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Getting a feel for it

Over at Gross Anatomy, Graham continues to give me opportunities to tag-team. Today he writes about the lapse of perspective and compassion that he is feeling lately. There’s a lot of neat research on the processes of professional training and socialization, and because medicine is so often thought of as the archtypical profession, a great deal of this work has been done on medical education.

Graham’s feeling of being overwhelmed and losing his precious sense of compassion is precisely what Howard Becker and his colleagues found in their now-classic study of medical students, Boys in White. The need to get through the program pushes aside the desire to provide careful, personal care as doctors learn the boundaries of their own medical knowledge, the knowledge of the field in which they work, and the overarching uncertainty that pervades their practice. They learn to learn as efficiently as possible. On one hand, this allows new doctors to develop and really appreciate their clinical skills, but with it comes some cynicism about the medical field and a marked emotional detachment (the latter is a pretty consistent finding in many programs of professional training) that, when students have time to reflect, is rather dismaying.

But Becker et al do see a light at the end of the tunnel: They found that idealism tends to return as graduation approaches, when completing the program seems like a less enormous obstacle. Numerous follow-up studies have confirmed this return to a focus on compassion and patient care, but with some nuances: Namely, they suggest that although new doctors regain much of their initial idealism, it is nonetheless tempered by other attitudes, such as the desire for personal success.