Professionalism, with regards to medical teaching, includes possession of a unique body of occupational knowledge, compliance with desirable standards of behavior and commitment to what the profession regards as morally right or good, in other words, as ethical conduct. Teaching, ethically involves making an analytical decision about what is to be done in order to achieve the most good for learners. This involves a complicated interaction between current settings, past experiences and personal beliefs and values [1]. In some professions, such as law, professional standards are different from ethical standards as professional practice may not always be ethical practice. For example an unethical action, like an attack on the character of a witness by the defense, may be acceptable in order to fulfill professional responsibilities to the charged client. But in teaching it is well recognised that ethical knowledge is not separate from professional knowledge [2].

Ethics is a collection of moral standards by which each person should be guided in their private and professional life. Ethics are not governed by a court of law but by the conscience of the person concerned. The medical profession is considered to be a noble profession because when a doctor saves the life of a patient, he is compared to God; hence, it becomes essential for a doctor to behave in an ethical manner. The code of ethics or conduct propagated by most medical councils is aimed at promoting the interest of the patients. The oldest code is 2000 year old and known as Hippocratic Oath. Emphasis is mostly on the ethics for doctor with respect to their patients. The ethics for medical teachers with respect to their students has been largely overlooked. According to WHO (SEARO) the teaching of ethics for medical teachers is mostly based in the department of Forensic Medicine that too based mainly on negligence and malpractice. Ethics in medical education is a very different and a vast topic for discussion [3]. Medical educators have twin commitments of ethics, between a patient and doctor and between a teacher and student. They play a crucial role in the medical education system. Their role goes far beyond simply spreading knowledge or conveying information. They are role models for their students who, consciously or subconsciously, emulate their behavior. They instill values that will influence the lives of their students. They are thus the major assets in good quality medical education [4].

Technology is a wonderful gift but responding to new social realisms and changing lifestyles is no mean feat as it also brings with it a new and steep learning curve. The relationship between medical teachers and would be doctors is a very important and sensitive one. It must be built on powerful fundamentals, arising out of mutual respect and trust as well as on the highest ethical standards. A yearning to teach and a strong desire to deliver in the best interests of students motivates teachers to seek continuous professional development. This is the key to delivery of quality education [5].

Professional ethics like Bioethics are more publicised than ever before mainly because of the increase in the number of professionals and violations of ethical principles that have come to the forefront. Bioethics provides a code of conduct by means of which behavioral standards can be regulated thus maintaining the integrity and respect the medical profession has acquired over the years. For medical teachers, it strives to raise the status of teaching by ensuring that service provided by medical teachers is of the highest possible standard. Also the conduct of medical teachers must place the medical profession in the highest possible regard in the interests of students, their parents and the community [6].

The present paper discusses the role of professional ethics between teachers and students. The objective of the paper is to discuss the basic principles of ethics and their relevance in medical education as well as their implementation.

Medical Educators Ethics must be considered at two levels. Firstly, administrative level, where all aspects of teachers conduct; teaching procedures and assessment are framed into a set of regulations drawn up by the university or institution. Secondly, personal level, which includes the teacher’s own attitude and conduct that is not otherwise prescribed and might never be detected [7]. The teacher's code of ethics comprises his or her duties, responsibilities, approach, outlook, honesty and most of all fairness. The ethical teacher is first and foremost an ethical person, someone in whom central moral virtues such as fairness, respect, trustworthiness, honesty, and kindness are settled dispositions which reveal themselves in the teacher’s every interaction with students and constitute the very manner in which he or she teaches [8].

A Teacher-Student relationship is based on mutual trust. Medical educators should create a learning experience for students which involves, stimulates and challenges them with a lifelong learning perspective. They create a thought-provoking learning environment. As students in medical colleges come from varied financial as well as religious backgrounds, teachers should respect the uniqueness and diversity of the learning community. They should be sensitive to the need for confidentiality concerning students, unless required by law, thus upholding public trust and confidence in the teaching profession [9].

Members of the Teaching Community should maintain professional limitations with their students by avoiding improper physical contact, inappropriate communication through any form of media and inappropriate relationships. They are duty bound and eventually liable for maintaining a professional distance. They should refrain from taking undue benefit of professional relationships with students for their own personal use and keep their exclusive position of trust and status as role models [10]. They should also exercise care in their language, gestures and attitudes, ensuring that they do not act in such a manner that is disconcerting to the student and not use abusive language or offensive names or make inappropriate remarks. A professional medical educator does not intentionally expose the student to disparagement.

Medical educators should demonstrate respect for diversity and promote equality irrespective of gender, race, religion, language or different needs or abilities of their students. They have a responsibility to deal considerately and justly with each student and to understand the needs of all each student so as to ensure that they reach their full potential; they must contribute to the creation of a fair learning environment by addressing any kind of discrimination and identify and refer to the competent authorities at the earliest possible stage, any issues that might impact on a students’ welfare [11].

