How to find a medical school with a robust ethics curriculum?

[1griffin]

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I'm looking for a medical school that is particularly strong in medical ethics. However, I can't figure out how to tell which schools are strong in that particular field, especially because so many schools list their ethics courses by other names, such as "Medical Professionalism". How can I know if a school's curriculum has a strong ethical focus, and does anybody have any suggestions for schools that work particularly hard to create ethically minded physicians? Thank you!

 

[flapjack3d]

Anywhere you go it will be a very minor part of your curriculum, relatively speaking. I suggest you don't choose a school based on this. You might choose one based on whether they offer a combined MD/MA in bioethics.

But one standout I'd imagine is rochester. I know they try to integrate humanities more into the curriculum than other places.

 

[VincentAdultman]

I'm looking for a medical school that is particularly strong in medical ethics.

Hang around long enough, and you'll see questions you'd never thought would be asked.

 

[theonlytycrane]

Lol


Sent from my iPhone using SDN mobile app

 

[cossackdoc]

I'm looking for a medical school that is particularly strong in medical ethics. However, I can't figure out how to tell which schools are strong in that particular field, especially because so many schools list their ethics courses by other names, such as "Medical Professionalism". How can I know if a school's curriculum has a strong ethical focus, and does anybody have any suggestions for schools that work particularly hard to create ethically minded physicians? Thank you!

I would think it would be exceedingly difficult to objectively determine such a mindset; every medical school undoubtedly espouses allegiance to such a goal. To answer your question regarding particular schools, a "strong ethical focus" is pretty broad, but it would likely be predicated upon the responses to specific issues that you might think worthy of discussion, as opposed to any particular school being relatively superior or inferior.

 

[TelemarketingEnigma]

OP, are you looking for a school that produces "ethical physicians" or a school that actually has a strong focus on things like bioethics in the curriculum? The latter is very different than "medical professionalism" and a little bit easier to find evidence of.

 

[Master_of_Savage]

I'm looking for a medical school that is particularly strong in medical ethics. However, I can't figure out how to tell which schools are strong in that particular field, especially because so many schools list their ethics courses by other names, such as "Medical Professionalism". How can I know if a school's curriculum has a strong ethical focus, and does anybody have any suggestions for schools that work particularly hard to create ethically minded physicians? Thank you!

Anywhere you go it will be a very minor part of your curriculum, relatively speaking. I suggest you don't choose a school based on this. You might choose one based on whether they offer a combined MD/MA in bioethics.

But one standout I'd imagine is rochester. I know they try to integrate humanities more into the curriculum than other places.

I know Northwestern has a combined MD/MA in bioethics program. I can't speak to its "strength" but I believe it is a 4 year program.

 

[precisiongraphic]

Georgetown has a Literature track and a Health Justice Scholar track - these may touch on medical ethics more than a standard program.

 

[Sephirakra]

If you're open to osteopathic programs, KCUMB also has a combined DO/MA in Bioethics.

 

[flapjack3d]

Is there any evidence that ethics classes actually produces more ethically minded physicians?

 

[mistafab]

Penn state has a great integration of medical ethics in their curriculum. I interviewed at their program and you could really tell they cared about it compared to other schools. Whether or not this translates into actual ethical development in their students I cannot say.

Just snoop around and you'll hear about more programs like that.

 

[1griffin]

OP, are you looking for a school that produces "ethical physicians" or a school that actually has a strong focus on things like bioethics in the curriculum? The latter is very different than "medical professionalism" and a little bit easier to find evidence of.

Thanks everybody for your help! Ideally, I would like to find schools that work to produce ethical physicians, and I think that a strong ethics focus in the curriculum might be evidence of the latter. (I know that curriculum is not everything, but I recently read a fascinating article on how ethics education shaped physicians during the Nazi regime, and it's something that I've been thinking about lately.)

 

[elitehacker1337]

Loma Linda?

 

[blackroses]

Loma Linda?

Which raises a question about whether or not actively discriminating against LGBT individuals qualifies as unethical

 

[hurtem&healem]

That is an interesting article from a purely historical curiosity view. It really just makes me think about this even more, though:

Is there any evidence that ethics classes actually produces more ethically minded physicians?

