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Med Educ. 2004 Sep;38(9):927-33.

Striking a balance: training medical students to provide empathetic care.

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Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, 1051 Riverside Drive, NY 10032, USA.



Medical students face many challenges as they progress through training, some of which refer to learning how to manage the stresses and anxiety of confronting illness and suffering. In trying to relieve anxiety, they may develop maladaptive responses that lead to a decrease in their level of empathy for patients. Education should aim to teach students how to deal with their responses so that they can tolerate patients' distress and treat them effectively.


This paper will address central dilemmas in students' attitudes towards patients during clerkships and suggest positive developmental goals to strive for in this formative time. It may be used as a reference tool for medical student educators and medical students to elucidate the educational tensions in teaching and learning about how to provide empathetic care.


Students and teachers can benefit from an awareness of the tension between the poles of pathology and health, not knowing and too much knowing, vulnerability and denial and reaction and inaction. Medical students can learn adaptive methods of managing their anxiety about dealing with illness and death and strike a balance in their approach to patients.

[Indexed for MEDLINE]

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