Medical Teachers should work in a collaborative manner with colleagues; as well as other professionals in the highest standards of professional courtesy, so as to impart the right message to their students. They should be prepared to help junior colleagues and respect their senior colleagues. While expressing professional opinion they should never reprimand or censure any colleague, or any other member of the teaching profession, especially in the presence of students. At the same time they should refrain from making public statements which may dishonour the medical profession [12].

Medical educators must develop and maintain good relations with parents and guardians and respect the role they have in students’ education. They should make efforts to encourage parents and guardians to take active part in the education and welfare of their children. They must make a constructive effort to protect students from conditions detrimental to learning, health, or safety [13].

Medical Teachers should comply with policies of the institute regarding the use of property, facilities, finances and ICT in their educational setting. They should conduct assessment and examination related tasks with honesty, integrity and fairness. They should represent themselves, their experience and qualifications honestly. They should only disclose confidential information within the parameters allowed and present facts without distortion, bias, or personal prejudice. They should be authentic and credible [14].

Medical Teachers should maintain high ideals in relation to teaching and learning, classroom management, planning, monitoring, assessment of teaching schedules. They should keep their professional knowledge and skills updated as part of their continuing professional development; they should respond positively to constructive feedback regarding their teaching practices and seek advice where necessary [15].

In short, medical educators must practice ethics in their academic and professional world, and in life, act as role model or mentors for their learners. Ethical principles should be applied in context of reality. Presuming and doing whatever students want may be ethically correct but it is the ethical duty of teachers to ascertain the genuineness of the requirement and to show the right way to students. If a student is found to be engaged in unethical or unlawful activities, a teacher is ethically bound to do something even though such a condition may or may not be written in his contract [16].

Some common breaches of ethics

The common un-ethical behaviors among medical educators encountered are

• Having inappropriate relationships with students (sexual, business partnerships, drinking etc.)

• Violation of institute related policies and educational procedures

• Failing to perform duties assigned

• Imposing personal views on students unrelated to the subject (political or religious views or views on controversial social issues)

• Improper grading, partiality, and lack of fairness

• Exposing students to embarrassment or ridicule (emotional or psychological harassment)

• Engaging students in unethical behavior

• Accepting gifts and favors, from students

• Deceiving students and their parents.

• Invading students’ privacy [17]

• Disrespectful behaviors and unprofessional interpersonal behavior that interferes with the working and learning environment.

• Loss of civility that interferes with the working and learning environment (for example shouts, insults, throwing objects or other displays of temper).

• Discrimination on the basis of age, gender, race, religion, disability, or sexual orientation.

• Misusing institutional property for personal business [18].

Is it possible to train people in ethical conduct

The term 'ethical conduct' brings to the fore ethical principles and their place in the teaching profession. These principles mandate specific behaviors in particular situations but do not promote individual adherence to ethical principles. In other words the organization or system can mandate what to do or not to do in particular situations but it is impossible to list all possible situations that arise. This becomes the territory of ethical decision making. The delivery of training related to ethical principles may be possible but training individuals to adhere to particular ethical principles when making decisions may not be possible [19].

Putting ethical principles into practice

Institutions can draft a policy for medical educators regarding academic honesty and widely publicize it. It should also contain some deterrents for nonconformity to ethical behavior. Ethical behavior can be ascertained through regular feedback from the students by the authorities regarding teacher's behavior and way of teaching. At the same time, teachers should also be rewarded for their ethically sound character in terms of promotion, increments and rewards [20].

Dealing with unethical conduct

The most effective way to handle unethical conduct is in a nonconfrontational manner. The teacher may be unaware that his behavior has offended someone and when it is brought to his notice and if given the opportunity to do so it will be corrected immediately. If the conduct is repeated or the above method is not possible then a counselor or a senior faculty may be involved. If the above methods fail or if the matter takes serious proportions, then it is up to the institute to take remedial actions [21].

SPS drafted the manuscript, performed the literature review & SR assisted with writing the paper.

Authors are thankful to Dean Dr. Vinayak Sabnis Sir for his support and encouragement. Authors are also thankful to M Murugan for his help. Authors also acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors, editors and publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.

Medical educators must practice ethics in their academic and professional world, and in life, act as role model or mentors for their learners. Ethical principles for medical educators comprises mainly of: Recognizing the unique and privileged student teacher relationship, Caring for students safety and welfare, Respecting diversity of students, Respecting confidential information, Maintain professional limitations, Upholding the reputation and standing of the profession, Respecting students, parents, colleagues, Providing accurate information and documentation. Institutions can draft a policy for medical educators regarding academic honesty and reward ethically sound character.