What kind of doctor do you want to be?

You haven't even graduated yet and already people are asking what kind of doctor you want to be. They usually mean which specialty do you want to pursue but the question could have another meaning.

As you progress through medical school you will learn a huge amount about disease processes and how to assess and treat them. This will be invaluable when it comes to making decisions about patients. However you will also need to consider the ethical dimension to medical practice.

Fortunately, the teaching of ethics and law, which once met with resistance, is now an integral part of medical training.

Ethics are moral principles governing or influencing conduct. Medical ethicists have traditionally based their teaching on two moral philosophical theories: consequentialism and deontology.

Consequentialism is deciding on the outcome with the best consequences for one person or for a group. Deontological reasoning has no concern for consequences, just for duty. For example, telling a patient the full extent of their terminal condition on the basis it is always right to be honest. You may already be familiar with the deontological decision-making models which underpin the principles of ethical duty – autonomy, beneficence (doing good), non maleficence (doing no harm) and justice.

It's never too early to think about the kind of doctor you want to be and how you will approach making difficult decisions. In practice, you will be juggling many models to reach a decision about a patient's care and in each circumstance you will need to reflect on the ethical issues while considering any guidance from the GMC.

You would be well advised to discuss difficult decisions with senior colleagues. A bit like treating a medical condition, there is not always a single answer and how you reach your decision will depend on the details of each situation.

GMC guidance is available for doctors covering all sorts of situations including end of life care, prescribing, research and confidentiality. There is also guidance from the GMC and the MSC for medical students, Medical students: professional values and fitness to practise.

Being a doctor is a challenging and rewarding career but it carries responsibilities as well as knowing you are always under the watchful eye of the GMC. There will be an ethical dimension to every professional decision you take. Recognising there are no right or wrong answers (but that much will depend on the specifics of each case and the views of the individuals involved) will help you to consider how best to approach each situation.

Whatever kind of doctor you want to be you will always carry with you what a former colleague of mine refers to as your 'ethical shadow'.

If you need help or advice with a medico-legal or ethical issue that has arisen from seeing patients during your course, you can call our 24-hour freephone advisory helpline on 0800 716 646.

Further reading

Ethical decision making, Dr Louise Dale, June 2013.

Ethics and law for medical students: the core curriculum, Tony Hope, Journal of Medical Ethics 1998;24:147-148.

This guidance was correct at publication 27/11/2013. It is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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