Being a doctor requires not just a strong work ethic, a steady hand and a sound knowledge of healthcare. It also means an ability to love.
That’s according to educators at Trinity College Dublin’s school of medicine, which has made love a “graduate outcome” that will be assessed for the first time from next year.
Claire Donohoe, a surgeon and senior lecturer at the college, sees the new requirement as a reminder to be “a human with other humans”.
Love in this context “calls on you to feel an emotional response to other people’s suffering or illness or ill health”, said Donohoe. “It’s being able to be comfortable sitting with the discomfort of watching other people suffer. Seeing other people going through difficult things and not losing the sense that they are people.”
Donohoe and Colin Doherty, head of the school of medicine at TCD, have co-authored an article published in the Journal of Medical Education and Curricular Development arguing for love’s inclusion as a core concept in the medical curriculum.
Their study met an unusually high level of scrutiny. This was understandable, said Doherty, as it was the first instance in Ireland of a medical school committing to love as a graduate outcome.
“If you actually fall in love with your patient, you’re doing something illegal,” he said. “We all understand that as a worry. But even the idea of [the word] being foundational and bringing in the vulnerability of the clinician, I think that’s still hard for normal practitioners to take. That speaks to medicine’s quantitative obsession.”
This “quantitative obsession” – or focus on measurable outcomes – feeds into one of the most significant talking points among those plotting medical training of the future: the growing role of technology and, specifically, artificial intelligence.
Machines may be able to “create a simulacrum of empathy and compassion”, said Doherty. “But in healthcare, when you bring love into it, you’re talking about actual clinicians stepping into the breach of the relationship and making a connection that is not going to be possible with a machine”.
The argument that he and Donohoe make in their paper is that treatment can go too far in the direction of cold, clinical logic.
Love is “very teachable”, added Doherty. “You put the student by the bedside [of a patient]. You introduce small aspects of the compassionate self to the student. They get it very quickly. In terms of other skills we teach them, this stuff is a no-brainer.”
Evaluation, however, is a challenge.
“Historically, we’ve gotten very good at trying to do objective, standardised exams,” said Donohoe. “Everything is very cut and dry. You get a point for washing your hands; you get half a point for making eye contact and that kind of stuff.”
Evaluating a capacity for love, she said, holds educators to a higher standard. It requires them to get to know their students, and better understand what drives their desire to practice medicine. It means small groups or one-on-one contact with students over time, and it cannot just be a box-ticking exercise, she adds.
Donohoe and Doherty do not envisage someone failing medicine as a result of a limited capacity for love. The idea is to equip students with skills related to the concept and set a standard for them to aspire to. It may help to steer students career-wise.
While the list of graduate outcomes for TCD medical students was updated last September to include love, as part of the introduction of a new curriculum, implementation is still in train.
“We are only coming to the end of year one of the new curriculum,” said Doherty. “These students will not be attending clinical placements until the spring of next year … So humanistic assessment will only start in year two and progress thought [years] three, four and five.”