I agree with the authors that professionalism should not be a one way effort as institutions must support international doctors by guiding them through cultural expectations and helping them integrate effectively.

Professionalism is not fixed , Core values like respect or empathy are universal , but how we show them can differ across cultures.

It calls for shared responsibility, emphasizing the role of institutions in easing the transition for newcomers.

Discuss cultural values that are universal such as altruism, respect, and accountability, while acknowledging their variable interpretations across cultures. In addition they highlight the variability and complexity of patient expectations

Finally Impact of addressing this issue would improve patients’ outcomes and doctor performance and professional competencies.

Dear Sir,

I found this letter an interesting take on the subject of cross cultural sensitivity and need to behave professionally in clinical situations. The authors mention a trial and error method of learning this competency which is by and large very true in countries and institutes where professionalism and importance of building a professional identity is not addressed clearly and only implied in an educational environment.

The role of institutes which employ graduates from varying background remains huge, however, efforts to sensitize newcomers is largely  wasted if such graduates have no idea of its importance. In short, level of sensitization must be assessed early perhaps at the time of admissions and continued from early formative years of medical education. Compromise on ethics is most definitely not acceptable in any place and consequences of errors in the form of case studies will be a good start to the process of sensitization.  The metaphorical reference to the chameleon captures the idea very aptly.