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Nurturing empathy

From classroom to clinical: When medical students become doctors


By Elizabeth Furey

The training director for Memorial’s Student Wellness and Counselling Centre’s psychology doctoral program is part of a three-year, $1.2-million international research collaboration.

Dr. Beth Whelan is the training director for the psychology doctoral program at Memorial’s Student Wellness and Counselling Centre.
Photo: Submitted

Dr. Beth Whelan, an associate professor in Memorial’s Faculty of Medicine, is studying the transition medical students face when moving from the classroom to the clinic in their third year of medical school.

The project, called PROFMED, is focused on students’ preparation for and experience of clinical placements.

‘Very difficult time’

Based out of the University of Bergan in Norway, PROFMED is led by Dr. Edvin Schei, a professor in the Department of Global Public Health and Primary Care there.

Dr. Whelan is the curriculum lead for the project and is the main researcher developing the curriculum.

“The transition between second and third year in medical school, when students move from classroom to clinic, is a very difficult time,” said Dr. Whelan.

“The outcomes of this study can potentially help inform curriculum development and planning for students who are undergoing this transition at medical schools around the globe, including Memorial.”

Loss of empathy

Research has shown that students typically enter medical school with a higher level of empathy than the average student.

However, throughout the course of their program, that heightened empathy fades and is below that of the average student by the beginning of the third year of their program.

The loss of empathy is partly due to the difficulty students experience once they leave the classroom and begin their clinical rotations and interact with actual patients with real life health concerns.

“There isn’t really a lesson that prepares you on how to tell a family member their loved one is dying.” — Dr. Rhiannon Tracey

Professional identity formation, roles and responsibilities and the emotion required to treat patients all contribute to the struggles third-year medical students face.

Dr. Rhiannon Tracey is a recent Faculty of Medicine graduate, currently completing her residency in orthopaedics.

Her first clinical rotation at the beginning of third year was in psychiatry. She says that going from the calm, quiet classroom experience to a busy psychiatric ward was “eye-opening.”

“When working with standardized patients in second year, there is a predictable pattern. There is no predictable pattern in the real world. There isn’t really a lesson that prepares you on how to tell a family member their loved one is dying or how to tell someone they have a life-altering disease.”

Avoiding burnout

Delivering those types of messages to patients and their loved ones can have more of an effect than most medical students realize.

Dr. Whelan says that students know they are supposed to be empathetic towards their patients, but also struggle with the belief that they are not supposed to feel. The result? Students tend to block out their own feelings.

Dr. Whelan says a decline in empathy is the last thing you want in a physician, as it can lead to burnout and poor patient care.

“It is our hope that this research and the curriculum we are building through this study will target these particular areas to help students smoothly transition into their clinical role, feel confident and competent in this new role, maintain their empathy and, ultimately, be more skilled clinicians.”

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