Unprofessional behavior adversely impacts a culture of safety and can contribute to adverse events. This study compared medical school graduates who appeared before their schools’ review boards for professional-related reasons to matched controls to explore whether professionalism lapses predict problems in residents and clinical practice. Compared with controls, physicians who appeared before their schools’ review boards were more likely to undergo disciplinary review and require remediation or counseling during residency and were more likely to be sued or sanctioned during clinical practice.