A Commentary on Medical Education

by Lauren Claus

The practice of medicine is filled with intimate and delicate moments; physicians are entrusted with tasks such as delivering a painful diagnosis, encouraging a patient to embark on a weight loss program, or calming the anxieties of new parents-to-be. These situations all require strong interpersonal skills, a comforting demeanor, and a deep sense of empathy. However, the road to medicine is typically thought to require different skills such as strong standardized-testing abilities and the capability to lead large groups or organizations. Although this paradox is often overlooked, it raises important questions about the current state and future goals of medical education.

On one hand, the amount of competition that premedical students encounter seems inevitable because so many students are interested in pursuing medical studies. According to the Association of American Medical Colleges, 48,014 applications were submitted (redundant) to medical schools in the United States in 2013 (2). With so many applicants, a system of standardized evaluation becomes necessary- and thus, every premedical student feels the pressure to demonstrate aptitude and success in the Medical College Admission Test, their Grade Point Average, extracurricular leadership, and research experiences.

These requirements are certainly not opposed in spirit to the practice of medicine. Of course, the personal reflection required to craft a personal statement and the scientific knowledge required to participate in research do well to prepare students for medical school. More generally, physicians must have the ability to think and act quickly to help their patients. Also, the current system of premedical education allows students to take a gap year before beginning medical school, which can provide a necessary opportunity to reflect on the vocation of medicine outside of a competitive framework. However, perhaps the traditional path to medical school would be improved if it contained an additional component that emphasized less tangible but equally important aspects of practicing medicine, such as experiences with illness, healing, or suffering. Although premedical students typically volunteer and shadow in clinical settings, they do not usually have the opportunity to follow the trajectories of individual patients or prepare for the emotional complexities of practicing an imperfect science.

Many physicians describe their experiences in these areas through writing. Rafael Campo, a physician at the Harvard Medical School and accomplished poet, recounts encounters with patients through his verse and sees this process as a component of practicing medicine. He also indicates that such poetry can become a powerful tool for building compassion, a trait that is difficult to measure but is “what most patients seem to feel is most lacking in medicine these days” (3). To this end, Campo leads writing workshops for medical students to introduce them to ways to connect their medical experiences with broader ideals (1).

It is important to note that the position which Rafael Campo emulates is not opposed to the extensive use of highly sophisticated scientific technology and treatments to help patients, but rather is concerned with “losing sight of some of the truths of the experience of illness” (2). The problem is not the advances themselves, but the possibility that they may lead to an attitude that loses focus on the human side of such treatments. Campo provides an example of this when he says that a doctor should “perform all those technical competencies” and focus on how to best treat the patient, but still “be able to warm the hand of the patient dying in the ICU despite all the IVs and ventilator settings” (2).

In the same way, medical education is not wrong in its emphases on applying scientific knowledge quickly and accurately, but could improve with increased focus on medicine as an interpersonal career. Such a focus is difficult to provide, however, because personal qualities such as empathy, compassion, and interpersonal abilities (such as clear communication skills) are not as easily taught or measured as a traditional scientific background. Because of this inherent quality, perhaps it will continue to be individual premedical students and individual physicians who reflect the principles of empathy and compassion that are implied but not explicit in the healthcare systems in which they practice.

Lauren Claus ’16 is an English concentrator in Adams House.

References

1. J. Davis, Rafael Campo’s Student Physicians Embrace Poetry to Hone Art of Healing (PBS, 2014).
2. L. Ward, Medical School Applicants, Enrollments Reach All-Time Highs (Association of American Medical Colleges, 2013).
3. R. Campo, Interview by Courtney Davis (Poets.org)