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Educ Health (Abingdon). 2018 Sep-Dec;31(3):142-147. doi: 10.4103/efh.EfH_279_17.

Does medical students' empathy change during their 5-year MBBS degree?

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Centre for Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.
Norwich Medical School, University of East Anglia, Norwich, England.
Norwich Medical School and the School of Psychology, University of East Anglia, Norwich, England.



Research evidence over the past 20 years has established that doctors' ability to empathize with their patients is a crucial component of effective health care. Consequently, teaching and reinforcing empathy has entered undergraduate medical education curricula; however, there have been mixed results in terms of its effectiveness. While there is evidence that empathy fluctuates during undergraduate medical training, there has been very little longitudinal research looking at medical students' empathy levels over their full course of study. The aim of the current study was to investigate whether medical students' empathy changed during their 5-year MBBS degree.


Students completed the medical student version of the Jefferson Scale of Physician Empathy (JSPE) at the start of Year 1 and then near the end of Years 2, 3, 4, and 5 during 2009-2015. Total empathy score for students who had completed the JSPE in all 5 years of medical training was compared over time using nonparametrical statistical analysis.


Results indicated that medical students' empathy varies with empathy being highest at the start of the medical course in Year 1, declining to a low in Year 3 and then rising again in Years 4 and 5. There was a tendency for female students to have higher empathy scores compared to male students in each of the 5 years, with scores significantly different in Years 2, 3, and 4. However, there were no differences in empathy scores according to the students' age.


The decline in empathy in the early years of undergraduate medical training is a concern. Medical educators should teach and reinforce empathy during early years of undergraduate medical training in a sustainable way to guard against declining empathy levels. Specific interventions targeted at increasing empathy in male students might be warranted in the future.


Empathy; Jefferson Scale of Physician Empathy; medical students; undergraduate medical education

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