On Medical Schools and Empathy

patientabuse:

When do medical students lose their empathy?

The moment I truly realized how much the system had affected me was taking the history of a young woman in her twenties (my age), who had presented with a nebulous constellation of symptoms and ultimately was diagnosed with an aggressive cancer that had a survival rate of less than 20%. She had three children, a husband, and until that moment, in the emergency department, had no idea that her life was about to change completely. I completed the history, felt a momentary stab of pity, and immediately searched for my consultant to tick the box and mark my form so I could get through the daily checklist of requirements I needed to fulfill to successfully complete the rotation. I did not stop to think about this patient and the news she was receiving and how that would affect her and the people who loved her until I was driving home. As I sat at the traffic lights and reflected upon her terrible diagnosis and equally distressing prognosis, the question that swam into my mind was this: “What kind of person have I become? And what kind of doctor will I then end up being?”

The third year of medical school turns students from altruistic to bitter

Many of the qualities that students entered medical school with—altruism, empathy, generosity of spirit, love of learning, high ethical standards—are eroded by the end of medical training. Newly minted doctors can begin their careers jaded, self-doubting, even embittered (not to mention six figures in debt).

The erosion of empathy, for example, may have long-reaching consequences. Patients of doctors who score lower on tests that measure empathy appear to have worse clinical outcomes. Diabetic patients, for instance, have worse control of their blood sugar and cholesterol. Cancer patients seem to experience more depression. Medication compliance diminishes. Even the common cold can last longer.

Teaching empathy in medical school

hen students first start medical school, they are often very empathetic. They are idealistic and desire to become healers, caring for rich and poor alike. Sometimes, however, the ability to connect emotionally with patients decreases during medical school, residency, and on into a doctor’s career. One study has shown that empathy significantly declines in the third year of medical school, when extensive exposure to clinical settings typically first occurs.

Articles
Evidence of declining empathy in third year osteopathic medical students
The devil is in the third year: a longitudinal study of erosion of empathy in medical school.
Humanism at heart: preserving empathy in third-year medical students.