CanMEDS Professional
Getting to Professional

Getting to Professional


Is every medical school graduate a professional? Every resident trainee? Everyone in practice?

What is the process of becoming a professional? 



Sean Hilton[1] postulates that professionalism is developed over time through attainment and attrition.




Hinton[1] considers ’phronesis’ to be practical wisdom, certainly this must be the goal of all seasoned professionals - to act with practical wisdom.

Practical wisdom relates to our personal, or intrinsic, qualities as well as our capacity for ethical practice. These are goals but also the expectations that patients and society hold us to.

The attainment of practical wisdom demands a great deal of reflective capacity, that is the ability to reflect on our actions and understand them and moderate them to remain in line with societal expectations and the standards of ethical practice.  "A mature medical professional is a physician who is reflective and acts ethically”[1] - it is about WHO WE ARE and WHAT WE DO.




In your training what supports your idealism?

What erodes your idealism?


Do you agree with the ideas represented in the chart above?

Why? Why not?


Where and how do you learn your 'practical wisdom'?

How much of a part do role models play in this?


How do you teach / model idealism for the learners you work with?


Compare and contrast this with how you learn about the medical expert aspects of professional practice.


Can idealism be taught, or can we only try to protect it from erosion during training?

What learning opportunities would be helpful to foster idealism?

What barriers can we remove?

What protective factors can we put in place to support idealism?




The process of acquiring this practical wisdom and defending against the negative influences that lead to cynicism take place over a formal education and a career.

Can we know the point at which one can be considered a professional? Or can we act the role before we embody it and express it in all of our actions?


Six Domains of Medical Professionalism

Hinton[1] Proposes Six Domains of Medical Professionalism; 3 of which are personal attributes and 3 are co-operative attributes of professionals:

Personal (intrinsic) attributes of professionals

  1. Ethical practice

  2. Reflection/self awareness

  3. Responsibility/accountability for actions (commitment to excellence/lifelong learning/ critical reasoning)



Co-operative attributes of professionals

  1. Respect for patients

  2. Working with others (teamwork)

  3. Social responsibility


Think of a physician you know and consider to be an outstanding example of professionalism.


Which of the 6 attributes does this person possess?


Give examples of a behaviour or action that exemplifies each attribute.


Of these 6 attributes which do you possess at this point in your training? Which attribute(s) would you like to develop further?


Which of these six domains are taught as part of your medical education or residency training? How do you learn about them? How can you develop these attributes?


1. Sean Hilton S. Medical professionalism: how can we encourage it in our students? The Clinical Teacher 2004;1(2):69-73.

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