This research study, published in BMJ Quality and Safety, compares interns’ and residents’ experiences, attitudes and factors associated with ‘speaking up’ regarding patient care and safety. The findings indicated that unprofessional behavior was observed more often than traditional patient safety concerns. Despite high potential patient harm, interns and residents were less likely to speak up about unprofessional behavior than about traditional patient safety. Different metrics of teamwork climate, professionalism, and safety are studied and discussed in this vignette-based survey study.