Best Practices for Student Professional Conduct

This document is intended to supplement the UAB Marnix E. Heersink School of Medicine Student Code of Professional Conduct. It is not a substitution for the general ideals and principles outlined in the Code of Professional Conduct. Instead, it is meant to provide a framework with which students, faculty, and staff can think about the practical application of the Code of Professional Conduct. Additionally, this document provides a shared way of talking about the Code of Conduct to foster a sense of communal commitment and understanding. 

The best practices presented in this document are not intended to be comprehensive or necessarily prescriptive. Instead, they serve as a diagnostic tool to facilitate adherence to the Code of Professional Conduct in order that we might maintain the highest standards of excellence, support the healthy development of future physicians, and maintain the primary importance of patient welfare. 

A final note: In the same way patients are best served by members of the healthcare team who seek out others to discuss, learn from, debate with, and look at the patient’s condition from a variety of angles, the same is true when using this document. Issues of conduct, professionalism, and behavior are as complex and diverse as the people they involve, and, except in the most extreme cases, they are multi-layered and often without clear answers. We are all better served when conversations about the ideals and principles in the Code of Conduct — and the elements of this best practices document — are discussed together.

Respect for Ourselves 

We commit to self-evaluation and developing the necessary skills to ensure we are engaged in self-care, particularly in times of increased intensity and stress.

• We will learn how to manage stress and recognize the symptoms of burnout, so that we can mitigate the long-term ramifications to our personal selves and our careers.

• We will develop the skills we need to engage in-the-moment wellness that will help us stay engaged in medical education and training.

We embrace asking for help and seeking out resources to assist us in maintaining our mental, physical, and emotional health and well-being. 

• We will normalize help-seeking behaviors and take advantage of the resources available to us as students. 

• We will be open to talking about the things going on in our lives, with classmates, faculty, and staff, and listening to others when they need to talk. 

We will approach all situations of patient care, whether educational simulations or clinical settings, with clear minds so that our focus can be on learning and providing the best possible care.

•  We will recognize that our personal lives could affect our abilities to care for patients in the most effective way or engage in learning. This means, at times, we will choose to prioritize education and patient care.

  • This might include: refraining from over consuming alcohol during clinical times; refraining completely from use of non-prescribed stimulants; using prescribed stimulants in the proper manner and dosage; to the extent possible, getting adequate sleep during times of patient care. 

Respect for our Classmates 

Maintaining respect and dignity for our fellow students, whether in-person or online. 

• We understand that others do not necessarily share our personal experiences and beliefs, and we recognize the validity and importance bringing a variety of voices into conversations. 

• We will not tolerate discrimination in any forms. This includes, but not limited to cultural, religious, personal beliefs; gender; sexual orientation and identity; disability; race and ethnicity; and age.

• We will speak up against discrimination, in any form. 

• We will purposefully strive to interact with classmates who are different from ourselves.

• We will refrain from using social media as an outlet to express our opinions and feelings about our classmates and colleagues.

• We understand that social networks are public domain and that comments made in these forums regarding other students can have personal and professional ramifications.

Respect our classmates’ learning experience.

• We will demonstrate respect for our classmates and instructors by being punctual and prepared for activities. 

• We will engage in group work, ensuring that all are contributing appropriately. 

• We will be aware of how our actions may affect others in group. 

  • Sometimes this might mean taking a step back, so that others may equally share roles in team activities.

Foster a collaborative environment and community that builds each other up.

• We will support our classmates through sharing appropriate learning resources that have been helpful to us.

• We will strive to support rather than impede others. We are all one team!

  • Unhealthy competitive behaviors and actions only negatively influence everyone’s experience in medical school.

• We will be aware that other stressors may compound the stress of medical education and training. 

• If we notice a classmate is struggling, we will offer to help as much as we are able, including guiding them to the appropriate resources.

• We will strive to assist classmates in maintaining a positive image in all social and public environments.

• We will be aware that our actions as a representative of the school may affect how our peers are viewed. 

  • We will maintain our professional identity for the sake of our classmates and ourselves. 

Respect for our Educators and School 

We recognize that being a student of the Heersink School of Medicine means we are part of an organization larger than ourselves with a history, reputation, and impact that extends beyond our time as students. 

• We will strive to set positive examples for students in classes below our own, and for students who will enter medical school after us.  

