It is inevitable that physicians in training will be exposed
to behavior by supervising physicians that the trainees find
unethical. By nature these events are rare. It is imperative
within any residency training program that resident physicians
have immediate access to a meaningful review process in cases
of moral conflict with supervising physicians. Here, I discuss
the reasons why this issue must be recognized and what it entails.
Most important, I discuss the procedural steps that are essential
for the training program to make this a meaningful safety mechanism
in residency training. This issue is central to promoting conscious
development of professionalism in clinical training. Physicians
in training, especially resident physicians, need to be taught
to value and protect their own professional integrity. The
responsibility for fulfilling this ethical duty falls on the
individual residency programs as well as the administrative
organizations that regulate residency training. Thus, ensuring
this process of review is an organizational ethical imperative.
Availability of this process is fundamental to promoting and
ensuring ethical behavior by all participants in residency training.