I mean, did that lecture series really have much of an effect on those medical students, or was it considered by the students as a huge waste of time since these were all beliefs they had been raised with all along? If they had SDN, would there have been a bunch of threads saying, "omg, these ethics lecture are a giant time suck when I would be better off studying for boards. Do they really think I need to be reminded that the Jew is an inferior race?"

Anyway, is there any evidence that ethics classes = ethical physicians?

 

[deleted480308]

I'm looking for a medical school that is particularly strong in medical ethics. However, I can't figure out how to tell which schools are strong in that particular field, especially because so many schools list their ethics courses by other names, such as "Medical Professionalism". How can I know if a school's curriculum has a strong ethical focus, and does anybody have any suggestions for schools that work particularly hard to create ethically minded physicians? Thank you!

As opposed to the schools creating unethical physicians?

What sort of help do you need to stay "ethical"? What does that mean to you specifically?

 

[1griffin]

As opposed to the schools creating unethical physicians?

What sort of help do you need to stay "ethical"? What does that mean to you specifically?

I agree with @cj_cregg that a good ethics curriculum will help us face the actual issues that we will encounter as physicians. Some of these are the type of big issues we all hear about (i.e., patient refusing treatment for religious reasons), but there are also smaller issues. For instance, do I tell a patient that they are the first person I have ever performed a given procedure on? For now, I don't know what other issues I'll encounter, but I would love a curriculum that can help me anticipate and prepare for such situations. I would also like to avoid becoming the type of physician that experiences the classic decline in empathy throughout medical school.

Hope that is a little clearer!

 

[deleted480308]

I agree with @cj_cregg that a good ethics curriculum will help us face the actual issues that we will encounter as physicians. Some of these are the type of big issues we all hear about (i.e., patient refusing treatment for religious reasons), but there are also smaller issues. For instance, do I tell a patient that they are the first person I have ever performed a given procedure on? For now, I don't know what other issues I'll encounter, but I would love a curriculum that can help me anticipate and prepare for such situations. I would also like to avoid becoming the type of physician that experiences the classic decline in empathy throughout medical school.

Hope that is a little clearer!

The "decline in empathy" doesn't have much to do with ethics as much as it does med school and training is just plain hard on us and you get less emotionally involved when you get you 743rd patient with copd that still smokes

I think you are overestimating the utility of this "training", but you do whatever makes you happy

 

[VincentAdultman]

I would like to find schools that work to produce ethical physicians

OP maybe I'm way off on this but if you don't graduate from an American medical school as an ethical physician then something went off the tracks long before you matriculated.

 

[TelemarketingEnigma]

Thanks everybody for your help! Ideally, I would like to find schools that work to produce ethical physicians, and I think that a strong ethics focus in the curriculum might be evidence of the latter. (I know that curriculum is not everything, but I recently read a fascinating article on how ethics education shaped physicians during the Nazi regime, and it's something that I've been thinking about lately.)

Based on my experiences working and interacting with a lot of bioethicists, I think a strong academic ethics curriculum is not necessarily going to tell you much about producing "ethical" or "compassionate" physicians. While clinical ethics are of course a part of it, the broad field of bioethics covers a lot of questions that, while fascinating, aren't particularly relevant to the daily life of a typical physician. I think this type of curriculum is important for providing a broader perspective, but as far as direct relevance, I think bioethics tends to be more directly informative for people in policy making positions, serving on IRBs, etc.

I don't think any school is trying to produce unethical or uncompassionate physicians, so if that's really all you're looking for I think you may want to look more at things like social justice or community service and engagement opportunities. But if you're interested in taking a deeper dive into the academic bioethical side of things, a lot of schools have dual degree or concentration programs you can look for.

 

[calivianya]

I'm interested in this question, too.

I currently work in a very ethically charged area (MICU) and want to become an intensivist. Have you guys ever seen the picture of Tina Fey being comforted with a broom? That's how I felt the first time I interacted with the family of a dying patient - like I was the person holding the broom. No clue what to do and no clue on how to go about getting any better at doing... whatever I was supposed to be doing and saying.

I'm now better than I used to be, having at least dozens of patients die. However, I still don't always feel comfortable attempting to segue the family into a conversation about code status. I've seen some people do it just totally naturally, as if their first words as an infant comprised a speech on medical futility. However, sometimes I have trouble being the one to initiate the conversation. I don't find this easy at all, and I feel like I never have the right words. If someone else has brought it up, sure, I'll talk futility all day long... but I really hate making people cry (and god, I've made a lot of people cry because I try to be honest when they ask me things), and families tell me I'm comforting but I still feel very clumsy in these situations.