• We recognize that, as ambassadors of the school, we determine how others view our institution in the present and years to come.

• We will take the initiative to reach out and be transparent when seeking clarification or advice.

• We will choose to be kind during in-person interactions and correspondence.

We accept that being part of a large, multi-faceted organization means there are rules, policies, and procedures we adhere to, even if the reasons seem unclear. 

• We will be open to communicating our thoughts and concerns so that anything unclear can be clarified. 

We embrace the work of seeking the best for our school, and we commit ourselves to seek clarification, challenge ideas and current thinking, provide feedback, and ask questions in ways that are professional and constructive. 

• We will always strive for positive improvements at our institution.

• After communicating a grievance, we will allow a reasonable amount of time (48 hours) for a response, before reaching out again.

  • When we are dissatisfied or have a complaint, we will criticize the action and not the person, whether an instructor or classmate. Refrain from using inflammatory language and making assumptions about their interactions. 
  • When possible, offer solutions.
  • Follow professional guidelines for submitting a complaint or concern.
  • When in doubt, seek a third party to proofread correspondence.

We accept that we are both represented by and representatives of the Heersink School of Medicine, and that external individuals and groups may base their judgements and perceptions of the School on their interactions and perceptions of us. 

• We will be mindful that our in-person and social media presence reflects on ourselves, but also the school of medicine, as a whole.

• We will conduct ourselves online the same as we do in person.

• We will be respectful and mindful of others, on and off campus.

We welcome the tension that comes with navigating personal autonomy while knowing our decisions and actions may reflect on our classmates, faculty, and administration. 

• As ambassadors of the School, our actions can reflect back on the school in positive and negative ways.

• We will exercise professional judgement in our words, whether spoken aloud or posted online.

  • Recognize that while our thoughts and opinions are valid, they may not reflect the views of the entire class.

  • In all public statements, acknowledge that opinions are our own and do not necessarily reflect those of the students, faculty, staff, and administration of the Heersink School of Medicine, nor the University of Alabama at Birmingham. 

• Before posting criticisms of the School of Medicine or calls for change/action online, we will seek guidance from appropriate faculty, staff, or classmates about how and when to express frustration.

We acknowledge that the faculty, staff, and administration are professionals here to help us reach our goals, and we will keep this partnership and professional relationship in focus, particularly when we have disagreements or are providing feedback.

• We seek to always provide feedback in a way that is constructive and direct. 

  • Use professional and non-accusatory language when providing feedback.

• We will be clear and considerate when communicating with others

• When there is a disagreement, we will attempt to remain open-minded of others’ opinions to promote a thoughtful discussion that will reach a positive solution.

• Where there are disagreements and we are uncomfortable with speaking with someone, we will find an appropriate third party to help facilitate the discussion.

Respect for our Patients 

We recognize the centrality of the physician-patient relationship, which forms the basis for effective care and treatment.

• We will not seek to build relationships with patients outside of the appropriate student/doctor-patient context.

• We will allow the patient’s best interest to guide all our decision making and communication.

• We realize that it is our responsibility to communicate clearly for the purpose of patient education and compliance. When we are not satisfied with the level of patient understanding, we will respectfully find the best communication strategy to achieve our goal for the care of the patient.

• When presented with the opportunity to reflect on our own preconceived notions, we will remain mindful that each of us has biases (unconscious or conscious) and will dedicate time to addressing such issues.

We will model the highest levels of professional behavior during patient encounters, whether simulated or real. We will show respect for our patients with all modes of action and behavior. For example:

• We will speak respectfully to our patients.

• We will communicate to others about patients with the highest level of respect.

• We will use best practices for facilitating rapport and trust, including body language cues.

• We will adhere to the standards of dress laid out by the Heersink School of Medicine, as well as those from the clinical settings in which we work.

We will adhere to the legal standards of privacy (regard for the privacy of the person) and confidentiality (protection of their health-related information) as we learn the nuances and complexities of patient confidentiality in real-world situations and cases.

• We will adhere to HIPAA and all relevant state and federal policies pertaining to patient privacy.

• As applicable to our clinical training, we will adhere to the policies of the various hospitals in Birmingham, on the regional campuses, and clinical facilities in which we are working. 

