Unprofessional Behavior Among House Officers in Pakistan's Public and Private Hospitals: Prevalence, Perceptions, and Participation

Professionalism in healthcare is crucial for maintaining patient trust and delivering high-quality care. Unprofessional behaviors among house officers (recent medical graduates undergoing training) raise concerns about their impact on healthcare outcomes. This study aims to assess the prevalence and perceptions of unprofessional behavior, as well as participation in it, among house officers in both public and private hospitals in Pakistan. A cross-sectional survey was conducted among 212 house officers from seven hospitals across Pakistan. The hospitals included both public and private institutions: 57% were private (Avicenna Medical College, Rashid Latif Medical College, Amna Inayat Medical College, Nawaz Sharif Medical College) and 43% were public (Quaid-e-Azam Medical College, Gujranwala Medical College, Khyber Medical College). A pre-validated and pre-tested questionnaire was used, covering demographic data and 29 questions related to unprofessional behaviors, including perceptions, observations, and self-reported participation. Data were collected through an online platform and analyzed using IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, NY, USA). Descriptive statistics were used to summarize variables, and Chi-square tests for independence were applied to compare proportions between groups (graduates from private and public universities) for each variable. Associations between demographic factors and knowledge of professionalism were analyzed, with a significance level set at p ≤ 0.05. Out of 212 participants, almost all (99.1%, n=210) were familiar with the concept of professionalism, but over half (53.8%, n=114) had not completed a formal medical ethics course, while 52.4% (n=111) engaged in self-directed study. Although 78.3% (n=166) had completed additional professional ethics training, Chi-square analysis revealed no significant associations between ethics training and changes in unprofessional behaviors, nor between gender, department, or type of institution, and the likelihood of observing or participating in unprofessional behavior (p > 0.05). However, certain unprofessional behaviors were significantly associated with previous ethics training (p < 0.05). While house officers demonstrated a strong awareness of professionalism, unprofessional behavior persisted regardless of gender or type of institution. These findings emphasize the need for enhanced ethical training and stricter monitoring to address and mitigate unprofessi