A Longitudinal Study of Mexican Medical Student Training and its Effect on Empathy in Medical Care

Perceived lack of empathy and compassion are some of the strongest barriers to the efficient delivery of healthcare, especially in conditions of stark inequality between authoritative physicians and indigent patients. These lacks have been recorded in bio-medical interaction across cultures through jokes, curtness, exasperation, frustration, and anger displayed by physicians towards their poorer patients. Patient reactions usually range between silence, passivity, misunderstanding, humiliation, and anger, in turn creating further complications, e.g. as patients might avoid medical visits, not take medicines on time or at the appropriate dosages, and might self-diagnose or seek alternative care. There is, hence, a critical need to understand the processes underlying the lack of empathy and compassion, observed in many studies, even as public health has become one of the key forces in the fight against poverty and injustice. Addressing this problem is a crucial part of efficient and equitable delivery of health and is indeed what the medical profession desires. The first and most important step in this research is then, to identify if, when, and how these attributes become part of the training of physicians. This data is necessary for any attempt to better the delivery of medical care to indigent patients without the accompanying negative impacts.

The principal objective is to investigate if, how, and when lack of empathy and compassion affect the transformation of medical students into physicians in a medical school in Puebla, Mexico by observing behavior and analyzing the social networks and interactions between actors in the system. Ultimately, this project will explore issues of health care delivery, particularly how the expectations, aims, and emotions of medical students change over time and how their training impacts the care they eventually provide patients.