Teaching medical students - ethical challenges.

Aim: To explore ethical challenges for general practitioners teaching medical students in urban general practice. Methods Semistructured face-to-face interviews with 60 urban general practice teachers with diverse teaching loads and practice demographics. Interview data were analysed following member checking of interview records.
Results: Participants identified concerns in relation to a number of areas including: student assessment and professionalism; teaching support from colleagues; patient consent and confidentiality; and the effects of teaching on consultation dynamics, patient satisfaction and patient care. Participants with smaller teaching loads and with full fee-paying patients were more likely to express concerns about involving students actively in consultations.
Discussion: General practice teachers should consider modelling seeking informed patient consent in difficult circumstances, while being mindful that patients may be reluctant to refuse or withdraw consent. Arguably students themselves should seek consent. General practitioners should consider maintaining the confidentiality of previously divulged patient information. Concerns about active student involvement in teaching consultations should be discussed with teaching colleagues from similar practice demographics, with reference to pertinent literature about patient attitudes to teaching.