Table 2.

Proposed Pillars of Professionalism for Equity and Accountability

Pillar of Professionalism	Key Points	Example of Equitable and Accountable Approach
1. Patient-centered care	Assessments of professionalism should relate directly to safe and ethical patient care. Physicians should engage structural humility, particularly with marginalized patients.²⁹ Physicians should attend to how their own subjectivity, positionality, and countertransference can bias their perception and behavior.	Situation: A Black medical student sees that a Black child has met all their developmental goals and comments, “that’s lit.” The supervising resident tells the student the behavior was unprofessional. Alternative: The supervising resident should consider how cultural, generational, racialized, and gendered differences in experience might shape their interpretation of the interaction. The supervising clinician should reflect on how the comment shaped the clinical encounter prior to making assessments about professionalism.
2. Inclusivity and accountability	Clinical teams should value the diverse contributions of each member based on both training (ie, rank, profession) and lived experience. Physicians should center mutual trust and effective communication to optimize patient care.³⁰ Individual professionalism should include honesty and accountability for colleagues.	Situation: A surgeon working with a resident in a laparoscopic procedure needed adjustment in the camera position and yells at the resident holding the camera, “Are you blind?!” Alternative: As valued as clinical team members, residents and technicians should be empowered to call attention to this behavior and encourage the surgeon to engage more positive skills to cope with stress.
3. Equity	Physicians should seek to dismantle racism, sexism, economic inequality, and other forms of oppression within medicine as an institution.¹⁰ Assessments of professionalism should promote justice for minoritized trainees.	Situation: A disabled student of color with 1 excused absence for chronic illness requests another excused absence to attend a conference on leadership for racially minoritized students in medicine. The supervisors lecture the student on professionalism and excessive absences. Alternative: Institutions should provide disabled students of color with accommodations, and time and funding to accept an award at a conference that would promote their professional development.