UAMS College of Medicine Professionalism Guidelines

Download these guidelines Updated October 2023 (PDF)

I.     Purpose

This Professionalism Guideline serves to document the expectations we collectively hold for ourselves in our interactions with patients, colleagues, health professionals, students (all medical and graduate students), house staff/trainees (including medical residents, medical fellows, post-doctoral fellows), staff, and the public. 

II.   Our Culture

The UAMS College of Medicine strives to achieve an environment of collegiality by demonstrating the utmost respect for one another, free from disruptive, threatening, and violent behavior. We will not accept inappropriate, unprofessional, or intimidating behavior within the workplace and learning environment. All persons, including patients, visitors, staff, all students, medical residents/fellows and post-doctoral fellows, and faculty are treated with courtesy, and dignity. All faculty members, house staff members, post-doctoral fellows and all students who practice at or in affiliation with UAMS conduct themselves in a professional, collaborative, and cooperative manner consistent with the UAMS Employee Handbook, the Medical Staff Bylaws of the affiliated institutions, the UAMS House staff Handbook, College of Medicine Student Handbook, UAMS Human Resources policies, other applicable UAMS policies and procedures, and the University of Arkansas Board of Trustees policies and any applicable University wide Administrative Memoranda. 

III.  Our Practices

Our culture is supported by the pursuit of ethical virtues and professional ideals.  [See the Appendix for specific examples]

A. Ethical Virtues

1. Responsibility for Patient Care
2. Integrity in Research
3. Respect for People 
4. Respect for Patient Confidentiality
5. Honesty, Integrity
6. Awareness of Limitations, Professional Growth, and the need for Life-long Learning
7. Deportment as a Professional
8. Avoiding Conflicts of Interest 
9. Responsibility for Peer Behavior
10. Respect for Personal Ethics
11. Respect for Property and Laws
12. Commitment to a Diverse, Equitable, and Inclusive work environment

B. Professional Ideals

1. Clinical and Scientific Virtues
2. Conscientiousness and Dedication to Duty
3. Collegiality
4. Personal Health
5. Objectivity
6. Responsibility to Society

IV.  Guideline for Honoring Exemplary Professional Behavior

For Faculty, House staff, Post-Doctoral Fellows, and Students:

Directly commend the individual whose exemplary professionalism you observed. 

For Faculty House staff, and Post-Doctoral Fellows:

Share your observations with the individual’s supervisor verbally and/or in writing.  Should you choose to write a letter about your observations, consider sharing it with the individual’s Department Chair and the Dean. You may choose to use the UAMS Recognition Toolkit that can be found under Staff Service Recognition – Employee Recognition Toolkit on these UAMS webpages: (https://hr.uams.edu/managers-toolkit/recognize/ https://inside.uams.edu/recognition-toolkit/).

For Medical Students:

Complete a Student Professionalism Assessment Form and indicate outstanding performance in the appropriate category.

V.   Guideline for Action When Lapses in Professionalism Occur

When any member of the UAMS community believes that s/he has witnessed or was the recipient of behavior manifest by a COM faculty member, house staff member, post-doctoral fellow, any student, or staff member that is inconsistent with our professional culture and practices, the following options serve as a mechanism for action.

• If possible, it is desirable to discuss the incident with the offending individual who may be unaware of how s/he is perceived or is impacting others (unless you feel that this conversation may result in personal harm and/or retribution).
• If the issue cannot be satisfactorily resolved by direct communication, take two subsequent steps:
  • Report the incident up the chain of command to one or more of the following individuals depending on the specific circumstances:
    • The direct faculty supervisor
    • The appropriate Residency Program Director or Laboratory Director
    • The appropriate Divisional Chief of Service
    • The Chair of the Department(s) involved
    • The appropriate Associate Dean of the College of Medicine
    • The Dean of the College of Medicine

