Newswise — The early years of medical training can be stressful, even traumatic at times, as students and residents directly confront the mortality of their patients and the enormity of their responsibility as physicians.
Students report feeling overwhelmed, professors note that exceptional students feel unsure of themselves, and residency managers note high levels of burnout and depression.
To gain insight into how educators might reduce the ill effects of the high-stress medical education environment, more than 100 students, faculty members, physicians and leaders from across the Harvard Medical School community recently attended the Academy at Harvard Medical School’s Annual Symposium on the Science of Learning, which featured experts on the psychological, physical and social dimensions of resilience.
Daniel Gilbert, the Edgar Pierce Professor of Psychology at Harvard University, noted that the human brain is unique in the animal world for its ability to imagine the future and learn from experiences it has not yet had.
There are, however, certain things the brain is not particularly good at predicting. For one, humans often don’t realize how little suffering is actually caused by seemingly traumatic losses, such as losing a job or becoming ill enough to require dialysis.
“Our inability to recognize our own resilience is one of the things that makes us fear what will happen when we suffer the slings and arrows of outrageous fortune,” Gilbert said.
Dennis Charney, the Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai and president for academic affairs for the Mount Sinai Health System, described the results of his investigation of the biology of depression and PTSD as well as his work with earthquake survivors, Vietnam-era prisoners of war and other individuals who have survived trauma and high stress. He has been working to understand, at the behavioral and biochemical levels, how some humans can survive and thrive under extreme stress.
Charney contrasted the high-stakes, high-speed model of medical education—see one, do one, teach one—with the training methods used by elite special forces of the U.S. military.
In the military, Charney said, failure is seen as an expected, natural part of the learning process, and trainees are given time and support needed to slowly build mastery.
Instead of delivering stress in harmful, high-dosage bursts, Charney suggested a system of “stress inoculation” that would help students develop resistance and resilience by being exposed to low doses of stress: For example, students might experiences increasingly challenging situations with reliable safety nets in case of failure.
“Avoiding failure makes sense, as long as you can avoid it for the rest of your life,” Gilbert said.
“It’s a lot like pathogens: If you’re going to encounter them, get vaccinated,” he said.
RSS