Intended for healthcare professionals


Do medical schools care? Rethinking compassion within medical training

BMJ 2022; 379 doi: (Published 10 November 2022) Cite this as: BMJ 2022;379:o2693
  1. Rob Jarvis, clinical senior lecturer
  1. University of Dundee, UK
  1. r.i.jarvis{at}

Individuals within medical schools are often compassionate, but is that enough? Rob Jarvis examines the structures and regulations in place in medical schools and argues that a lack of compassion is having a serious effect on student wellbeing

I have headed up student support in a medical school in Scotland for nigh on a decade, and I have spoken with hundreds of students struggling in one way or another with their progression through medicine. I have witnessed a growing level of anxiety and stress, with cohorts of keen, bright, enthusiastic, and committed young adults becoming more anxious, stressed, depressed, and cynical.

Among medical students, rates of depression, anxiety, burnout, and stress are high.1 Following the covid-19 pandemic, wellbeing has remained at a concerningly low level for UK university students.2 Internationally, evidence confirms a picture of sub-par mental health among doctors to be.3 Poor mental wellbeing or burnout are linked with low self-worth, reduced empathy, medical errors, impaired professionalism, and higher rates of drop out from medicine.4 Personally, I saw frustration, panic, eating disorders, self-harm, attempts at suicide, failure, absence, and many repeat years. Gradually, I became convinced that a significant degree of the mental health burden in our students is exacerbated—if not caused—by us, the medical school.

Any professional training or educational institution needs processes and regulations relating to admissions, progression, professionalism, and transition to the regulatory body. These are underpinned by key values of the profession, such as patient safety and public trust. However, these same processes cause harm to students, to the culture of how the profession cares for its own, and to the trust students have in their institutions.

Most teachers and clinicians within a medical school are compassionate; we are, after all, a caring profession. But the rules, regulations, and processes that …

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