Dr. Victor S. Sierpina

Today, I describe an antidote to loss of empathy during medical school, an all too common casualty of medical education. One study showed that up to 70 percent of graduating medical students entering internship met clinical criteria for “burn out.” This results in depersonalization, loss of human connection, and decreases in motivation, compassion, and empathy. It is a catastrophic, unhealthy cascade.

Medical educators strive to prevent such a negative outcome while still being charged with producing highly skilled, qualified, and competent medical graduates.

One approach that is now in its third year of trial at UTMB is the Physician Healer Track. Early student feedback shows it is effective in improving their professional skills and personal lives on multiple levels.

The Physician Healer Track was conceived and developed by UTMB School of Medicine faculty Drs. Cara Geary, Julie McKee, Susie Gerik, Era Buck, and Lee Grumbles. The course is supported by the efforts of a couple dozen other dedicated volunteer physician educators. The focus is to take students starting in year one of medical school into intimate and highly personal experiences that improve empathy, stress resilience, self-compassion, mindfulness, self-awareness, and improved communication skills.

About 80 students volunteer to participate in this track in addition to their regular studies. They meet with faculty once monthly over dinner for group discussions during their first two years. This is preceded by assigned readings, videos, and submission of reflective essays. They enroll in a two month preceptorship of both clinical and classroom learning between years one and two. Third year monthly dinner sessions have now started and will continue in their fourth year.
Throughout the course and preceptorship, students are progressively introduced to deeper self-awareness through a variety of psychological tools and personality profiles like the Myers-Briggs and Enneagram. They journal and reflect as they learn about the practices of empathy, cognitive behavioral therapy, rational emotive based therapy, nonviolent communication, compassion including self-compassion, and the cultivation of stress resilience. Gratitude, humor, mindfulness, improved self-care, stress management, nutrition, and exercise are taught and encouraged. These topics are often neglected or ignored during regular medical school, their absence contributing to diminished student wellness as well as empathy.

Students further study and practice patient-care skills including breaking bad news, psychospiritual pain management, motivational interviewing, and interprofessional interactions with chaplains, nurse, and hospice volunteers.

We are optimistic that this new generation of healers will emerge from medical school with their empathy intact and even stronger and their ability to communicate with their patients enhanced by heightened understanding of themselves, improved mindfulness, and self-care. Their improved resilience to stress will help them lead colleagues and patients to a new kind of personalized, patient-centered, integrative and holistic medical care.

Holistic physician, clown, and humorist Dr. Patch Adams articulated a similar value in medical care and education that none of us can afford to ignore or lose in life:

“Compassion is a conscious way of being loving to create atmospheres in human groups and ways of being with people that make comfort and ease suffering.”

Bringing this kind of emphasis to medical education is the prime objective of the Physician Healer Track at UTMB.
Dr. Victor S. Sierpina is the WD and Laura Nell Nicholson Family Professor of Integrative Medicine and Professor of Family Medicine at UTMB.