My theory on why med students show decline in empathy

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calimeds

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I'm experiencing it myself. The more I bust my ass to get top grades, the more I start to view those around me who won't do the same as lazy. It's not anything I'm doing consciously - it's just gradually happening.

I wonder if the empathy decline shown by students in med school could come down to this - they see themselves and other med students / doctors as the hardest working, most self-sacrificing group of people they are in frequent contact with, and so start to judge others by that scale.

Just a hypothesis. Okay, back to the books. . .
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I don't think its more of a decline in empathy per say, but a decline in the idealistic vision of empathy. You can still care for people without being determined to cure all of their problems and connect with them on a transcendent, spiritual bond.
 
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calimeds said:
I'm experiencing it myself. The more I bust my ass to get top grades, the more I start to view those around me who won't do the same as lazy. It's not anything I'm doing consciously - it's just gradually happening.

I wonder if the empathy decline shown by students in med school could come down to this - they see themselves and other med students / doctors as the hardest working, most self-sacrificing group of people they are in frequent contact with, and so start to judge others by that scale.

Just a hypothesis. Okay, back to the books. . .
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Yeah thats not why. Or at least not for most people. It has nothing to do with feel superior or judging others.
 
alwaysaangel said:
Yeah thats not why. Or at least not for most people. It has nothing to do with feel superior or judging others.
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I suspect it has more to do with a degree of jadedness and/or desensitization, as it does with most other healthcare professionals. When you see it day in and day out, your become desensitized toward some of these things (in part because you have to to survive).
 
music2doc said:
I suspect it has more to do with a degree of jadedness and/or desensitization, as it does with most other healthcare professionals. When you see it day in and day out, your become desensitized toward some of these things (in part because you have to to survive).
Click to expand...

Yup. When you see people die everyday it just isn't a big deal. Its the end of the world to the family of that one person, but to you its just one of your ten patients and it happens every day.

Part of it is desensitization, part of it is crude humor as a coping mechanism. Either way, it has nothing to do with feeling 'better' than others. It has to do with seeing things from a completely different perspective than the patient.
 
I think the OP got the definition of empathy wrong. Empathy means the ability to understand another person's feelings, and thinking of others people as lazy is more like arrogance.
 
I think Flamen04 and alwaysangel have it right. It really is a decline in the idealistic vision, that gets replaced with real world practical nature, maturity, and mastery. For example, I was called out by a pre-med in another thread for not showing empathy to someone who was dismissed from college for cheating. I liken that situation to a drug seeker. In the pre-med world, the idea of empathy must be extended to every single person regardless of situation. I see this as the immature form of empathy: not being able to understand or differentiate situations, it just gets sloppily applied to everything like a little kid frosting a cake.

Calimeds, I think what you are describing is something separate but related to empathy. It's easy to go through 80 hours a week on a surgery rotation and see all the nursing staff, even in surgeries, go out for lunch breaks and complain about having to to work into 42 hours per week overtime. All of your non-med college friends will bring up similar complaints from time to time, and it's easy to lose that sense of "I feel for ya." Because you don't in comparison.
 
calimeds said:
I'm experiencing it myself. The more I bust my ass to get top grades, the more I start to view those around me who won't do the same as lazy. It's not anything I'm doing consciously - it's just gradually happening.

I wonder if the empathy decline shown by students in med school could come down to this - they see themselves and other med students / doctors as the hardest working, most self-sacrificing group of people they are in frequent contact with, and so start to judge others by that scale.

Just a hypothesis. Okay, back to the books. . .
Click to expand...

👎thumbdown👎thumbdown👎thumbdown👎

And that's the problem with "Wanna Be" Dr.s like yourself. Just remember....that CNA who was a single mother and had to put herself through CNA school worked just as hard as you did...MAYBE HARDER!. Just because you're pre-med doesn't give you the right to post this egotistical garbage.
 
alwaysaangel said:
Yup. When you see people die everyday it just isn't a big deal. Its the end of the world to the family of that one person, but to you its just one of your ten patients and it happens every day.

Part of it is desensitization, part of it is crude humor as a coping mechanism. Either way, it has nothing to do with feeling 'better' than others. It has to do with seeing things from a completely different perspective than the patient.
Click to expand...

