Classification of Professionalism Concerns

The FoMD's Office of Professionalism has set a classification of professionalism concerns, modified with permission from J. Bolton, Office of Professionalism, University of Mexico.

  1. Misunderstanding/miscommunication
    • When the incident is reviewed, a misunderstanding and/or miscommunication on the part of the person who filed the professionalism concern is likely.
    • Insight is demonstrated by the person named in the report.
  2. "Oops"
    • The individual knows the rules, and does generally follow them. On a rare occasion, he or she has a lapse and does not meet role expectations.
    • Insight is demonstrated, the person recognizes their error and professionalism, perceived lapse or perceived interpretation of their demonstrated behaviour, and is remorseful.
  3. "Can't"
    • The individual can't fulfill role expectations because the individual does not know the rules of the role, or may not have the skills to enact them.
    • There may or may not be insight.
    • The person is new to the culture, or does not understand the rules of the workplace. Therefore, the filed concern may be due to the person's lack of knowledge of workplace rules.
  4. "Won't"
    • When the situation is reviewed, it appears that the individual generally knows the social rules of the workplace and role expectations, has the skills to enact the rules, and to behave within rule expectations. However, the individual chooses to break the rules, or feels that the organizational rules do not apply.
    • They demonstrate unprofessional behaviours, are disruptive and/or mistreat others.
    • The subject of the concern generally does not have insight, remorse or regret.

Note: Concerns around racism will be classified, dealt with and intervened with separately and differently, although it is recognized that events of unprofessional behaviours, mistreatment, harassment and discrimination can be centred around and include racism.

For more information, please read the FoMD Commitment to Action Against Racism »

Levels of professionalism intervention

The FoMD's Office of Professionalism has a standardized approach to professionalism interventions, allowing for professionalism lapses while still identifying problematic professionalism behaviours. These standards are derived from the Vanderbilt Graduated Intervention (Hickson et al, Acad Med 2007) and ().

  1. Level 1: Informal, "Cup of Coffee" conversations for single, isolated incidents.
  2. Level 2: Non-punitive "awareness" interventions for apparent patterns of behaviour or incidents.
  3. Level 3: Remediation at the department or program level if the pattern persists.
    • Action plans to mentor, complete tasks, and consequences for ongoing unprofessional behaviors.
    • Professionalism learning plans with an assigned mentor/ coach. Removal of learners may occur during this process.
  4. Level 4: Investigation and disciplinary processes if the plans above have failed or there is immediate concern for harm to others. This will involve a teaching suspension during the investigation. The Triage Committee has a duty to report possible egregious concern to our formal institutions for formal investigations and disciplinary sanctions. These institutions include:
    • Â鶹ÊÓƵ
    • Alberta Health Services
    • College of Physicians and Surgeons of Alberta
    • Alberta Dental Association
    • College of Medical Laboratory Technologists of Alberta
    • Alberta College of Medical Diagnostic and Therapeutic Technologists
    • College of Registered Dental Hygienists of Alberta

In the instance of a potential egregious professionalism concern (see above for full definition), where there is concern for serious potential impact to others (i.e., colleagues, peers, learners, public, patients) with regards to safety, mistreatment, or harassment, these will be dealt with on a case-by-case basis. This may include but is not restricted to:

  • Harassment (sexual, racial)
  • Discrimination
  • "Won't" professionalism behaviour as per above classification with failure of remediation/leader-developed action plans
  • Level 3 or 4 disruptive behaviour (Health Quality Council of Alberta)

Appropriate formal bodies will be consulted, preserving confidentiality. Intervention will be guided by consultations with the appropriate formal bodies, with accelerated levels of intervention as appropriate. The Office is not responsible for managing investigations.

Formal investigations through these institutions include:

  • Â鶹ÊÓƵ Faculty Agreement
  • Â鶹ÊÓƵ Accommodation Policy and the Discrimination and Harassment Policy
  • College of Physicians & Surgeons of Alberta (CPSA) Health Professions Act, Province of Alberta
  • Alberta Health Services Policy: Workplace Violence Prevention and Response Policy
  • Medical Laboratory Technologists of Alberta, Complaints and Discipline
  • College of Registered Dental Hygienists of Alberta
  • Alberta College of Medical Diagnostic and Therapeutic Technologists
  • Alberta Dentistry College (ADC), Health Professions Act