How medical school alters empathy: student love and break up letters to empathy for patients

Empathy teaching in medical school has a chequered history. Just over a decade ago, Hojat et al. 1 published an influential paper concluding that student empathy actually erodes during medical school, with erosion accelerating from third year onwards as students experience the realities of patient care. Given that empathy is a core quality for a future physician, empathic decline – part of the problem of ‘ethical erosion’2 – is a shocking result. Not all quantitative studies have reached the same conclusion, though a recent review3 of studies that measure empathy during medical school found that, in Western countries at least, the overall trend is indeed for empathy scores to decline.