5 Common Yet "Unofficial" Lessons From Medical School

As medical humanities are being integrated in the official curriculum to focus on doctor-patient relationship, courses like empathy, disability and death involving arts, comics are also a new medium to help people tell their stories.

Not only is it helpful for patients, but also for the medical students and practitioners. For instance, medical students have begun using comics to narrate their stories in the field of medicine where they illustrate mostly the disparity seen in real life experience from their formal curriculum.

These unwritten, unspoken and unofficial lessons presented by medical students are known as “hidden curriculum” by the medical educators. Based in Pennsylvania State University, physician Michael Green, literature professor Kimberley Myers, and anthropologist Daniel R. George examined the student comics for the past seven years and identified five common yet “unofficial” lessons from medical school, which are important in the path of becoming a physician.

1. Students are at the bottom of the hierarchy in medicine

In medical humanities courses, students are stressed to respect patients regardless of the disease process, socioeconomic status or belief system. It is also done well when it comes to practice. However, the lesson that was not taught to the medical students is that they may not get the same respect from the members of their own profession.

A first year medical student, Ken Noguchi, said when he asked his nurse preceptor the greatest complaint about doctors, he was surprised that the nurse said, “I wish doctors would communicate better with each other.” Doctors are also said to not get along well with each other.



2. Students are treated as interchangeable generic unites

Students also reveal their anxiety about losing their individual identity on the graphics storytelling. One example would be students being identified as “med student” frequently, which is considered demeaning to the students.

While “med student” seems to show prestige for the public, it can be used pejoratively in the practice of medicine especially to young and hopeful professionals-in-training. Such generic labelling can in turn deny the medical students if the practising doctors use it excessively.



3. Students are required to understand the attending physician’s expectations

Unlike the clear-cut formal curriculum learned in school, the rules, culture and expectations in hospitals can be unclear. Hence, it can sometimes wear out medical students as they feel that they are expected to predict what is coming or read the minds of the attending physicians.

A student expresses the challenges of pleasing a doctor he calls Priapus, a Greek fertility god, who can always find a way to show his anger.



4. To succeed, students need to sacrifice their well-being

Besides, the irony is clear when medical students are sacrificing their time and health to put patients’ health as a priority, especially when wellness initiatives are actively advocated in medical schools nowadays. Thus, getting ahead means working most of the time, even if it means taking away the body and spirit.

Nevertheless, physician Sally Mahood criticised the hidden curriculum and encouraged people to break the silence in order to change the current situation that does not meet professional standards and ethical expectations.

5. Medicine is not patient-centred in practice

Many medical students also find themselves stuck in a paradox when what they understood from the formal education does not correspond in the real world. In practice, the lack of time, piles of paper work and emphasis on rapid hospital discharge comes in the way when medical students attempt to practise the lessons they have been taught.

Through the comics, students show their frustration and disappointment in the system as they become participants as well as contributors to this issue, struggling to maintain their ideals in the realities of medicine.





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