any perceive that professionalism in the practice of medicine has eroded to an alarming degree. From this perspective, physicians have surrendered their professional autonomy to business managers and to the companies they work for; their self-regulation to lawyers and the courts; their scientific mission to companies more concerned with sales than with science; and the education of their students and their peers to drug companies, whose funding comprises a growing and essential share of the education budget. This erosion of professionalism is viewed not as the result of any plan but as the sum of countless accommodations by physicians to their evolving social, economic, legal, and regulatory environments, all of which place even the most conscientious physicians in positions of conflict of interest.

Medical professionalism is a set of issues spanning the social sciences, history, economics, law, and ethics. The working group on Professionalism includes individuals interested in exploring the concept of professionalism in all of these dimensions. Since professionalism has been identified as one of the most important elements in the curricular reform in the medical school, key individuals who are working on these efforts are participating in this working group. We hope that the deliberations of the working group on professionalism will make concrete and practical contributions to the new medical school curriculum.

Finally, we hope to build upon the synergistic talents of those involved to explore possible research projects related to professionalism and moral development. What are the factors that promote or erode the qualities of professionalism during medical school, post-graduate training, and medical practice? What are possible strategies for countering this erosion at each of these levels? How can we evaluate whether these strategies are effective? At a conceptual level, how do professional ideals change in response to changing practice patterns, such as has occurred with the shift towards managed care? Does professionalism involve a commitment to promoting social justice, and if so, what are the bounds of this obligation? How does the concept of professionalism vary across different continents and cultures, and are there lessons to be learned from cross-cultural comparisons? The most recent accomplishment of this working group was the second Ackerman Symposium, titled "Professionalism: From Principles to Practice," which was held on April 8 and 9, 2005 (http://ackerman.med.harvard.edu/).

The working group on Professionalism is co-chaired by Professor Alan Brandt and Dr. Robert Troug. If you would like to participate in this working group, please contact Dr. Robert Truog (Robert.Truog@childrens.harvard.edu).