Med school battles ‘ethical erosion’

Harvard Medical School now offers a program for third-year students to combat “ethical erosion” and to help students retain their idealism, reports Duke Divinity School’s Faith & Leadership web site. It had been discovered that many medical school students lose a sense of idealism and altruism as they move through their studies.

But the problem is broader still. A study in the March 2008 issue of Academic Medicine reported that a “significant decrease in vicarious empathy is of concern, because empathy is crucial for a successful physician-patient relationship.” In other words, if doctors cannot empathize with their patients then that lack of connection is going to have a negative effect on their practice of medicine.

This made me wonder about possible parallels to vocational ministry. Do ministerial students suffer from “ethical erosion” as they learn the information and skills needed in their vocational role? By moral erosion I mean the lessening of a minister’s ability to actually live for Christ and serve others out of a deep personal connection with God and the people to whom he or she is ministering.

Before I went to seminary years ago I heard a number of people say things like, “Don’t let seminary ruin you. Don’t let it take away your passion for Christ.” It didn’t. I came out with more desire and passion to serve. But I have seen some ministers suffer this fate.

Let’s see what Harvard Medical School discovered and see if we can learn anything about how we train vocational ministers. It may also give us some clues about training non-vocational ministers—our church members.

Harvard set up a pilot program “creating a community of mentors, students and patients who are accountable to one another in the work of relieving human suffering,” Faith & Leadership reported. “It’s a relationship-based model of learning where duty and commitment imbue the learning process, the learner and the teacher,” said David Hirsh, director and co-founder of the program.

Students, as a result, learned to be empathetic and patient-centered.

Hirsh said there are three important missions when helping a person to become a physician/caregiver. “One is knowledge, one is skillfulness, and the other might go under the rubric of professionalism.” He described professionalism as including altruism, duty and humanism, by which he seems to mean a genuine care and concern for other people.

“Medical schools have been traditionally quite excellent at helping students learn the knowledge part and the skill part, across a wide variety of skills,” Hirsh said. “Medical schools traditionally have not used deliberate training for professionalism. They’ve relied on bringing in wonderful people and having them do wonderful things, and hoping professionalism takes care of itself.”

When I first read those words about “wonder people” doing “wonderful things,” I thought there was a real parallel to vocational ministry. Many wonderful men and women train to do wonderful things in ministry.

The way Hirsh uses “professionalism” in his field seems to be different from how we use it in ministry, where we typically associate professionalism with the knowledge and skills of ministry. Hirsh see professionalism as how one actually carries out his or her work—how the doctor relates to patients. In ministry, we could liken it to how the minister relates to church members.

Through the years I have met many, many wonderful ministers who simply love and have a deep commitment to the church members they seek to serve and lead. They love them despite their flaws and flagging commitment. Such ministers are God’s select servants. They may not be widely known or exalted, but they are ministers in the best and highest sense of that word.

It is, however, easy for some of us ministers to lose that connection with those to whom we have been called to serve. God’sministry becomes our ministry. And when it does, we lose something very deep and valuable.

And here again ministry should be like medicine. “It’s not about us as individuals,” Hirsh said. “It’s about relieving human suffering.” Ministry is about more than relieving human suffering; it’s also about bringing faith, hope and love to others.

“The patient needs to matter to the student,” Hirsh said. And, it would seem likewise in the minister-member relationship.

Harvard Medical School has sought to bring these values to its students by enhancing each student’s relationship with a mentor, faculty, fellow students and patients. The students spend more time on cases and stay with each case longer. As a result, they get to know patients better. The students also grow to understand that they are always learning in the midst of a community that includes the doctor, patient and other doctors.

When communities function well, “they can be incredibly helpful, as they mutually affirm high ideals, service-minded ideals,” Hirsh said. “So the community of students with their faculty and with nurses and other professionals, and frankly having students engaged with the community of patients that they are serving, puts them in a position to recognize the nuances and subtleties and fullness of the community. It’s all about relationships.

“My highest ideals can inform my work,” he continued. “My work can support my highest ideals. It sounds dreamy, but in the real world of work, hard things happen. They’re going to happen whether we have solid community or not.”

May we all be informed by our highest ideals in the midst of the “real world of work.”

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