While you're mostly right, it is quite an overstatement to say that this has nothing to do with why empathy decreases. Sure, perhaps it isn't for most students but to categorically say this doesn't happen is likely wrong. Even if it's not the primary reason for what the OP describes, is there a potential for this to be one of the contributing factors?

Different people are motivated by different things and they are also affected by their experiences in different ways. I don't think we can ever look at just one answer as a blanket explanation for why this pretty widespread phenomena is observed.
 
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Pietrantonio said:
👎thumbdown👎thumbdown👎thumbdown👎

And that's the problem with "Wanna Be" Dr.s like yourself. Just remember....that CNA who was a single mother and had to put herself through CNA school worked just as hard as you did...MAYBE HARDER!. Just because you're pre-med doesn't give you the right to post this egotistical garbage.
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It's her fault for getting pregnant and adding that layer of difficulty. I wouldn't empathize with her.
 
I think the entire educational system and selection process in this country is to blame. It is not a little known secret that unfortunately medical schools do not select for the most caring or compassionate individuals but instead select for the best test takers.

Regardless of what anyone else says, medical schools are simply selecting for the best test takers. It is simply a numbers game and every applicant is just a number. In fairness I will say however that I can party understand why this is done. Medical school and the path to medicine is nothing but test after test and then some more standardized testing. Poor standardized test takers will have a tough time surviving and the schools know this.

The problem, in my opinion, is that being a good test taker really has nothing to do with one's ability as a physician. Unfortunately the process selects for these individuals which can score a 35 MCAT but not understand human beings and interaction.

I can ramble on this topic forever so I will shut up now....
 
brandxnew said:
It's her fault for getting pregnant and adding that layer of difficulty. I wouldn't empathize with her.
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Well, maybe she's a single mother because her husband died, or left her for another woman. Or maybe she was using birth control properly and was one of the 1% of people who gets pregnant anyways. Or maybe she WAS just being irresponsible. The point is that you can't always be so judgmental of someone else's situation. Part of being empathetic is understanding that no one is perfect, and that YOU aren't such a terrific person that you are above making errors in judgment yourself.
 
To be frank, I think it mostly has to do with not knowing the type of commitment you're making into becoming a physician. A lot of people have the academic part figured out, but still struggle with the practical part. School and working in a busy clinical setting are two different things. School, at least for me...was a pretty seflish activity. I get grades for myself. Sure I help some peers here and there, but I was focused on my own success mostly. Working in the clinic however, it's about trying to help everyone else out, and make sure your mistakes don't affect others. It's a different mindset for starters, and I think it bleeds into the demeanor we have with patients.

In addition, let's see...public health people say that wealth is correlated with health. Going to be honest here...Who would you feel more compassionate towards? A guy with a code brown, homeless, drug seeking, and seems belligerant? OR, a person from the middle class, in a nice neighborhood, who has probably something acute and is honestly concerned for his/her health? Of course, these situations are interchangable. There are homeless people who are concerned for their health, and the affluent who are drug seekers, or really belligerant to health care. I used to volunteer in a private hospital, and it was a lot of fun being able to talk to the patients. I had vets, nurses, carpenters, doctors, PhDs, social workers, etc as my patients. Then I volunteered at a level one regional trauma center and safety net hospital, and now I just got a job there....You see a far different patient population. Lots of homeless, shelter-dwelling, immigrant populations... I think once you're exposed to that, I think you can lose that romantic vision of being at the bedside with patients, and developing that connection. Maybe i'm not being very articulate with my point-anyone with clinical exp can chime in on this plz?

And I would imagine most training site for medical students/residents are in safety net hospitals...so i think that plays into something as well. just a thought.
 
And I would imagine most training site for medical students/residents are in safety net hospitals...so i think that plays into something as well. just a thought.
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I would imagine so. Most people with money aren't going to want to be seen by students.
 
brandxnew said:
It's her fault for getting pregnant and adding that layer of difficulty. I wouldn't empathize with her.
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Hey you. Don't become a doctor.
 
IDK but this whole process in becoming a doctor is definitely turning me into a cocky son of a b*tch.
 
