Developmental life of the medical student: curriculum considerations.

Few medical educators would dispute that the emotional development and well being of the medical student is of critical importance in the pathway to physicianhood. It has been suggested that failure to address this aspect of medical education may account for various health problems and levels of impairment during medical school and beyond. Some authors have suggested that the personal development and "professionalization" of the student occurs through modeling, the medical school "culture," and the "hidden curriculum." In recognition of the randomness, incompleteness, or inadequacy of this approach, a number of attempts have been made to address this important but difficult dimension of medical education. However, programs designed to foster self-reflection and appreciation of affect in the physician-patient relationship are often limited as electives or unsupported by faculty and staff and therefore fall short of their objective. The author proposes that a pedagogical framework based on an analogy of life cycle theory (a la Erikson or others) offers a schema within which to consider efforts being made in medical curricula to promote self-awareness, appreciation of affect in oneself and one's patients, and a context in which to minimize the risk of illness and impairment.