Worked Examples: Witnessing Unprofessional Behaviour by a Colleague

Witnessing a colleague behave unprofessionally is one of the most uncomfortable SJT scenarios — and one of the most commonly tested. These questions assess whether you understand your duty to uphold professional standards, even when it means having a difficult conversation or raising a formal concern.

This lesson works through detailed scenarios involving different types of unprofessional behaviour.

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The Core Framework

When you witness unprofessional behaviour, the SJT expects you to consider:

Factor	Question to ask
Severity	How serious is the behaviour? Does it affect patient safety?
Immediacy	Does someone need to act right now to prevent harm?
Pattern	Is this a one-off lapse or a recurring pattern?
Your relationship	Are they a peer, a junior, or a senior?
Setting	Did this happen in front of patients, staff, or privately?

The answers to these questions determine whether you should:

• Address it directly with the colleague (most common correct first step)
• Escalate to a supervisor or senior
• Report to a formal body (rare — usually only if internal channels have been exhausted)

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Scenario 1: Inappropriate Comments About a Patient

You are a medical student in the doctors' mess. A fellow student, Sam, makes fun of an elderly patient's incontinence, laughing about how "disgusting" the patient was. Several other students are present.

Option Analysis

Option	Rating	Reasoning
A: Laugh along to fit in with the group	Very inappropriate	This condones the behaviour and normalises disrespect towards patients. It violates the NHS value of respect and dignity
B: Say nothing at the time but feel uncomfortable	Inappropriate	While understandable, inaction fails to uphold professional standards. The SJT expects you to act
C: Speak to Sam privately afterwards: "I know you were joking, but I felt uncomfortable with the comments about that patient. They are vulnerable and it does not feel right to laugh about their condition"	Very appropriate	Private, empathetic, assertive, and focused on the behaviour not the person. This gives Sam a chance to reflect without public humiliation
D: Report Sam to the medical school fitness-to-practise panel	Inappropriate, but not awful	This is a significant over-escalation for a first-time comment, especially without first speaking to Sam directly. However, if Sam's behaviour is part of a pattern, it may become appropriate later

Key Learning

• Joking about patients, even in private, is unprofessional because it erodes the respectful attitude that should characterise all interactions
• Speaking up is a professional duty, even when it is socially awkward
• Private conversation first; formal reporting only if the behaviour continues or is serious

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Scenario 2: A Colleague Under the Influence

You are an FY1 on a night shift. Your fellow FY1, Dr Khan, arrives smelling strongly of alcohol. Their speech seems slightly slurred and their movements are uncoordinated.

Option Analysis

Option	Rating	Reasoning
A: Say nothing because you might be mistaken about the alcohol	Very inappropriate	If Dr Khan is impaired, patients are at immediate and serious risk. The potential consequences of doing nothing are catastrophic
B: Speak to Dr Khan privately and express your concern: "I am worried because I can smell alcohol and you seem unwell. I do not think it is safe for you to see patients right now. I think we need to speak to the on-call registrar or supervisor"	Very appropriate	Direct, compassionate, and focused on patient safety. It treats Dr Khan with dignity while taking the necessary action
C: Immediately contact the on-call registrar or clinical supervisor to report your concern	Very appropriate	This is a situation where escalation is appropriate even as a first step because patient safety is at immediate risk. Both B and C are very appropriate — the best answer may depend on the specific options available
D: Offer to cover Dr Khan's patients yourself so they can go home	Inappropriate	While well-intentioned, this covers up a serious patient safety and professional conduct issue. The colleague needs help, and the system needs to know this happened

Why This Scenario Is Different

Unlike most scenarios, this one may justify immediate escalation without first having a private conversation. The reason is:

• The risk to patients is immediate and serious
• You may not be able to resolve this on your own (Dr Khan needs to be removed from clinical duties)
• The on-call system needs to arrange cover
• Dr Khan may need professional and personal support

However, if you do speak to Dr Khan first, combine it with escalation — do not simply rely on Dr Khan's assurance that they are fine.

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Scenario 3: A Colleague Falsifying Records

You are a medical student on placement. You see a fellow student, Maya, signing the clinical skills log to indicate she has performed a procedure she did not actually do.

Option Analysis

Option	Rating	Reasoning
A: Ignore it because it does not affect you	Inappropriate	Falsifying records is academic dishonesty with potential patient safety implications. In medicine, dishonesty undermines trust and, if the student qualifies without the necessary skills, patients could be harmed
B: Speak to Maya privately: "I noticed you signed off a procedure you did not do. I know it is tempting when you are behind on sign-offs, but this could have serious consequences if it is discovered. More importantly, you need that skill to be a safe doctor. Can I help you find an opportunity to do it properly?"	Very appropriate	Empathetic, direct, and focused on both the ethical issue and the practical solution
C: Report Maya to the medical school immediately	Inappropriate, but not awful	Reporting is appropriate if Maya does not respond to direct communication, but as a first step it is over-escalation
D: Sign the same procedure yourself since everyone seems to be doing it	Very inappropriate	This compounds the dishonesty and creates the same risks for you

Key Learning