Strategies for Promoting Empathy in Medical School
1. Offer medical students free counseling or therapy sessions on a regular basis. I know that this sounds really extreme or touchy-feely, but during the first weeks of school we had several sessions regarding everyone’s feelings about working with cadavers. That is the only time in the first six months of medical school that the curriculum has acknowledged that medical students have feelings that they may need to process.
Since we’ve been working in clinic, I’ve had classmates witness a death for the first time, get sprayed with the blood of an HIV positive patient and be in the room when a patient was given the news that their disease will be fatal. All of these events register to me as needing potentially more de-briefing and processing then working with a cadaver.
The curriculum can’t address the issues that all students will face in a timely fashion, but having an established a weekly or bi-weekly therapy appointment will allow students to build a safe relationship with a therapist and process the events they witness and their emotions as they occur.
2. Promote a culture of reflection. Medical students are busy people. There are always more tests to take, more papers to read, more requirements to meet and more chores that absolutely have to get done. The schedule does not allow a much time for spontaneous reflection. Even during breaks from school, I’ve witnessed my classmates staying busy socially and productively. Very rarely do you hear about anyone just taking the afternoon to exist.
By giving medical students tools to actively reflect on their lives and by promoting a culture of reflection, the administration can help prevent students from becoming disillusioned or burnt out. Active reflection is a skill that med students can hopefully pass on to their patients as well.
3. Acknowledge that losing a little bit of empathy is not necessarily a bad thing. As pointed out by my roommate, if she felt empathetic for every patient, she’d go crazy. Part of losing empathy is a survival strategy. Without a slight loss of empathy, no one could ever become a pediatric oncologist. Feeling all of those patient’s feelings would make the job too exhausting to continue. Yes, losing empathy happens. Now it’s time to talk about it.
One other potentially positive effect of these strategies is giving physicians tools to help reduce the amount of substance abuse in the profession. We’ve had several mentions in class thus far about substance abuse not being a great coping mechanism and how it’s significantly increased in physicians, but there doesn’t seem to be a movement to help students cope even at the earliest stages of their medical careers.
Well, these are my suggestions for improving empathy. What are yours? I’d love to hear your thoughts about how to improve empathy in med school or why it matters.