To the Editor: 

In the November 2014 issue of The Journal of the American Osteopathic Association, Snider and Johnson¹ described the correlations between an objective professionalism score and academic performance in first- and second-year osteopathic medical students. These correlations are of grave importance, as lack of professionalism may be a predictor for future unprofessional performance.² These correlations give us as educators the means to identify “problem learners” as soon as possible in their careers and facilitate corrective actions in due time. 

However, we need to be humble, gentle, and patient with our students. The threat of pigeonholing exists, especially when it concerns objective professionalism scores. We have to ask ourselves whether we measure what we want to measure. Do we measure professionalism in objective professionalism scores? And do we measure it objectively? 

Words are important. First, the items in the professionalism score described by Snider and Johnson¹ all cover behavior. When students do not arrive on time or do not dress in appropriate attire, they demonstrate unprofessional behavior. However, this behavior does not necessarily mean unprofessional inner virtues and attitudes. Professionalism and professional behavior may be 2 sides of the same coin, but they are not synonymous. I believe the extent to which these 2 concepts relate to one another requires further research. 

Second, can we measure professional behavior or even professionalism objectively? I have reservations with the term objective. Professionalism is not something absolute, and behavior is always open to a number of different interpretations. In one context, behavior may be seen as professional, and in a different context, the same behavior may be assessed as unprofessional. 

I thank Snider and Johnson¹ for showing the correlation between unprofessional behavior and academic performance. However, I caution us to be humble in what we think we measure in our students.