Our Medical School Education

There was an article published in the New York Times recently about education in medical schools. The article, entitled “In Medical School Shift, Meeting Patients on Day 1,” highlighted some of the changes being implemented in medical schools across the country. Moving away from a more traditional pre-clinical curriculum, schools now try to get students earlier access into hospitals and in contact with patients. Such methods allow students to learn from day one how to care for patients, in addition to learning the more traditional curriculum of biology, anatomy and physiology.

As the article laments, “in the last few years, medical schools including those at N.Y.U. and Harvard University have been doing some soul-searching about whether this [traditional pre-clinical] curriculum creates doctors who lack humanity, who see patients as diseases rather than as whole people and who have what the medical literature calls “ethical erosion” — a loss of idealism, empathy, morality.”

As I’ve written in an earlier post, the first two weeks of being in a hospital and interacting with patients helped orient me to what being a doctor was like. And in addition to our biochemistry course, we’re now taking a course on social medicine and another one called “Patient-Doctor 1” that assigns you into a small group of classmates and mentors who visit patients together. My main concern though is that this shift both does not go far enough and is a little too late.

The emphasis is still on these more traditional pre-clinical courses. We have biochemistry every morning for four hours and soon we’ll have anatomy, genetics and so on, whereas we have social medicine and “Patient-Doctor 1” only once a week for two hours. The coursework of the former is also much more demanding than the latter. But I think the main factor here is that the curriculum is still oriented around diseases rather than around “whole people” or even the community. We are eventually going to be doctors working in a specific community and will need to know how to interact with and learn from that community. Of course one can argue that a knowledge of the disease is absolutely necessary and I agree. But there’s a reason that we still see an “ethical erosion” of idealism, empathy and morality in medicine today. It starts with our medical training in school. And I don’t mean just medical school. I think college and even our secondary school education can do a better job of incorporating and taking more seriously a curriculum of empathy. Plus it’s not just doctors who should learn how to do this stuff.

I haven’t finished a month of med school yet so my thoughts about all of this may change down the line. The common sentiment I’m getting now from my classmates is that we’re all a passionate bunch who want to do good in the world. My hope is that this passion doesn’t change. As I heard from one of my classmates after his experience interviewing a patient, the first thing the patient said to him was, “I’m glad I’m getting you before you become jaded.”

2 Responses to “Our Medical School Education”
  1. Liz Shen says:

    Totally agree with you on the need for a curriculum of empathy, as challenging as it is to teach that. But in college, I found myself having the exact same thoughts, and it seems like most other people in professions develop empathy as they grow in maturity. I think medicine is different though, since the majority of students inevitably become jaded from a profession that is supposed to be selfless but ends up being self-centered. (Every student ends up worrying about making their rounds, seeing too many patients in too little time in order to satisfy and impress their attending physician.) Finding a way to NOT become jaded has been on my mind a lot, and is definitely a goal I’m trying to flesh out. But you’re totally right about how ‘ethical erosion’ starts with medical training.

  2. Eric Lu says:

    Hi Liz that’s a very good point. This article that I read today reminded me of your comment and I think you might find it interesting: http://www.kevinmd.com/blog/2010/09/goals-starting-medicine-disillusioned.html

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