A study published this month in Academic Medicine looked how medical school affects levels of “vicarious empathy” in students, or as the paper is titled, “Is There Hardening of the Heart During Medical School?”

The short answer: it looks like it. The authors report that students’ vicarious empathy declines significantly after the first and third years. Here’s how the authors explain the post-first year drop:

For all the students studied, the significant decrease in vicarious empathy that occurred after completing the freshman year of medical school may have resulted from a high degree of student stress and anxiety caused by the students’ competitiveness and desire to overachieve on examinations. Additional stressful factors may include the media’s presentation of doctors as heroes, which helps create a skewed image of the ideal physician for entering freshmen medical students. As the students progressed through their freshman year, they probably realized there is a mismatch between the media representation and reality.

And that post-third year decline? The authors attribute it to seeing patients in the clinic, especially “challenging patients” in “university tertiary care centers.”

Inside Higher Ed talked with the study’s lead author, Bruce Newton:

Asked if vicarious (as opposed to imaginative or cognitive) empathy can be taught, Newton paused. Probably not. It is what you have. He stressed the need, however, for more emphasis on teaching and role modeling. He proposed, for instance, the formation of teaching academies within medical schools, where some faculty would be freed from the pressure of securing external research grants to focus on students instead.

Med schools tough. Its hard; students get cynical, Newton said. Whats needed, he said, is just more human contact. Whether or not empathy can actually be taught, more personalized instruction is one strategy, he argued, to help students maintain the higher levels of empathy they generally bring to medical school the first day, and not the last.

That Inside Higher Ed piece has a number of comments following it and they’re worth reading through. A few commenters there remark that the students’ decline in empathy is a natural — even healthy — response.

-Greg Dahlmann