The Hidden Curriculum of Medical School

While most of medical education and training is about the nuts and bolts of clinical care — how to treat hypertension, how to manage a ventilator, how to take out a gallbladder — the process also involves learning how to be “a doctor.” As opposed to lessons covered in textbooks and classrooms, this kind of learning is done through modeling, or what medical sociologist F. W. Hafferty has called the “informal” or “hidden curriculum.”
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A new study published in this month’s issue of Academic Medicine proves that effort does matter, and that learning is possible. Even established clinicians can be re-inspired to adopt new humanistic skills, becoming better teachers and role models in the process.

In the study, groups of established physician-teachers from five different academic medical centers met at least twice a month. During the meetings, the doctors either practiced skills designed to enhance compassion, or reflected on their own work through discussion and narrative writing.
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At the end of our phone conversation, I asked Dr. Branch if his program would work in any setting, for any doctor. “Anybody can do it, and there are groups of clinicians that have regularly held similar types of meetings for at least a decade or more,” he quickly replied. He had been part of such a group for 10 years, when he lived in another state, a group made up of academic and private practice physicians.

And then, underscoring perhaps the greatest challenge for any kind of reform, Dr. Branch added, “But they would have to believe that such work was important.”