Does Med School Promote or Destroy Compassion?
According to the dictionary, the definition of compassion is, “a feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the suffering.” I have always believed that compassion is a necessary prerequisite for a physician, yet I have met some physicians and physicians-to-be who don’t appear to have a well developed sense of compassion.
After a conversation that I had with a fellow medical student the other day, I started thinking about which qualities are inherently necessary for a medical student to possess, and which ones can be learned from instruction. Can common sense actually be taught? Is a knack for science a necessary prerequisite for being a good doctor? Must a doctor actually be compassionate in order to be effective?
I can’t help but think that compassion is most definitely an integral component in effective healthcare. Perhaps I just can’t comprehend a world in which people would be able to heal the sick without being compelled by a need to alleviate suffering. But, we’ve probably all known a few doctors who don’t seem to truly care about their patients. The reality is that they exist, and the truth is that it is sometimes the educational system, as well as a largely disjointed healthcare system, that actually contribute to the apathy of physicians.
I look around at my fellow classmates and I wonder if all of them are inherently compassionate people. Do they even need to be? Should the educational system be designed in such a way that compassion is taught with the same fervor as biochemistry? If medical students are not compassionate to begin with, will the system end up helping them grow into caring doctors, or will it have a deleterious effect on their humanity?
To me, it seems like compassion should either be a prerequisite to medical school, or it should be integrated into the curriculum. I know that admissions committees do everything they can to only accept qualified candidates, and that many of them value compassion as an important quality. But would they be more apt to admit the 4.0 GPA student who doesn’t have any obvious compassionate qualities, or the 2.0 GPA student who truly believes in alleviating the suffering of the sick? It certainly is a tough decision.
Many medical school administrations are taking active steps towards guaranteeing that they are producing proficient, as well as compassionate doctors. But I’m not convinced that they are always successful. It seems harshly ironic that the very system that is dedicated to producing skillful, compassionate doctors, is the cause of many students’ declining empathy towards patients. Perhaps the real question we should be asking is, “can compassion even be taught?”
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My name is Kendra and I am a newly minted doctor about to begin my residency in Psychiatry at 
Excellent article.
This is actually a topic that a good amount of the schools seem to be considering. At this year’s annual meeting, L. Jane Easdown MD, presented on Vanderbilt University’s Department of Anesthesiology’s resident selection process.
Vanderbilt is using the behavioral interview to attempt to get at issues such as this and avoid selecting residents who lack the qualities of a good physician. The review committee decided to assess potential residents on the following four ACGME competencies: Professionalism, Patient Care, Communication Skills and System Based
Practice.
The presentation was really interesting since Dr. Easdown provided some background on how they had come to the decision to begin selecting residents in this manner. They had run into the problem, on more than one occasion, of selecting residents who looked great academically and tested well but later displayed lapses in judgement, were unreliable and had a series of other issues. This is not discussed in the paper, but it provides some background on why this change was made.
I’d also mention that since the implementation of the behavioral interview, they have not run into these issues again.
The complete reference to her article is:
Easdown J, Castro P, Shinkle E, Small L, Algren J The behavioral interview- a method to evaluate ACGME competencies in resident selection: a pilot project JEPM 7(1): Jan- June 2005.
It’s also online at: http://jepmadmin.org/VolumeVI/Issue1/Abs.spring.04.The%20Behavioral%20Interview.pdf
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