title: A Delphi study of medical professionalism in Arabian countries: the Four-Gates model.
abstract: BACKGROUND
  Medical professionalism has been described as a set of attributes and behaviors, yet the Western frameworks of medical professionalism may not resonate with the cultural values of non-Western countries.
  
  
  OBJECTIVE
  This study aims to formulate a professionalism framework for healthcare providers as interpreted by local medical professionals in Arabian countries.
  
  
  METHODS
  A purposive sample of 17 experts from diverse disciplines participated in a Delphi study in three rounds. Consensus was identified by content analysis and by numerical analysis of responses on the basic attributes of medical professionalism in Arabian context.
  
  
  RESULTS
  Eight professional traits were shortlisted and coupled in four themes (Gates): dealing with self, dealing with tasks, dealing with others and dealing with God. Self-accountability and self-motivation were interpreted from a faithful viewpoint as "taqwa" and "ehtesab", respectively, in Arabic.
  
  
  CONCLUSIONS
  The Four-Gates Model helps in better understanding of medical professionalism as grounded in the minds and culture of Arabs. The model may act as a genuine framework for teaching and learning of medical professionalism in Arab medical schools.
  
  
  CONCLUSIONS
  The study highlights the divergent interpretation of medical professionalism between Western and Arabian contexts. The Four-Gates Model may work for faith-driven societies, but not for non-Muslims Arabs students or teachers or in institutions with humanistic values.
authors.affiliation: University of Dammam , Saudi Arabia .
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Al-Eraky
authors.forename: Jeroen
authors.initials: J
authors.lastname: Donkers
authors.forename: Gohar
authors.initials: G
authors.lastname: Wajid
authors.forename: Jeroen J G
authors.initials: JJ
authors.lastname: van Merrienboer
mesh_terms: D002983:Clinical Competence; D003469:Culture; D003697:Delphi Technique; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D008297:Male; D008877:Middle East; D010819:Physician's Role / Q000523:psychology*; D010817:Physician-Patient Relations