Assessment and Management of Professionalism Issues in Pathology Residency Training

Professionalism issues are common in residency training and can be very difficult to recognize and manage. Almost one-third of the milestones for pathology recently instituted by the Accreditation Council for Graduate Medical Education encompass aspects of professionalism. Program directors are often unsure of how and when to remediate residents for unprofessional behavior. We used a case-based educational approach in a workshop setting to assist program directors in the management of unprofessional behavior in residents. Eight case scenarios highlighting various aspects of unprofessional behavior by pathology residents were developed and presented in an open workshop forum at the annual pathology program director’s meeting. Prior to the workshop, 2 surveys were conducted: (1) to collect data on program directors’ experience with identifying, assessing, and managing unprofessional behavior in their residents and (2) to get feedback from workshop registrants on how they would manage each of the 8 case scenarios. A wide range of unprofessional behaviors have been observed by pathology program directors. Although 1 Division of Laboratory Medicine, Department of Pathology, Penn State Hershey Medical Center and College of Medicine, Hershey, PA, USA 2 Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA 3 College of American Pathologists, Northfield, IL, USA 4 Department of Pathology, Anschutz Medical Campus, University of Colorado—Denver, Aurora, CO, USA 5 The Joint Pathology Center, Silver Spring, MD, USA 6 Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA, USA 7 Department of Pathology, Vanderbilt University School of Medicine, Nashville, TN, USA 8 Department of Pathology and Cell Biology, Columbia University Medical Center—New York Presbyterian Hospital, New York, NY, USA 9 ProPath Associates, Dallas, TX, USA 10 Department of Pathology, Georgia Regents University, Augusta, GA, USA 11 Department of Pathology, University of South Alabama, Mobile, AL, USA 12 Department of Pathology, Houston Methodist Hospital, Houston, TX, USA Corresponding Author: Ronald E. Domen, MD, Department of Pathology, H160, Penn State Hershey Medical Center and College of Medicine, 500 University Drive, Hershey, PA 17033, USA. Email: [email protected] Academic Pathology July-September 2015: 1-9 a The Author(s) 2015 DOI: 10.1177/2374289515592887 apc.sagepub.com Creative Commons CC-BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm). there is occasionally general agreement on how to manage specific behaviors, there remains wide variation in how to manage many of the presented unprofessional behaviors. Remediation for unprofessional behavior in pathology residents remains a difficult and challenging process. Additional education and research in this area are warranted.