What Can We Learn From the Letters of Students and Residents About Improving the Medical Curriculum?

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There is a long history of narratives and fiction by physicians that include information about their medical education—for example, books such as The House of God,1Blood of Strangers,2 and, most recently, When Breath Becomes Air.3 These books depict events that at times challenge values of medicine, such as professionalism, compassion, confidentiality, or patient safety, under the pressure of a demanding schedule, lack of supervision, and an overwhelmed staff. Often, a patient’s illness or injury engulfs students, residents, and patients in a chaotic struggle leading to tragic, heroic, or sometimes comic consequences. Frequently in the process of the narrative the author may make observations of trainees’ personal and professional identity crises, curricular and supervisory inadequacy, and mistreatment of trainees or patients. These books and others by physician authors offer a valuable perspective for those considering a career in medicine as well as for those seeking to improve medical education.
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