• Enter a report into the confidential reporting system:  i-Safe, found on the UAMS Intranet.  Reports made to i-Safe are reviewed by the Employee Relations Specialists in the Office of Human Resources and the Assistant and/or Associate Dean for Faculty Affairs, as appropriate.  Medical Students may also report unprofessional behavior using the College of Medicine O2 online system; reports to this system go to the Associate Dean for Student Affairs and then the appropriate supervisor(s).
• Individuals’ concerns need to be taken seriously and addressed appropriately.  The UAMS College of Medicine faculty will not tolerate retaliation. <Title VII of the Civil Rights Acts of 1964, 42 U.S.C. 2000e, and the Arkansas Whistleblowers Act, Ark. Code Ann.s.16-123-108>
• If the observer or the recipient of the unprofessional behavior is unsure of the appropriate chain of command, s/he can confidentially consult any of the individuals noted in the list above, as well as the UAMS College of Medicine Wellness Program Director, and the UAMS Employee Assistance Program for guidance as to how s/he should proceed.
• Imminent danger – Immediately report to UAMS Police any actions which appear to pose an immediate threat of harm to any individual to safeguard the health and safety of others. 501-686-7777.
• Sexual harassment represents a serious lapse of professional behavior that, by UAMS policy, must be reported to the Office of Human Resources (Employee Relations Manager, 501-686-5650).  When any UAMS employee receives a report of sexual harassment, he or she must immediately notify their supervisor or Department Head who, in turn, must notify the Office of Human Resources prior to taking any action to investigate or resolve the matter informally and must act only on direction from the Office of Human Resources.  Employees who need to report an incident of sexual harassment after regular business hours should report the incident to the UAMS Police Department if the employee’s supervisor is unavailable or other administrative offices are closed. The UAMS Police Department will take appropriate action and will notify the Office of Human Resources at the beginning of the next business day.  
• COM residents and students can also seek help from an ombudsperson (ombuds), The ombuds functions independently of the COM faculty and administration and is not aligned with any department. Interactions with the ombuds are informal and confidential; information will not be shared without the student’s permission, the only exception being when the ombuds believes there is an imminent risk of physical harm to self or others, or as required by policy, law, or court order. Conversations with the ombuds will not automatically start a chain of activities that yield formal complaints, but if the student wishes to pursue a formal process, the ombuds can assist with identifying appropriate channels and resources within UAMS.

VI. Corrective / Disciplinary Actions

It is the intent of the UAMS COM community to support the remediation of Faculty, House staff, Post-Doctoral Fellows and Medical Students who have significantly breached this guideline. 

For Faculty, House staff and Post-Doctoral Fellows:

Performance improvement counseling or corrective action will be initiated depending on the specific facts and circumstances.  Significant violation(s) or repeated patterns of disruptive behavior may result in serious action, up to and including termination. A single egregious instance of disruptive behavior may warrant disciplinary or corrective action, including termination, in accordance with appropriate University of Arkansas Board of Trustees policies.

For Medical Students:

Corrective action will be taken according to the academic standards and policies in the COM Student Handbook.  Significant violation(s) or repeated patterns of unprofessional behavior may result in serious action, up to and including dismissal. A single egregious instance may warrant corrective action, including dismissal.  

VII.  Some Useful Web References

• U of A Board of Trustees Policies
  Academic Affairs Policies
  UAMS Administrative Guide/Compliance 360
  • Policies and Procedures
  • UAMS Code of Conduct
  • Drug-Free Workplace
  • Drug Testing
  • For Cause Drug Testing Policy
  • Sex/Gender Based Non-Discrimination Policy
  • Employee Disciplinary Notice
• College of Medicine Student Handbook
• UAMS House staff Handbook
• Appropriate Treatment of Residents/Fellows
• UAMS Employee Handbook
• UAMS Medical Staff Bylaws

Appendix

Applicable to all Faculty (and specific groups as designated)

A. Ethical Virtues 

1. For Faculty, House staff, and Student Clinicians

• a. Responsibility for Patient Care
  • Maintain the best interest of the patient as the foremost concern.
  • When you are off duty, or on vacation, be sure that your patients are adequately cared for by another practitioner.
  • Obtain the patient’s informed consent for diagnostic procedures, therapies, and all treatments, including surgical procedures. *
  • Follow up on ordered laboratory tests. *
  • Complete patient record documentation promptly and conscientiously.
  • Coordinate with your team the timing of information sharing with patients and their families to present a coherent and consistent treatment plan.
  • Maintain collegial relationships among physicians who are jointly involved in the care of a particular patient. Communicate directly with each other when issues, questions or concerns arise.
  • Charge patients or their insurers fairly and appropriately. *
  • Do not abuse alcohol or drugs that could diminish the quality of patient care or academic performance.
  • Do not allow to develop or engage in romantic or sexual relationships with patients. If such a relationship seems to be developing, seek guidance and remove yourself from the situation.
  • Be mindful of your personal reactions to patients and colleagues. Seek guidance if you feel your reactions could be impairing your patient care or your professional demeanor and judgment.
  • Do not abandon a patient. Once you assume care of a patient, your responsibility continues until the problem has resolved or you are assured that your patient is under the care of another physician.  
  • Do not withhold urgently needed treatment to a patient because of inability to pay.

