Really interesting article over on recently that discusses how 3rd year of med school is the real beginning of a subtle but profound transition between being an idealistic and empathetic med student to being jaded and bitter. Finishing up my 3rd year of med school, I can completely empathize with this (no irony intended).

Dr. Danielle Ofri writes “I discovered that the third year of medical school is when these high-minded traits begin to erode, an observation that won’t come as a surprise to anyone who’s been through traditional medical education…It’s no wonder that the third year of medical school figures prominently in studies that document the decline of empathy and moral reasoning in medical trainees.”

I definitely have experienced these feelings from time to time. Sometimes it’s fairly subtle, for example, thinking a patient in pain is being kind of whiny to keep getting Dilaudid. Being in the hospital seems to make everyone, doctors and patients, kind of whacked out after awhile.

On the worst days, I think this whole medicine thing is a sham and the most therapeutic action to take is to create social conditions that make it easier for people to realize their deep connection with not only all of humanity, but with all of existence. It’s more important now than it ever has been for people to step up and provide guidance for the field of medicine – that unique combo of art and medicine – to grow, or we’ll continue to stagnate under the weight of profiteering, bureaucracy, and the delusion that what we’re doing is 100% pure evidence-based science. 

It’s not. 

Overall, the year has definitely not left me feeling hopeless. If anything, it’s provided first-hand insight into the problems we’re facing, and for that, it’s been invaluable. It’s provided opportunity for personal reflection, even though I haven’t always taken advantage of it. 

I’ve observed that the people who really seem to struggle are those who have difficulty with humility. I don’t think it’s entirely their fault – they’re selected to attend medical school because they’ve achieved highly from an academic standpoint (though whether we’re choosing the “right” type of person for medicine is a separate but related topic). They’re rewarded for performing better than their medical school peers. It hit me recently how ridiculous a message it sends to assign class rank to medical students on one hand while telling them “you need to learn how to work in a team!” on the other – look, it’s not so easy to switch those mindsets at the drop of a hat. yet it is necessary to have some type of criteria to determine how to select candidates for residencies. I don’t blame those individuals for being hyper-competitive – it’s an impulse I certainly feel at times – but I do think we need to seriously re-evaluate how we’re training doctors. I’m definitely excited about reading Dr. Ofri’s book. The Mindful Medical Student by Dr. Jeremy Spiegel is a book that seemed to go under the radar of most reading lists, but I found it very helpful before I started med school, and I’d like to read it again after third year.

But I don’t have the time – I’m too busy cramming scientific facts for the next multiple-choice test.