Appendix 68b - Socialized Medicine

by Michael Greger, MD and United Progressive Alumni

[ Medical School Resources | Appendices | Discussion ]

Nicolas Martin, Executive Director of the American Iatrogenic Association, writes about a office visit to a doctor: "When I speculated on the nature of my malady he responded sarcastically, 'You didn't go to medical school.' True, and that may be why I haven't been utterly desensitized to the suffering of others as seems the case with many physicians."[815]

"I was a cold, detached son of a bitch and getting more so... I hadn't always been like this."[816]

Quoting from the Journal of Nervous and Mental Disease, "There is an immense literature on the adverse effects of medical education and training.... There can no longer be any doubt that the deprivations of medical school erode emotional well-being...."[817] Medical school, "provides an education," said one student in a JAMA article, "but also a socialization process, set up to turn people into heartless bastards, not by design but by default." Another student swears, "There are people deliberately trying to dehumanize us."[818] From a letter published in JAMA:

[After four years of training, medical students] have almost invariably become... even more detached and mechanistic than they were to start with.... As a group they are also more immature emotionally and sexually than their peers or the rest of the population.... Their world is physically, emotionally, and intellectually circumscribed.... The personal growth and maturity that develop among other young adults during their 20s may fail to occur among students of medicine, who often do not complete their medical education until well into their 30s.[819]

Developmental psychologist Erik Erikson thought the principle task of young adulthood was to develop intimate relationships. He conceived of the opposite of intimacy as the withdrawal into isolation and self-absorption.[820] As the Boston Women's Health Book Collective concludes, "Most doctors finishing their training are in late adolescence, psychologically speaking."[821]

"The medical educational and socialization process is long, intensive, and exacting."[822]

Conclusions from Hafferty's Into the Valley: Death & the Socialization of Medical Students:

[Medical] students' preoccupation with the academic rigors (and injustices) of medical training directs their attention away from the inculcation of values, attitudes, motives, and rationales concerning what it means to be a physician.

Medical training is a form of moral education more akin to 'doctrinal conversion' than to fine-tuning of previously established values, attitudes, and rationales.... The medical role 'consists of a separation, almost an alienation from the lay medical world; a passing through the mirror so that one looks out on the world from behind it and sees things as in mirror writing.' The individual comes to see the 'world in reverse.' That is essentially what this study found. Students were expected not to simply abandon one set of values for another, but to stand their previously held lay values on their heads.[823]



[815] Martin, NS.

[816] Gordon, LE. "Mental Health of Medical Students." The Pharos 1996(Spring):2-10.

[817] Zeldow, PB, SR Daugherty and DP McAdams. "Intimacy, Power, and Psychological Well-Being in Medical Students." Journal of Nervous and Mental Disease 176(1988):182-187.

[818] Rosenberg, DA and HK Silver. "Medical Student Abuse." JAMA 251(1984):739-742.

[819] Matkovich, l. Letter. Journal of the American Medical Association 264(1990):1658.

[820] Branch, WT. "Professional and Moral Development in Medical Students." Transactions of the American Clinical and Climatological Association 109(1998):218-230.

[821] Boston Women's Health Book Collective. Our Bodies, Ourselves New York: Simon and Schuster, 1973:252.

[822] Fox, RC The Sociology of Medicine Paramus: Prentice Hall, 1988:57.

[823] Hafferty, FW. Into the Valley Yale University Press, 1991:181.



Add a comment | Add a link