*Medical students are not licensed to practice, nor can they charge patients. They are expected to participate in patient care under supervision of a faculty physician.

2. Integrity in Research 

• a. For All Faculty, House staff, Post-Doctoral Fellows, and Medical Students 
  • Adhere to the highest scientific and ethical standards when engaged in research.
  • Adhere to and promote the principles of integrity, accountability, independence/impartiality, respect for persons and communities
  • Adhere to institutional, state, and federal regulations that govern research 
  • Do not engage in research that knowingly and unnecessarily jeopardizes the health, safety, or longevity of human subjects and/or animal subjects.
  • Ensure good data management, including the planning, generation, documentation, analysis, use, storage, and appropriate destruction of data
  • Register clinical trials with clinicaltrials.gov
  • Ensure the research team has the necessary skills, training, resources, and support to carry out the proposed research
  • Anticipate issues that may arise as a result of working collaboratively and decide in advance how such issues will be addressed, including in the contract and/or protocol and communicating the outcome to the members of the research team
  • When publishing and presenting reports, give proper credit and responsibility to colleagues and others who participated in the conduct and/or initiation of the research.
  • Ensure an accurate and complete statement of authorship regarding reports and publications of research and its outcomes. Co-authorship should be assigned to individuals who meaningfully contribute to the project and should satisfy the criteria for authorship recommended by the International Committee of Medical Journal Editors (ICMJE)
  • Ensure the timely and public dissemination of the research and its main outcomes (subject to the protection of confidential information and proprietary rights).
  • Facilitate the publication of research and its main outcomes without inappropriate influence on the publications from funders or other interested parties.
  • Report research results accurately and honestly in scientific and scholarly presentations and publications and to the press.
  • Maintain and make available research documentation for scientific, ethical, and regulatory review as well as for peer review and publications review procedures.
  • Ensure the proper security of confidential data, as well as the appropriate access to non-confidential data by interested parties and the public.
  • Complete a Conflict-of-Interest Disclosure Statement (Disclosure) annually and within thirty (30) days of acquiring a new significant interest.  You may access the COI Disclosure Statement at http://muse2.uams.edu/ .  *
  • Follow any management plan(s) that have been implemented to mitigate the conflict of interest. *
  • Disclose funding sources, company ownership, and other real or potential conflicts of interest in written and spoken research presentations and in educational presentations.
  • Do not engage in intentional, fraudulent, or grossly negligent behavior, including but not limited to inappropriate development of research protocols; inadequate management of a research project; fabrication, falsification, plagiarism, deliberate misrepresentation, or other practices that deviate from the academic and scientific communities’ commonly accepted norms. Ensure that action is taken when there is evidence for severe non-adherence to standards, wrongdoing, or poor practice* Medical students are not required to complete COI disclosure statements

3. Respect for People

• a.   For All Faculty, House staff, Post-Doctoral Fellows, and Medical Students
  • Treat patients, patients’ family members, colleagues, health professionals, staff, students, and teachers with respect. 
  • Do not use offensive or derogatory language, either verbally or in writing when referring to patients or their illnesses.
  • Do not harass others physically, verbally, psychologically, or sexually. Do not yell and do not throw objects.
  • Do not discriminate based on sex, religion, race, national origin, disability, age, or sexual orientation.
  • Be mindful of your interactions with students, trainees, and colleagues. Recall that close relationships that span any kind of power hierarchy, especially in a shared work environment, carry risks for both parties. Seek guidance if you feel your reactions could be impairing your professional demeanor or judgment.  
  • Do not use your authority to damage or hinder a subordinate’s position, career, or personal development.
• b.  Specific to Faculty, House staff, and Student Clinicians
  • Treat patients with kindness, gentleness, dignity, compassion, and honesty.
  • Respect the privacy, modesty, and belief systems of each of your patients.

4. Respect for Patient Confidentiality

• a. For All Faculty, House staff, Post-Doctoral Fellows, and Medical Students
  • Only share the medical or personal details of a patient’s history, diagnostic or therapeutic regimen, or prognosis with those health care professionals integral to the well-being of the patient or within the context of an educational endeavor, at which time the patient’s identity must not be disclosed.
  • Only reveal confidential information about a patient to their family members after obtaining specific permission to do so (except in the case of a medical emergency when the patient is not conscious and incapable of giving consent).
  • Do not discuss patients or their illnesses in public places where the conversation may be overheard.
  • Do not publicly identify individual patients, in words or in writing, without adequate justification and the patients’ authorization.
  • Do not invite or permit unauthorized persons into patient care areas of the institution.
  • Do not share your confidential electronic passwords.
  • Do not seek confidential data on patients without a professional need to know.
  • Do not photograph or videotape a patient without their written authorization.

