An ethical paradox: the effect of unethical conduct on medical students' values.
OBJECTIVE
To report the ethical development of medical students across four years of education at one medical school.


METHODS
A questionnaire was distributed to all four classes at the Wake Forest University School of Medicine during the Spring of 1996.


METHODS
Three hundred and three students provided demographic information as well as information concerning their ethical development both as current medical students and future interns.


METHODS
Results were analyzed using cross-tabulations, correlations, and analysis of variance.


RESULTS
Results suggested that the observation of and participation in unethical conduct may have disparaging effects on medical students' codes of ethics with 35% of the total sample (24% of first years rising to 55% of fourth years) stating that derogatory comments made by residents/attendings, either in the patient's presence or absence, were "sometimes" or "often" appropriate. However, approximately 70% of the sample contended that their personal code of ethics had not changed since beginning medical school and would not change as a resident.


CONCLUSIONS
Results may represent an internal struggle that detracts from the medical school experience, both as a person and as a doctor. Our goal as educators is to alter the educational environment so that acceptance of such behaviour is not considered part of becoming a physician.
Georgia Institute of Technology and Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
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Satterwhite
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Satterwhite
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Enarson
D000328:Adult; D000704:Analysis of Variance; D004992:Ethics, Medical / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008505:Medical Staff, Hospital / Q000592:standards*; D035863:Moral Development; D009657:North Carolina; D028743:Professional Misconduct; D012938:Social Perception; D012945:Social Values; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States