By Ajay Major and Aleena Paul
On the first evening of the AAMC 2013 Annual Meeting in Philadelphia, actors from The Center for the Application and Scholarship of Theater in Medicine showcased “Milestones,” a production chronicling the journey of Dr. J. Smith from her first day of medical school to her third year of residency. The audience watched as Dr. Smith transformed from a blissfully optimistic but naive medical student to an overwhelmed physician, unable to cope with the stressors in her life and acting unprofessionally towards her colleagues. The circumstances behind this transformation were all too familiar to the medical students in the audience: the overwhelming volume of knowledge to be gained, the family members who don’t understand long nights spent at the hospital, and the constant, biting fear of inadequacy. In the discussion following the play, it was heartening to hear faculty stressing the importance of the humanities in maintaining compassion and empathy as medical students tread the arduous path to becoming physicians.
This is not a new concept. Medical educators have long agreed that patient-centered values of self-reflection, communication, collaboration, and empathy should be inculcated in students early in their education to advance quality across the health care system. Adequate training in clinical empathy for students improves patient outcomes, decreases costs, and avoids provider burnout. Unfortunately, research suggests that the socialized hierarchy and “hidden curriculum” of medical education are structural barriers that impede training in the humanism of medicine and may even sap medical students of their compassion and optimism for the profession. It is apparent that there is a disconnect between what medical students need to become compassionate physicians and what is actually available for them during their medical training.
To be frank, these dimensions were not on our minds when we launched in-Training, the online magazine for medical students, in April 2012. Arriving at medical school with a background in news reporting, we sought—and did not find—a forum to continue our own passion for journalism as a force for patient advocacy and collaboration among medical professionals. We founded in-Training to learn more about the community and culture we were about to enter, to participate in the shared experience of being a physician-in-training, and to learn from the wisdom of our peers.
However, when our initial call for submissions garnered over 150 inquiries from medical students across the country in merely two weeks, we came to the startling conclusion that we had stumbled upon an unfilled niche in medical education. Over the past 17 months, in-Training has met this pressing need for a communal gathering place for the medical student body. With over 210 articles authored by 101 medical students at 50 institutions across the United States, Canada, India, and even the Dutch Antilles, in-Training has become a forum for medical students to showcase their literary and artistic endeavors and share their thoughts on arts, politics, science, and literature with their peers around the globe.
The majority of pieces we have published are self-reflections. Medical students finally have a place to call their own where, through reading or writing, they can take a moment in their hectic schedules to reflect on the profound transformation they are undergoing as physicians-in-training. They address diverse topics, including developing patient–physician relationships, maintaining compassion, improving medical education, addressing health disparities, and refining the health care system. The pieces on in-Training are stories of the everyday moments that define today’s medical students and tomorrow’s physicians.
Since we launched, we have learned that the medical student voice is organic, evolving with the changing tides of medicine and health care. To preserve this living, breathing nature, we refined in-Training’s mission this past summer to encourage self-reflection, communication, and collaboration among our medical student audience. We now recognize that our original mission of encouraging the use of media as a vehicle for patient advocacy is only possible once we physicians-in-training have a place to care for our own wellbeing and to navigate our own transformation from blissfully optimistic but naive medical students into compassionate and collaborative physicians.