Medical Schools Need To Cut Their Cutthroat Culture


By Glen Jacobs, DED

The United States will be short 120,000 doctors by the end of next decade, according to the latest research from the Association of American Medical Colleges.

That shortage will become permanent unless medical schools make the path to becoming a doctor a bit less arduous.

Some medical schools seem to take pride in imposing a heavy emotional and physical toll on their students. Toughen up aspiring doctors early on, the thinking goes, so they’re prepared for long hours and high stress when they’re working in clinical settings.

That thinking is outmoded — and risks dissuading people who would make excellent physicians from considering careers in medicine. To graduate skilled doctors — and enough of them — med schools must invest more in their students’ mental and physical health.

It’s no secret medical school is challenging. It should be, of course. Students are learning to navigate matters of life and death. Classes and lab work demand long hours and significant intellectual effort. Students also invest years of their time and significant sums of money.

Given these challenges, it stands to reason that med schools should do all they can to help their charges succeed.

At some schools, however, the academic culture is toxic. Students are expected to master material on their own; seeking help is seen as a sign of weakness. Nearly half of all medical students report having been publicly embarrassed by faculty, staff, or peers.

One survey from the Annals of Internal Medicine found that about half of medical students are suffering burnout — that is, severe emotional and physical exhaustion. Burnt-out students have a harder time absorbing information and are more prone to make mistakes in clinical practice.

Many talented young people have taken note of these negatives — and decided that medicine may not be the right field for them. The number of med school applicants has essentially been flat for the past four years.

Neither medical schools, nor a healthcare system desperate for doctors, can afford to see the pool of potential med students dry up.

Medical schools can create a more supportive learning environment without sacrificing rigor. Indeed, the Association of American Medical Colleges has explicitly called for schools to better support “the health and well-being of the learners.”

Some have heeded that call. The University of Pittsburgh School of Medicine, for instance, offers free mental health care delivered by a dedicated team of providers to its more than 900 students.

Stanford Medical School runs a cognitive behavioral therapy program to teach proven techniques for reducing stress. Administrators have also set up an annual wellness survey specifically to identify and treat the problem of sleep deprivation that’s all too common among med students.

The University of Wollongong in Australia runs a student advisors program that’s proven effective at preventing burnout among Aboriginal, Torres Strait Islander, and other at-risk student populations. And a number of medical schools have launched formal mentorship programs that pair first-year students with second-years who provide academic guidance and emotional support.

Recent academic research has chronicled the positive effect that institutional investments in academic and mental-health support can have on student performance. We’ve acted on the findings from this research at St. George’s University.

Our students work closely with learning strategists to navigate academic challenges and stay on schedule. Small-group instruction and collaborative learning environments informed by the latest pedagogical research are the norm. St. George’s also offers popular programs on time-management, effective note-taking, and mock residency interviews — essential skills students don’t typically learn in the classroom.

All Americans have a stake in improving the lot of medical students. After all, we’ll need a lot more of them to address our doctor shortage.

A healthier med school culture may also help diversify the ranks of physicians in the United States. The cutthroat status quo has yielded a doctor workforce that’s almost three-quarters white. Twenty percent of physicians are Asian. Less than 5 percent are black.

Racial, ethnic, and socioeconomic minorities are far more likely to consider careers in medicine if the institutions that have historically excluded them can prove they’re invested in their success.

Medical school should be tough. But it doesn’t have to be miserable. By investing in support services outside the classroom, medical schools can boost student well-being — and turn out better doctors.


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