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Open Access Highly Accessed Research article

The physician’s role and empathy – a qualitative study of third year medical students

Hanne-Lise Eikeland1*, Knut Ørnes1, Arnstein Finset1 and Reidar Pedersen2

Author Affiliations

1 Department of Behavioral Sciences, Institute of Basic Medical Sciences, University of Oslo, Domus Medica, Sognsvannsveien 9, Oslo 0372, Norway

2 Institute of Health and Society, Centre for Medical Ethics, University of Oslo, Kirkeveien 166, Fredrik Holsts hus, Oslo 0450, Norway

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BMC Medical Education 2014, 14:165  doi:10.1186/1472-6920-14-165

Published: 9 August 2014



Empathy is important in ensuring the quality of the patient-physician relationship. Several studies have concluded that empathy declines during medical training, especially during the third year. However, there is little empirical research on what may influence a medical student’s empathy. In addition, studies of empathy in medicine have generally been dominated by quantitative approaches, primarily self-assessment questionnaires. This is a paradox given the complexity and importance of empathy. In this paper we explore medical students’ opinions of what may foster or inhibit empathy during medical school, with a particular emphasis on how empathy is influenced by the initiation into the physician’s role.


We performed semi-structured qualitative interviews with 11 third year medical students. Content analysis was used to analyse the transcribed interviews.


Five aspects of the the physician’s role and the students’ role acquisition emerged when the students were asked to describe what may influence their empathy: 1) Becoming and being a professional, 2) Rules concerning emotions and care, 3) Emotional control, 4) The primary importance of biomedical knowledge, and 5) Cynicism as a coping strategy.


This study suggest that the described inhibitors of empathy may originate in the hidden curriculum and reinforce each other, creating a greater distance between the physician and the patient, and possibly resulting in decreased empathy. Mastering biomedical knowledge is an important part of the students’ ideals of the physician’s role, and sometimes objective and distanced ideals may suppress empathy and the students’ own emotions.

Empathy; Medical education; Professionalism