• We will maintain respect of our patients’ privacy in the exam room, hallway, and outside of the encounter.

We embrace both the unique tensions of a changing world with new technologies and recognize the timeless responsibility physicians have to guard patient information.

• We will not divulge patient information, including photographs, on any form of social media, unregulated electronic communication, or other digital platform without the written legal consent of the patient or representative.

Respect for our patients is vital for their health outcomes and instrumental for developing an appropriate patient-doctor relationship. Establishing and maintaining respect should be a priority throughout each of our encounters in medical school, setting a firm foundation for our careers. 

• We acknowledge the potential harms of preconceived notions about our patients before and throughout our interactions, remaining mindful that they could undermine the physician-patient relationship.

• We acknowledge our lived experiences might be different from those of our patients. We will refrain from judgment about their words, actions, or beliefs that might detract from the quality of care we provide.

Understand that the time we spend with each patient is essential for providing the best care and both the patient and providers are using valuable time to be present. Both the patient and the student are committing their time to any encounter, and both time commitments are equally worthy of respect. We acknowledge that no time spent caring for patients is wasted.

• We will seek assistance from supervisors when in need of help to provide best care.

• We acknowledge the responsibility to be transparent about any lack of skill or knowledge that could potentially harm a patient. 

• We seek to learn and grow as physicians, and we recognize that it is at times crucial to seek external guidance and information to that end.

Respect for Profession

Maintain a professional presentation within the institution and beyond.

• We will use professional language when interacting with patients, peers, and other members of the health care team.

• We will maintain a professional appearance, in accordance with the stated dress code, for all clinical interactions.

• We will show respect for educational settings and the learning environment as a professional learner.

• We will maintain a professional online presence, recognizing our role as a representative of our School and our profession.

Continuously strive to improve the field of medicine and healthcare for all

• We will demonstrate commitment to curiosity, self-improvement, and lifelong learning. 

• We will work to maintain an updated clinical and scientific knowledge base.

• We will work to advance knowledge by asking questions of unsolved problems.

• We embrace our role as a teacher through sharing knowledge with patients , classmates, and colleagues.

Recognize the “opportunity, responsibility, and obligation” of the practice of medicine

• We will recognize our limitations, and will ask for help when needed

• We will express interest and engagement towards our roles and responsibilities

• We will respond with tact, empathy, and understanding when caring for patients and interacting with classmates and colleagues.

• We understand the unique pressures and sacrifice required of our profession that at times may require prioritizing patient care over personal preferences.

• We will prioritize mutual respect and productive conversation when differences of opinion occur.

Best Practices for Addressing Acts of Misconduct

The complete process and procedures for addressing acts of misconduct can be found in the Student Code of Professional Conduct. While some of the below information is duplicated from the Code of Conduct document, the purpose of this section is to provide some operational and theoretical best practices for how these processes will be followed in the event of a reported act of misconduct. 

• The Heersink School of Medicine will conduct a thorough investigation of any reported violation of the Student Code of Professional Conduct.

• The following questions will direct the investigation.1

  • Act: Was there a potential violation?

  • Knowledge: Did the student know, or should a reasonable student have known that the Act was a violation?

  • Significance: Would tolerating the Act damage the honesty and integrity of our profession or community?
    1Adapted from the University at Buffalo Jacobs School of Medicine and Biomedical Sciences https://medicine.buffalo.edu/orientation/checklist/code-professional-conduct.html 

• The goal of addressing violations of the Student Code of Professional Conduct will always be the personal and professional growth of the individual(s) involved. However, there may be instances when the behavior is egregious and considered a violation of these standards.  As a result, a student may be sanctioned or dismissed.

Best Practices for Student Engagement with the Code of Professional Conduct

• Students are introduced to the school’s Code of Professional Conduct and best practices, expectations for learner, faculty, and support staff professional behavior, and mechanisms available for reporting unprofessional behavior including mistreatment at the beginning of medical school. This statement, policies, expectations for professional behavior and the reporting mechanisms are covered in detail again prior to the start of clinical coursework during orientation to the clerkships. 

• Students attest to reviewing the Code of Professional Conduct and best practices document during the mandatory annual student credentialing process.  Students are reminded of reporting mechanisms during orientation to each preclinical and clinical course, on the School of Medicine’s websites, and through digital signage in Volker Hall.