For most people, I think that it is "compassion fatigue." This is how I've seen many in the medical field feel burnt out after a while.
 
TheMightySmiter said:
Well, maybe she's a single mother because her husband died, or left her for another woman. Or maybe she was using birth control properly and was one of the 1% of people who gets pregnant anyways. Or maybe she WAS just being irresponsible. The point is that you can't always be so judgmental of someone else's situation. Part of being empathetic is understanding that no one is perfect, and that YOU aren't such a terrific person that you are above making errors in judgment yourself.
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I wouldn't be judgmental, I just wouldn't care.
iniquus said:
Hey you. Don't become a doctor.
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I think I'd be ok in plastics. 😎 Cosmetic of course.
KindofBlue said:
Wow. So is your face.
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That doesn't even make any sense!
 
.
 
Last edited:
That and you meet some pretty terrible people along the way, which doesn't help.

alwaysaangel said:
Yup. When you see people die everyday it just isn't a big deal. Its the end of the world to the family of that one person, but to you its just one of your ten patients and it happens every day.

Part of it is desensitization, part of it is crude humor as a coping mechanism. Either way, it has nothing to do with feeling 'better' than others. It has to do with seeing things from a completely different perspective than the patient.
Click to expand...
 
No, that's just becoming an academic elitist. Loss of empathy more likely occurs from being burned out from stress/fatigue/etc or a particularly bad run of patients, especially entitled ones, that leads you to believe the majority of patients don't deserve your compassion.
 
Wow, people are being unnecessarily harsh at the opener.

Doctors are harder working then the majority of the population. Seeing how lazy other people are can make you have less empathy.
 
Due to desensitization/habitualization towards apathy as a defense mech due mass amounts of pain you see in your day and then reinforced by lack of time to feel sad for patient1's pain as you scurry to treat patient2.
< Theory which involves doctors as source of lower rating >
Patients with infantile and unrealistic demands and notions of which can not be possibly attended too as a doctor. Such as demanding things like anti-biotics for a viral infection or a head ache and believing the doctor lacks bedside manner when they tell them to lose weigh and eat better instead of "treating them." Thus when surveyed the patients rate their doctors lower in empathy and other positive attributes.
< Theory which involves patients as source of lower rating>

Which theory of mine do you think is more at play here?
 
serenade said:
Due to desensitization/habitualization towards apathy as a defense mech due mass amounts of pain you see in your day and then reinforced by lack of time to feel sad for patient1's pain as you scurry to treat patient2.
< Theory which involves doctors as source of lower rating >
Patients with infantile and unrealistic demands and notions of which can not be possibly attended too as a doctor. Such as demanding things like anti-biotics for a viral infection or a head ache and believing the doctor lacks bedside manner when they tell them to lose weigh and eat better instead of "treating them." Thus when surveyed the patients rate their doctors lower in empathy and other positive attributes.
< Theory which involves patients as source of lower rating>

Which theory of mine do you think is more at play here?
Click to expand...

From what I have seen and heard from doctors it's number 2..... It's not really the pain.... But dealing with ignorant patients.

The internet is a huge source of the problem (WebMD) I have very intelligent friends in competitive/high paying careers who think that they know everything because of WebMD.

Another problem I have seen is really incompetent RN's. (Although this may have been a few isolated incidents)
 
I think that it just gets frustrating having to deal with stupid people who think they know more than you do. Sacrificing your youth for a-holes who will sue you at the drop of a hat. That kind of stuff.
 
kg062007 said:
I think that it just gets frustrating having to deal with stupid people who think they know more than you do. Sacrificing your youth for a-holes who will sue you at the drop of a hat. That kind of stuff.
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Agreed,

Lawsuits are definitely a big problem. People know how much they can get paid from malpractice insurance.
 
Truth be told, I went into this field cuz I'm a die-hard bio nerd who wanted to make some serious $$$ while doing what I love: science! lmao interpersonal empathy was never a driving factor for me.