5. Honesty, Integrity

• a. For All Faculty, House staff, Post-Doctoral Fellows, and Medical Students
  • Be truthful in all verbal and written communications.
  • Acknowledge your errors of omission and commission to colleagues and patients.
  • Be aware of how personal, institutional, or financial considerations may influence clinical decision-making.
  • Do not knowingly mislead others.
  • Do not cheat, plagiarize, or otherwise act dishonestly.
  • Do not abuse privileges, e.g., inappropriate expenses being charged to the medical school, laboratories, or the hospital.

6. Awareness of Limitations, Professional Growth, and the need for Life-long Learning

• a. For All Faculty, House staff, Post-Doctoral Fellows, and Medical Students
  • Be aware of your personal limitations and deficiencies in knowledge and abilities.
  • Know when and from whom to ask for supervision, assistance, or consultation.
  • Promptly countersign the work of trainees after providing appropriate supervision.
  • Do not engage in unsupervised involvement in areas or situations where you are not adequately trained.
  • Give appropriate credit and authorship for trainee and collaborator contributions.
• b. Specific for Clinicians
  • Be aware of your own physical and emotional limitations.  Taking care of and addressing your own personal health and wellness is paramount for you to adequately be present to care for others in need.  Also consider your limitations if you are ill, distraught, or overcome with personal problems.

7. Deportment as a Professional

• a. For All Faculty, House staff, Post-Doctoral Fellows, and Medical Students
  • Clearly identify yourself and your professional level to patients and staff. Wear your name tag when in patient areas.
  • Dress in a neat, clean, professionally appropriate manner.
  • Maintain a professional composure despite the stresses of fatigue, professional pressures, or personal problems.
  • Do not make disparaging remarks about other health care professionals to patients, patients’ family members, residents, post-doctoral fellows, students, or staff members.

• b. Specifically for Clinicians
  • Do not introduce medical students as “Doctor”; if a medical student, introduce yourself as such.
  • Do not write offensive or judgmental comments of any kind in patients’ charts.
  • Do not criticize the medical decisions of colleagues in the presence of patients or in inappropriate places, e.g., in areas where patients or families can overhear.
  • Refer to patients by the name with which they are most comfortable. Be sure to ask them.
  • Ensure that learners feel safe working in your environment by appropriately orienting them to the team and culture in which you are working. 
  • Create expectations of your team that student mistreatment of any kind will not be tolerated. Ignoring a learner or excluding them from learning opportunities counts as mistreatment.  Derogatory comments about a learner will not be tolerated.

8. Avoiding Conflicts of Interest 

(See Conflict of Interest and UAMS Gift Policies  https://coi.uams.edu/policies/)

• a. For All Faculty, House staff and Medical Students
  • Maintain the best interests of the patient when making all clinical decisions.
  • Do not accept gifts from drug companies or medical equipment vendors or suppliers.
  • Do not participate in individual incentive programs sponsored by pharmaceutical or medical equipment companies.
  • Do not refer patients to laboratories or other agencies in which you have a direct personal financial stake.
  • It is a professional obligation to avoid real or perceived bias in all the educational and professional advice you offer.  Therefore, if you serve as a consultant for a commercial entity or within a “speakers’ bureau” for pharmaceutical or device manufacturing company, make full disclosure of those relationships to any audiences you teach, any committees on which you serve, and any patients whose care could be influenced by those relationships.  
  • Avoid direct employment of family members.  (See UA Board Policy on Nepotism 410.1 )

• b.   Specifically for Clinicians
  • Maintain the best interests of the patient when making all clinical decisions.
  • Do not accept a kickback for any patient referral or non-referral.

• c.   Specifically for Basic and Clinical Scientists
  • Do not participate in grant, manuscript, or professional review procedures of anyone with whom you are collaborating, have worked with, or may have a conflict with, for any reason. Be mindful that the perception of conflict is conflict.

