Online student culture as site for negotiating assessment in medical education

Being kind in unkind spaces: a qualitative examination of how medical educators and first year medical students perceive empathy training

Introduction

It has become de rigueur for healthcare systems to tout their ability to provide compassionate medical care that addresses the emotional as well as physical needs of patients. Not surprisingly, then, there is considerable pressure on medical schools to train their students to be empathic. Existing literature on empathy training in medicine tends to focus on how to build emotional intelligence in individual trainees, largely ignoring the sociocultural factors that contribute to or thwart empathy development in medical school. Additionally, research tends to examine student perspectives, with little attention given to medical educators and their viewpoints.

Methods

In this paper, we adopt an "emotion practice" framework and utilize an inductive descriptive study design to qualitatively consider how first year medical students (N = 23) and their instructors (N = 9) perceive empathy training at a site we call Midtown Medical School.

Results and discussion

We find that both groups have an understanding of empathic capital but differ in their beliefs about the utility and legitimacy of this capital. Both educators and students also recognize the limitations of standardized empathy curriculum but do not agree on the implications of such rote learning. Finally, students and instructors alike find the hidden curriculum of medical school to be antithetical to empathy development, concurring that it is difficult to cultivate empathy in spaces where biomedical coursework is prioritized over social-emotional learning. In short, both groups find it difficult to be kind in an unkind place.

"We're IMGs, and we're often seen as human garbage outside of primary care": A qualitative investigation of dynamic status hierarchy construction online by medical trainees

In the United States health care system, "USMDs," or allopathic US-trained medical graduates, are generally considered higher status than "non-USMDs," or osteopathic and international medical graduates (also abbreviated as IMGs). Two key aspects of this professional hierarchy have yet to be understood: one, how it is socially and culturally reproduced during specific medical training timepoints, such as the US residency placement cycle; and two, how changes within this hierarchy may be occurring among the new generation of medical trainees and professionals. To answer these questions, I qualitatively analyzed comments from a selection of medical student Reddit posts, called "Name and Shame," where users discussed their experiences with discrimination and mistreatment during residency interviews spanning 2018 to 2020. From this analysis, I found that after exposure to and discussion of stories of applicant mistreatment, while some students on the forum reproduced this professional hierarchy, others rejected this inequality, with non-USMD users advocating for themselves and USMD students supporting their lower status peers. These findings highlight that the construction and understanding of this USMD/non-USMD hierarchy may be more dynamic than previously thought, especially among contemporary trainees now entering the medical profession.

Virtual Interviewing for Radiology Residency: Pluses, Minuses, and A Review of the Literature

This article reviews current medical literature to assess the benefits and drawbacks of virtual interviews for radiology residencies as well as the downstream effects of these changes, best practices, and potential future recruitment methods. Topics covered include the effects of remote recruitment in promoting accessibility and applicant diversity and equality as well as fiscal, environmental, and time savings in combination with technical challenges, the complications of over application, challenges in assessment of program culture and location, impact on morale, and hidden financial and emotional costs. Learnings from other medical specialties are highlighted in addition to the process of signaling, guidelines for conducting and participating in virtual interviews, and matters for future consideration.