Three longitudinal and six cross-sectional studies of medical students demonstrated a significant decrease in empathy during medical school; one cross-sectional study found a tendency toward a decrease, and another suggested stable scores. The five longitudinal and two cross-sectional studies of residents showed a decrease in empathy during residency.
Assuming that the empathy self-assessment tools employed in this type of research are valid, then the decline appears real.
The authors propose a model to account for a decline in empathy. Factors attributed include individual personality types, inappropriate learning environment, inappropriate role models, excessive duty hours, mistreatment of trainees, high workload, and loss of peer support. All contribute to burnout, lower quality of life and depression. The result is a decline in empathy.
The loss in empathy may be a coping mechanism. Could a decline in empathy be a normal reaction to distressing aspects of the human condition? If so, is the current decline in empathy any different than that experienced by our medical predecessors?
If, in fact, we are becoming globally less empathetic as a profession, then the quality of medical care may be at stake.
We have much still to learn about ourselves as healthcare providers.
