Building and maintaining the workforce in healthcare has become an area of concern in recent years. Medical schools put students through a rigorous course load combined with hands-on experiences that are both physically and emotionally draining. Students must serve long hours in the clinic to gain exposure to a variety of cases. Some believe this style of education negatively impacts their perceptions of medicine, inevitably resulting in burnout, while others question whether this increasingly competitive education system produces adequate physicians.
The problem lies in the emphasis of medical education: are students being taught to live out their passions and provide services to others out of genuine compassion, or are they becoming jaded by constant exposure to highly stressful situations? As interest in the profession and number of competent applicants increase, so does the level of competition. At this rate, an easy and clean-cut solution is not so readily available.
Top-notch applicants have certain characteristics in common, including compelling personal motivation, excellent academic ability, an above-average MCAT score, and strong test-taking skills, which initially qualify them to take on this demanding occupation. Medical schools aim to select students that demonstrate outstanding performance in the sciences because a strong knowledge base is integral to becoming a good physician. This mindset, however, has garnered a culture in which applicants must make an increasingly greater effort to stand out from their peers.
This trend continues in medical school. The positive feedback loop is put on a never-ending cycle, resulting in 16-hour shifts, 80 hours per week, and with as many as 40 patients to tend to. Interesting cases are valued over common health problems, and treatment has become merely a tool for teaching.
Proponents of an education system more focused on quality of patient care have taken steps to implement changes. Some schools focus on service and interaction with the surrounding community and work toward engendering qualities of compassion and empathy within their students. St. Louis University, a leader in this regard, emphasizes in its mission statement the “provision of patient-centered, compassionate, culturally competent health care, and involvement with the community through public service.”
Joe Shi, a recent alumnus of WashU and a second-year medical student at SLU, said he believes his school’s curriculum truly stresses “the concept of service to the community as part of the responsibility of a true physician.” Along with a pass/fail curriculum and fostering close, working relationships with their deans, SLU offers a variety of service opportunities and is open to creating more.
Shi has worked with the Health Resource Center (HRC), a free, student-run clinic in one of the city’s underprivileged neighborhoods. The patient histories and physical examinations are performed entirely by medical students with an attending physician and pharmacist present at each session. “It’s a great opportunity for students to learn basic clinical skills while giving back to the community,” he said in regards to his experience there.
Shi’s statement testifies to the primary motivation of the school in developing an environment in which the importance of giving overshadows the satisfaction of achieving. A shift like this may effectively reshape students’ perceptions of patients as individuals that they are in charge of bettering the lives of.
Although there is no easy solution to the issue of education reform, medical education can be guided in a direction targeted towards ingraining solicitous qualities in students. A genuine willingness to serve is essential, especially at a time when the trend is to specialize despite the disconcerting lack of primary care physicians. Instilling a sense of responsibility for the quality of healthcare in our future doctors is achievable. However, this relies on shifting the focus of medical education towards fostering a heart for service and an attentiveness to the needs of the community. After all, we would hope our own doctors truly do care for our well-being.