Dear Sir,
As a fifth-year medical student in the United Kingdom, I found the article ‘Professionalism in medical practice’ by Ang(1) to be particularly informative. Analysis of unprofessional behaviour is key to novel regulation of professionalism. Uncovering the cause of unprofessional behaviour enables the introduction of preventative and remedial measures.
The article describes several systemic issues in current medical education systems and highlights that the hierarchal structure of medical education causes most errors to be framed as the shortcoming of the individual rather than attempting to uncover and resolve systemic faults.
However, a key limitation of the article is the failure to acknowledge how the organisation of health systems may lead to psychological strain on individuals, resulting in errors in professionalism. A significant example is overworking of medical professionals owing to systemic issues. The literature has demonstrated that overworking of professionals leads to an increase in medical errors.(2,3) One study found that medical professionals were 2.2 times more likely to report an error if they were experiencing burnout.(2) Exploring psychological stress is important when referring to medical professionalism, as it provides an insight into avoidable errors.
Further investigation into the psychological consequences of these systemic issues is necessary for a thorough understanding of the healthcare system and to produce an efficient healthcare system with the correct psychological support required to minimise errors.