During a typical day in the third and fourth years of medical school, students work with countless other students. For example, on any given clerkship I work with anywhere from 0 students to 6 or more. So what happens when you put multiple medical students in a setting where we are all vying for clerkship grades and letters of recommendation? The obvious answer is competition. On many levels competition can be very useful in pushing everyone to be their best. However, many times it can get out of hand and there may be negative consequences. Every medical student has heard of the story of the \u201cgunner\u201d who gets to the hospital earlier than anyone else and takes all of the patients for their benefit. The question then becomes what kind of student outcomes exist in these settings of competition?<\/p>\n\n\n\n
Competition among medical students can lead to many poor outcomes in medical education and patient care. Unfortunately, in the medical setting, there is a long documented history of students cheating or falsifying information. One review found that up to 58% of medical students admit to cheating (Kusnoor, 2013). Cheating on the clerkships often manifests itself as falsified information regarding work that students performed. This often includes listing parts of the physical exam and history that were not actually obtained or assessed by the student. Medical care can be disrupted at any level if a reporter gives this false information, and the mistakes can be costly. Students list multiple reasons for making these false reports. Responses usually come down to two main themes: Fear and Praise. I will be the first to admit that on rounds there can be a sense of fear that as students we missed something that we probably should not have missed. I will also say that nothing is better than being praised for something that you did find or assessed correctly. Both responses truly come down to ego, not wanting to be wrong or uniformed, and wanting to be praised for being correct or informed.<\/p>\n\n\n\n
Another study published in Academic Medicine<\/em> reported that a large decline in empathy has been noticed among medical residents and students (Neumann, 2011). Their review suggested stress and \u201cburnout\u201d as the key determinant of decline. They indicated that among multiple studies burnout and stress lead to inappropriate behavior, cutting corners, and an overall decline in showing empathy to the patients (Neumann, 2011). Burnout among residents and medical students is in no way a new topic and has led to many negative patient outcomes in the past. While many administrative and legal changes have been made to try and decrease stress and burnout, increasing competition amongst students is likely to contribute to student burnout.<\/p>\n\n\n\n Moving forward, it is important for institutions, both schools and the hospitals students practice in, to try and decrease competition for better medical education and patient care. Here are my five tips for cutting back on competition on the clerkships:<\/p>\n\n\n\n References:<\/p>\n\n\n\n Kusnoor, MD, Anita V., and Ruth Falik, MD. “Cheating in Medical School”. Southern Medical Journal<\/em>. 2013; 106 (8): 479-483.<\/p>\n\n\n\n Neumann, PhD, Melanie, Edelhauser, MD, Friedrich, Tauschel, MD, Diethard, Fischer, MD, Martin R., Wirtz, PhD, Markus, Woopen, MD, PhD, Christiene, Haramati, MD, Aviad, and Christian Scheffer, MD, MME. “Empathy Decline and its Reason: A Systemic Review of Studies with Medical Students and Residents”. Academic Medicine<\/em>. 2011; 86 (8).<\/p>\n","protected":false},"excerpt":{"rendered":" During a typical day in the third and fourth years of medical school, students work with countless other students. For example, on any given clerkship I work with anywhere from 0 students to 6 or more. So what happens when you put multiple medical students in a setting where we are all vying for clerkship […]<\/p>\n","protected":false},"author":89,"featured_media":3494,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,46],"tags":[],"class_list":["post-3493","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-student-stories"],"yoast_head":"\n\n