Disabling practitioners: hazards of learning to be a doctor in American medical education.

Ongoing work with first and second-year medical students suggests that American medical culture is characterized by a juxtaposition of notions of "competence" and "caring," and that the training of students to be competent physicians requires a reconstruction of "common sense" views of the patient, of sickness, and of the personal boundaries of the medical student. Contradictions that arise from efforts to maintain qualities of caring while undergoing these changes are highlighted.