The article by Wearn and colleagues in the 14 May 2010 issue of the NZMJ entitled In search of professionalism; implications for medical education (http://www.nzmj.com/journal/123-1314/4116/content.pdf) is timely and I strongly support the proposal that there be an extension of teaching of professionalism into clinical years and beyond. Obviously, medical teaching has to involve a combination of classroom and clinical settings but I would question the inference in the paper that only university employees are equipped to teach and coach attitudes in clinical practice.

A large proportion of postgraduate students come from a mix of cultures and are not local graduates, nor are many new hospital consultants, so certainly there is a place for ensuring that there is a continuum in the education of professionalism and to include all senior medical officers. For me, the value of professionalism is that it leads to better outcomes for patients. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists has a module about ethics that is done after the Membership and, sadly, the Council has recently decided to make it an option rather than compulsory. I would like it to be an essential component of all training and, amongst other things, we need to recognise that words such as altruism and societal responsibility conflict with the attitude of many young people today.

It was good to see mention of the word " mindfulness" although it would be a shame if it moves into the realms of self-absorption and hedonism. As well as awareness of one's own mental processes, I think mindfulness encompasses listening more attentively, being flexible, recognising bias in our judgements, being curious and humble, to enable us to act with principles and compassion.

MAH (Tony) Baird
Auckland Uro Gynaecology
Parnell, Auckland