The ‘special obligations’ of the modern Hippocratic Oath for 21st century medicine


  • Eric Holmboe,

    Corresponding author
    1. American Board of Internal Medicine, Philadelphia, Pennsylvania, USA
    • Correspondence: Dr Eric Holmboe, Chief Medical Officer, American Board of Internal Medicine, 510 Walnut Street, Suite 1700, Philadelphia, Pennsylvania 19106, USA. Tel: 00 1 215 446 3606; E-mail:

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  • Elizabeth Bernabeo

    1. American Board of Internal Medicine, Philadelphia, Pennsylvania, USA
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Profound advances and discoveries in medicine have markedly improved the lives of many over the 50 years since the modern Hippocratic Oath was written. Regrettably, these advances were and continue to be implemented suboptimally and inequitably across the globe. ‘Special obligations to all my fellow humans’ is an important theme of the modern Oath. From this perspective, we reflect on the special obligations of the medical profession, and examine how these obligations have changed over the past 50 years.


We draw from perspectives of the social contract, professionalism, quality improvement, patient safety and a group of 31 international colleagues involved in medical education as we examine these obligations for individual doctors, health care institutions and medical education systems. The perspectives of the 31 clinician-educators helped us to situate the meaning of the theme of ‘special obligations’ in the context of challenges facing medical education and health care in the 21st century.


Improving the quality of care and patient safety, and reducing health care disparities are now paramount as ‘special obligations’ for doctors, health care systems and medical education organisations, and require us to work collectively and collaboratively in an increasingly interconnected world. In our view, traditions such as the Hippocratic Oath will be worthy of public support only when the medical profession demonstrates in meaningful and transparent ways that it is meeting its social and civic obligations to make the world, not just health care, a better place.