9. Responsibility for Peer Behavior

• a.   For All Faculty, House staff, Post-Doctoral Fellows, and Medical Students
  • Take the initiative to reach out to students, trainees, physicians, nurses, and other employees who appear to be having difficulty or seem impaired, to offer support and if indicated, link them with resources made available by UAMS.
  • Report serious breaches of professionalism consistent with this guideline. 

10. Respect for Personal Ethics

• a.  For Clinical Faculty, House staff, and Medical Students
  • You are not required to perform procedures (e.g., elective termination of pregnancy, termination of medical treatment) that you personally believe are unethical, illegal or may be detrimental to patients.  In the event of conflict between the patient’s needs and your conviction – in a non-emergent situation – show respect for the patient and request the prompt help of your supervisor or another competent practitioner willing to care for the patient.  
  • In any life-threatening emergency, physicians are obligated to provide the patient with emergency care.  Physicians should take care to respect any patient wishes or any advanced directives that provide guidance is such cases. There may be times where the patient’s capacity to make decisions comes into question in these instances, a consultation with Psychiatry Consultation Team or the Medical Humanities and Ethics team should be considered.

11. Respect for Property and Laws

• a.   For All Faculty, House staff, Post-Doctoral Fellows, and Medical Students
  • Adhere to the regulations and policies of UAMS and its affiliated institutions.
  • Adhere to all applicable local, state, and federal laws and regulations.
  • Do not misappropriate, destroy, damage or misuse property of UAMS or its affiliated institutions.

12. Commitment to a Diverse, Equitable, and Inclusive work environment

• a. For All Faculty, House staff, Post-Doctoral Fellows, and Medical Students
  • Actively reinforce a work environment that supports diversity, equity, and inclusion for all.
  • Faculty play an essential role in creating a culture of inclusion and addressing challenges that arise in the clinical setting, assuring that hostile environments involving patients or other team members toward our learners will not be tolerated. For anyone who needs assistance in addressing issues that affect the culture for diversity, equity, and inclusion, please contact the office Dr. Brian Gittens, Vice Chancellor for DEI at UAMS. 

B. Professional Ideals

1. Clinical Virtues

• a.   For All Faculty, House staff, and Medical Students
  • Attempt to cultivate and practice accepted clinical virtues, such as caring, empathy, compassion, fortitude, justice, integrity, and humility.

2. Conscientiousness

• a.   For All Faculty, House staff, Post-Doctoral Fellows, and Medical Students
  • Fulfill your responsibilities thoroughly.
  • Work with your responsible supervisor to improve the system if something interferes with your ability to perform clinical or research related tasks effectively.
  • Learn from experience, recognizing errors to avoid repeating them.
  • Dedicate yourself to lifelong learning and self-improvement. Clinicians should invest in a personal program of continuing education and continuous quality improvement.

3. Collegiality

• a.   For All Faculty, House staff, Post-Doctoral Fellows, and Medical Students
  • Be willing to teach others at all levels of education and training.
  • Thoughtfully answer questions from trainees and colleagues to the best of your ability without belittling or humiliating them. 
  • Contribute to vital UAMS administrative functions and committees.
  • Use communal resources (equipment, supplies, and funds) responsibly and equitably.
  • Promote a work environment that fosters diversity, ensuring equity and inclusion.

• b.   For Clinicians
  • Cooperate with other members of the health care team in clinical activities and with other members of the research team in research activities.
• c.   For Basic and Clinical Scientists
  • Cooperate, whenever possible and to a reasonable degree, with other members of the UAMS research community when called upon for advice or consultation concerning their research activities.
  • Share resources (reagents, equipment), wherever possible, with other researchers.  

4. Personal Health

• a.   For All Faculty, House staff, Pos-Doctoral Fellows, and Medical Students
  • Honor your own health and well-being remaining physically, mentally, and emotionally fit to optimize your professional performance.

5. Objectivity

• a.   For Clinicians
  • Avoid providing substantial professional care to members of your family or to any person with whom you have a romantic relationship.

6. Responsibility to Society

• a.   For all Faculty, House staff, Post-Doctoral Fellows, and Medical Students
  • Provide responsible advice to policy makers on social and public health issues to which accurate medical knowledge is vital.
• b.   For Clinicians
  • Avoid unnecessary patient or societal health care expenditures.
• c.   For Basic and Clinical Scientists and Post-Doctoral Fellows
  • Disseminate research results in the appropriate venues in an accurate and timely manner. 

Initial Approval by the COM Faculty: December 9, 2008
Revisions approved by the COM Executive Committee:   June 19, 2012;  July 21, 2022; October 30, 2023