To Train our Future Doctors, the Only Cost is Patient Care
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I have a friend in medical school in Philadelphia. She is currently in her third year and just beginning her clinical training and treatment of real patients. While her first two years of class work were immensely difficult academically, the next two to four to however many more years of school, internships, and residencies, she has will be more intense physically and emotionally.
Medical school and the subsequent internships and residency programs are widely regarded as the most difficult training period for any profession. Dr. Pauline Chen recently wrote a piece in the New York Times discussing the rigors and stress of her four years of medical school. She cites three studies by Dr. Liselotte Dyrbye from the Mayo Clinic concerning medical student burnout, suicidal thoughts by medical students and degree of empathy towards patients.
In a third study, Dr. Dyrbye found that when tested for empathy, medical students at baseline generally scored higher than their nonmedical peers. But, as medical students experienced more burnout, there was a corresponding drop in the level of empathy toward patients.
Dr. Chen explained that she became a doctor, as many do, in order to help those in need. But when students are bombarded by lectures, exams, and clinical training, that original goal takes a backseat to surviving the semester and retaining their sanity.
In 2003, the Accreditation Council on Graduate Medical Education (ACGME), tried to fix the system, not in medical school, but during internships and residencies, by reducing work hours for residency training programs across the country. This movement was partly spurred by the wrongful death litigation brought by Libby Zion's father in New York.
While reduction in residency hours is certainly a step in the right direction to ensure the highest standards of patient care, Dr. Chen and her former classmates feel that changes have to be made during the four years of medical school. Burnout is a serious problem among medical students. While doctors should be held to the very highest standards of knowledge, excellence and experience, there has to be a balance reached in order to preserve the humanity of our future doctors. If not, the true victims of medical school burnout won't be the doctors, but the patients who those doctors sacrificed their sanity to help.