How many of these MD/MA programs are clinically driven and help with things like how to convince families that their loved ones' illnesses are unfixable and withdrawing care is the only reasonable thing to do, in a way that's not going to cause people to collapse and/or start sobbing in the room? I feel like that's a really tricky line to toe. Honest without being mean, compassionate without being deceptive about the patient's condition... you know?

 

[wholeheartedly]

@1griffin I think it's great you're interested in this and want to become an ethical physician, but after almost a decade working in health care I agree with some others above that the kind of ethical dilemmas you're thinking of aren't really what most people face day to day or where most people go wrong.

The big stuff you cover in ethics courses like end of life stuff, consent, capacity to make decisions, the social justice stuff is all important, but often there are things in place such as hospital policy state laws and ethics committees to help you work through some of that stuff. They make for very interesting discussions though.

But the day to day ethical lapses that happen in healthcare are pretty straight forward stuff that people go wrong on for reasons far different than a lack of knowing what the right thing to do is. These are things like residents or nurses documenting exams they didn't do or vitals they didn't take because they got busy or forgot and don't want to get in trouble for screwing up. Everyone knows this is wrong, but they still do it and rationalize their behavior figure that it's no big deal or that they already know what the exam would've shown and that the consequences of them screwing up are far worse than any potential harm to the patient.

I've seen a lot of people lie to cover there own asses while throwing someone else under the bus. My colleagues and I tried to page a resident repeatedly for a patient issue and got no response (path resident home call) and wound up having to call the attending at 2:30 a.m. to deal with the problem. He gets in touch with her and she calls us back with loud party music/people in the background and begs us to lie and say we called the wrong number (there's only service pager number we ever call) we said we weren't going to lie for her about what happened. So she proceeds to concoct this big lie and blame it on us. Patient care got delayed and then staff got screwed.

This kind of crap is far from rare. It isn't anything a class is going to help with. It's purely a function of individual character and integrity. Do you have what it takes to do what you know is right even when it's going to make things suck for you? Can you admit to your superiors you made a mistake or forgot something? Is your environment supportive enough for you to feel comfortable owning those mistakes?

That's the day to day stuff that makes or breaks an ethical physician. They can't teach that in school.

 

[Lucca]

It's worth mentioning that bioethics is also its own scholarly field, closely related to law and clinical research. It's not just a way for people to learn to be "more ethical", bioethicists study consent, work to create documents to advise lawyers and policy makers on regulating upcoming bio technologies, advise physicians on setting up clinical trial protocols that are ethical, safe, and scientifically meaningful.

I know that's not what the OP asked about, but I would be remiss if the only thing people thought bioethicists did was think about how to be nicer to people lmao.

The NIH has a pre and postdoctoral program in Bioethics for people (lawyers, MDs and researchers) interested in the scholarly side of the field.

 

[VincentAdultman]

It's worth mentioning that bioethics is also its own scholarly field, closely related to law and clinical research. It's not just a way for people to learn to be "more ethical", bioethicists study consent, work to create documents to advise lawyers and policy makers on regulating upcoming bio technologies, advise physicians on setting up clinical trial protocols that are ethical, safe, and scientifically meaningful.

I know that's not what the OP asked about, but I would be remiss if the only thing people thought bioethicists did was think about how to be nicer to people lmao.

The NIH has a pre and postdoctoral program in Bioethics for people (lawyers, MDs and researchers) interested in the scholarly side of the field.

Yes Bioethics is a thing and is totally legit. But, as you said, not what the OP asked about.

 

[TelemarketingEnigma]

Yes Bioethics is a thing and is totally legit. But, as you said, not what the OP asked about.

I think it's an important thing to get across though, because:

I think that a strong ethics focus in the curriculum might be evidence of the latter.

being clear on what ethics is and is not will help OP figure out what they are really looking for

 

[TSteezy]

Michigan has integrated optional "Paths of Excellence" into our 3rd and 4th year curriculum. We've been told to look at them like minors. One of the Paths is called "Ethics." Look it up!