Unethical Behaviour Witnessed by Medical Students During Their Medical Studies

Background: We sought to determine students' perception of ethical behaviour of their peers and instructors during their course of studies, both in the preclinical and clinical years. To this end, we administered a questionnaire to senior medical students in order to assess whether they witnessed unethical behaviour during their four-year course of studies. Methods: A two-part questionnaire was distributed to all members of the graduating class of 2007. The first part of the questionnaire asked whether students ever witnessed unethical behaviour; whether it occurred during the preclinical or clinical years of study; whether the unethical behaviour witnessed was performed by a student, resident, senior physician, nurse or other; whether the student reported the unethical behaviour to anyone; and finally, if they discussed the event with their classmates. The second part of the questionnaire was based on one designed and utilized by [3]. Results: Forty of the 56 students responded to the questionnaire. Twenty-one students (52.5%) responded that they witnessed unethical behaviour during their course of studies. Three (14.3%) observed the behaviour during their preclinical years, 10 (47%) in their clinical years of study and 8 (31.8%) during both the preclinical and clinical years. Thus, 11/21 (52.3%) students reported witnessing unethical behaviour during their preclinical training and 18/21 students (85.7%) during their clinical training. The eleven students who witnessed unethical behaviour during their preclinical training reported that six episodes (52.5%) were by students and five (45.4%) by faculty. The eighteen students who reported unethical behaviour during their clinical years reported 2 episodes by students (11%), 4 by residents (22%) and 12 by faculty (67%). The most common unethical behaviour observed was treating patients differently because of their background/race/beliefs (44.4% of episodes), followed by describing patients or their families in a derogatory manner and discussing confidential information in an inappropriate setting (38.8% for both). Conclusions: It is obvious from these findings that many students have the perception that they are witnessing unethical behaviour during their studies. Medical educators must move beyond the formal curriculum in order to reconstruct the overall learning environment of medical education so that students will be exposed to professional behaviour throughout their studies.