The moral education of medical students.

The author begins his essay by discussing George Eliot's novel Middlemarch, in which a doctor, early in his career, wanders from his idealistic commitment to serving the poor. Although he establishes a prominent practice, he considers himself a failure because "he had not done what he once meant to do." The essay explores how many of us (physicians included) forsake certain ideals or principles--not in one grand gesture, but in moment-to-moment decisions, in day-to-day rationalizations and self-deceptions, until we find ourselves caught in lives whose implications we have long ago stopped examining, never mind judging. Medical education barrages students with information, fosters sometimes ruthless competition, and perpetuates rote memorization and an obsession with test scores--all of which stifle moral reflection. Apart from radically rethinking medical education (doing away with the MCAT, for example, as Lewis Thomas proposed), how can we teach students to consider what it means to be a good doctor? Calling upon the work of Eliot, Walker Percy, and others, the author discusses how the study of literature can broaden and deepen the inner lives of medical students and encourage moral reflectiveness.