That being said, I had some truly awesome patient encounter experiences my 3rd year that almost made me consider a clinical medicine specialty. But these type of patients are the exception... not the rule! Your average patient will be like

america-lead.jpg


and once you come across enough of these, in combination with realizing most issues dealing with patient health and the unrealistic demands and expectations of physicians stem from systemic problems plaguing the way our health care is setup and other societal issues that are WAY TOO BIG and COMPLEX to fix on an individual level... empathy ERODES and a tunnel vision for other things begins to set in


Namely,

money-doctor.jpg
 
Narmerguy said:
While you're mostly right, it is quite an overstatement to say that this has nothing to do with why empathy decreases. Sure, perhaps it isn't for most students but to categorically say this doesn't happen is likely wrong. Even if it's not the primary reason for what the OP describes, is there a potential for this to be one of the contributing factors?

Different people are motivated by different things and they are also affected by their experiences in different ways. I don't think we can ever look at just one answer as a blanket explanation for why this pretty widespread phenomena is observed.
Click to expand...

I think the OP did a poor job of trying to articulate why busting his ass leads to a decrease in empathy for him. I would attribute this type of disillusionment to something more akin to resentment. I have to work hard and contribute something to society, but the hedgefund owner who makes 7 figures doesn't need to do either. You work in the hospital even though you're sick as a dog and you see patients coming into the ER perfectly healthy asking for prescriptions for motrin because they are too cheap to pay for it. We live in a world that's lacking in equity, and it's very easy as a physician to look around from the medicine bubble and feel almost oppressed. Of course I haven't started school yet, but after working hard to get my foot in the door it's hard not to feel like you're owed something for it, even though you're not.
 
mTOR said:
Truth be told, I went into this field cuz I'm a die-hard bio nerd who wanted to make some serious $$$ while doing what I love: science! lmao interpersonal empathy was never a driving factor for me.

That being said, I had some truly awesome patient encounter experiences my 3rd year that almost made me consider a clinical medicine specialty. But these type of patients are the exception... not the rule! Your average patient will be like

america-lead.jpg


and once you come across enough of these, in combination with realizing most issues dealing with patient health and the unrealistic demands and expectations of physicians stem from systemic problems plaguing the way our health care is setup and other societal issues that are WAY TOO BIG and COMPLEX to fix on an individual level... empathy ERODES and a tunnel vision for other things begins to set in


Namely,

money-doctor.jpg
Click to expand...

👍 I had a patient (207kg) who can't afford medical treatments but can smoke pot 3x week while probably collecting disability. And who do you think pays for this.....:smack:
 
music2doc said:
I suspect it has more to do with a degree of jadedness and/or desensitization, as it does with most other healthcare professionals. When you see it day in and day out, your become desensitized toward some of these things (in part because you have to to survive).
Click to expand...

I'd agree with this. I don't think working ridiculously hard or having ignorant patients would make you less empathetic, it would just make you arrogant and judgemental.

After having so many patients, when another patient comes in with their problems, you would have inevitably seen worse. It might be hard to empathize with what you deem a small problem, even when to the patient it's huge (and doesn't understand why you don't see it that way).
 
You do not have the credentials to claim your opinion as a theory, that's not how things work. :eyebrow:
 
calimeds said:
I'm experiencing it myself. The more I bust my ass to get top grades, the more I start to view those around me who won't do the same as lazy. It's not anything I'm doing consciously - it's just gradually happening.

I wonder if the empathy decline shown by students in med school could come down to this - they see themselves and other med students / doctors as the hardest working, most self-sacrificing group of people they are in frequent contact with, and so start to judge others by that scale.

Just a hypothesis. Okay, back to the books. . .
Click to expand...


Not sure if this is really a lack of empathy, but I totally get it. When you never see the outside of the library, and you're extremely hard on yourself continuously, it's pretty easy to become jaded at the rest of the world. Other people have time to relax, time for family and friends, time for exercise, financial security (less so these days though) and, most infuriatingly, can feel good about themselves without pushing the limits of their mental endurance on a daily basis. You knew you were giving all of these things up when you started, but not how thoroughly you'd give them up or how small the reward/work ratio actually is in medical school.

Basically, I feel you. Hang in there, keep crushing it, get through to third and fourth year. Those years are hard, but seem to be a lot less isolating.
 
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