PROFESSIONALISM IN PRACTICE: A QUALITATIVE ASSESSMENT OF RESIDENTS’ TRAINING NEEDS IN MEDICAL LAW AND ETHICS IN TEACHING HOSPITALS OF KHYBER PAKHTUNKHWA
Main Article Content
Keywords
Medical ethics; Medical law; Professionalism; Residency training; Qualitative research; Pakistan
Abstract
Background: Medical professionalism today requires more than clinical competence. Physicians must also understand legal responsibilities, patient rights, and ethical decision-making. In Khyber Pakhtunkhwa (KP), increasing regulatory oversight, patient complaints, and public scrutiny have made the medicolegal environment more demanding for postgraduate residents working in public sector teaching hospitals. However, structured and applied training in medical law and ethics remains limited during residency.
Objective: To explore the lived experiences of senior residents regarding medical law and ethics and to identify their perceived training needs within the public sector Medical Teaching Institutions of KP.
Methods: A qualitative phenomenological study was conducted from October 2024 to May 2025 across six public sector Medical Teaching Institutions representing Central, Northern, and Southern KP. Twenty-four senior residents (RT-3 and RT-4) were recruited using purposive sampling. Data were collected through semi-structured, in-depth interviews. Interviews were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s inductive thematic analysis approach. Seventy-eight initial codes were generated and organized into 24 sub-themes and six overarching themes. Data saturation was achieved at the 21st interview and confirmed with three additional interviews.
Results: Six major themes emerged: The Legal Shadow, Socio-Ethical Dissonance, The Pedagogical Void, Systemic Barriers, Medicolegal Literacy Needs, and Professional Identity Formation. Residents described practicing defensive documentation due to persistent fear of litigation and complaints. Cultural norms often conflicted with legal standards of patient autonomy. Training in medical jurisprudence was largely informal and shaped by observation rather than structured teaching. Infrastructure limitations and political pressures further complicated ethical practice. Participants strongly recommended case-based legal workshops, documentation training, conflict de-escalation skills, and institutional legal support systems.
Conclusion: Senior residents in KP practice in an environment of significant medicolegal vulnerability without adequate structured preparation. Integrating applied medical jurisprudence into residency programs is essential to strengthen professional accountability, reduce legal anxiety, and support ethical clinical practice.groups. After surgery, in group A, after postoperative 2 cases had felt moderate anxiety, while in group B, 10 cases had felt moderate anxiety.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Asma Azam
MBBS, MHPE (scholar), Lecturer, IHPER, Khyber Medical University, Peshawar
Nazia Shahana
MBBS, FCPS (General Surgery), MHPE (scholar), Police and Services Hospital, Peshawar
Zoeya Ayesha Khan
Pre-Law student (rising senior), The University of Texas, Austin, Texas
Saad Ali Khan
BSC(Vanderbilt-Pre-Med), MSC(Pharmacology) First Year Medical Student, University College Dublin (UCD)
Sharqa Yasin
BDS, House Officer, Institute of Dental Sciences, Khyber Medical University, Kohat
Hoor Gulalai sharif
MBBS, House Officer, DHQ hospital, Kohat.
