BMJ  2004;329:1363 (11 December), doi:10.1136/bmj.329.7479.1363-a

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Can medical students learn empathy at the movies?

Abergavenny

Doctors are often portrayed in films as materialistic and arrogant, but some films could be a useful addition to the medical school curriculum, an analysis of 150 films shows.

The report, in Archives of Disease in Childhood ( 2004;89: 1084-8)[Free Full Text], says, "Materialism and a love of money have pervaded cinematic portrayals of doctors dating back to the 1920s, and continue to be prominent in recent movies."

It cites as an example the materialistic approach to medicine shown by Dr Jim Nookey, a character in Carry on Again Doctor (1969). The character sums up his philosophy by saying, "Specialise, that's what I'd like to do—specialise. The whole Harley Street bit with bags of lovely filthy rich women patients."

Surgeon William Hurt learns empathy when he becomes a patient in The Doctor, a film that could be useful for teaching medical students Credit: TOUCHSTONE PICTURES/KOBAL

Compiled by Glenn Flores, a paediatrician at the Medical College of Wisconsin, the report looks at how doctors are portrayed and names the top 10 most useful films for medical education. The medical specialties most favoured by doctors in films are surgery (33%), psychiatry (26%), and family or general practice (18%).

Best portrayal of doctors in films Most useful films for medical education 1 Red Beard (1965) 1 The Doctor (1991) 2 The Hospital (1971) 2 Arrowsmith (1932) 3 Article 99 (1991) 3 The Citadel (1938) 4 State of Emergency (1993) 4 Not as a Stranger (1955) 5 Miss Evers' Boys (1997) 5 Pressure Point (1962) 6 The Elephant Man (1980) 6 Whose Life is it Anyway? (1981) 7 Panic in the Streets (1950) 7 Miss Evers' Boys (1997) 8 Spellbound (1945) 8 The Interns (1962) 9 Death and the Maiden (1994) 9 Critical Care (1997) 10 Guess Who's Coming to Dinner (1967) 10 And the Band Played On (1993)

Paediatrics accounts for a modest 2%, and not all references to it are positive: "Paediatrics can't just dump their overload on us. Tell them to cut down on their lunchtime and tennis. Maybe they'll have more time to practise medicine" (Sunchaser, 1996).

The report names the best medical film as Red Beard (1965), from Japan, in which an arrogant young man learns the true meaning of being a doctor from a mentor who cares for the poor. Runner-up was The Hospital (1971).

The top 10 most useful films for medical education are headed by The Doctor (1991), which stars William Hurt as a "hotshot surgeon with a detached demeanour" who learns about empathy and compassion when he contracts cancer.

In second place was Arrowsmith (1932), which "deftly explores a doctor's motivations and struggles with a clinical versus research career and is thus inspirational and enlightening for medical students." In third place was The Citadel (1938). Best humorous films were M^*A^*S^*H (1970), Body Parts (1991), and High Anxiety (1977).

"Doctor movies continue to fascinate because they can be humorous, thought provoking, informative of the public's perception of doctors, and they never cease to entertain. Movie doctors provide insightful and realistic portraits of the challenges, rewards, and excitement of being a doctor," concludes the report.

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