The Journey to Professionalism: In Service to Community

James Ulager, M.D.

Written by James Ulager, M.D., FAAFP, Associate Vice President of Clinical Operations, University of Vermont Health Network Medical Group, and UVM Assistant Professor of Family Medicine

This is the third blog post in a series on professionalism at the University of Vermont Larner College of Medicine.

I feel very fortunate to have had the opportunity to participate in Dean Page’s task force to draft a professionalism statement for the Larner College of Medicine. As is often the case, the most rewarding part of this group was the chance to work alongside truly outstanding colleagues, staff, residents, and students. It was also a wonderful opportunity to pause and consider for a moment the goal we call professionalism. What is it, and how is it attained? While I claim to hold no definitive answers to these questions, my experience on the committee has helped me consider our journey to professionalism in three ways.

First: It is, in fact, a journey. Read the statement. Ambitious, is it not? I’d love to tell you that my career has embodied these virtues thoroughly and consistently since the beginning, but such a fabrication would belie the very professionalism I would be attempting to claim. Why set such a high bar, then? The reason is that the essence of professionalism is not one of stasis, but of movement. We may never quite reach perfection, but if we stop striving towards it, there is no standing still, but a slide backwards.

Second, professionalism is not solitary journey, but a collegial one. Because the bar is so high, we need colleagues to keep us on the path, occasionally with accountability, but more often with example. There is nothing more instructive – or more humbling – than witnessing your colleague in a moment of high professionalism, unless it is seeing the same thing in a resident, student, or even better a patient. I am specifically recalling two separate home hospice visits when – from their deathbed – my patients spoke words of healing and of comfort to me.  How much we learn from those we are here to serve!

Finally, in considering my own professional journey in light of what I learned from the committee, I realized this: Becoming a professional is not an event that occurs when we earn a professional degree. It is not conferred, but it is lived. I recall my thoughts on professionalism at the time I finished residency. I was knowledgeable (so I thought), confident (so I told myself), and a fully formed professional (so I wished to believe). In fact, I was really a fool. The more I grasped at being a professional by virtue of qualification or authority, the more it eluded me.  Fortunately for me, things soon got messy enough to shed this foolish notion. I made mistakes. I said things that came out the wrong way.  I had to apologize for things. Practice got so busy that I forgot to put on the charade.  I was forced by circumstance to be my genuine self, because that’s all I had the energy left to be.  Why was I surprised to learn that this was just what my patients wanted?

This reflection brings us to the third thing I learned about professionalism: While we must work towards it, we cannot grasp at it. To do so is to miss it completely, and end up with something that looks more like self-importance and egotism.  Professionalism is achieved only by genuinely giving ourselves away in service to our patients, our students, and our community.

So where does that leave us? I can speak only for myself: I have a long way to go on the journey. I remain optimistic, however, because I know I won’t be doing it alone.  I have the very best in colleagues, staff, patients, and families to guide the way. I am grateful each day to walk in such company.

  • Read the Larner College of Medicine’s statement on professionalism and watch a short video
  • Read the first blog post in the series from UVM Professor and Chair of Pathology and Laboratory Medicine Debra Leonard, M.D., Ph.D., task force chair
  • Read the second blog post in the series from Lyndelle LeBruin, M.S., M.P.H., senior lab/research technician and project coordinator in the Department of Pathology and Laboratory Medicine

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