters is that we as a profession define the tenants of what Professionalism *is* and also define specifically what it is *not*.

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"Below are resources that define professionalism and seek to focus it on what key knowledge, skills, and attitudes are required to ensure public trust and promote integrity
within the profession."

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"Note a historical context in which the informal and formal assessment of “professionalism” has extended beyond these ideals to negatively impact the careers of women, people who identify as LGBTQ+, and underrepresented minorities in medicine."

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"Examples of this have included the way in which women, Black or Latinx students and LGBTQ+ learners have been targeted for certain forms of self-expression of racial, ethnic, or gender identity."

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"The assessment of professionalism should seek to be antiracist and eliminate all forms of bias."

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The work of @dereckwpaul @TraumaDocSF @LouiseAronson @DAbdelHameid to name a few are cited here to help inform training programs and establish a Professionalism that seeks to be antiracist.

This work is now in this ACGME Milestone text used by all IM training programs.

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