Updated at 9:30 a.m. ET on January 9, 2026<\/p>\n
Every few weeks I turn up in a hospital gown at a medical exam room in Massachusetts and describe a set of symptoms that I don\u2019t really have. Students listen to my complaints of stomach pain, a bad cough, severe fatigue, rectal bleeding, shortness of breath, a bum knee, HIV infection, even stab wounds; on one occasion I simply shouted incoherently for several minutes, as if I\u2019d had a stroke. Then the students do their best to help.<\/p>\n
I have been given nearly 100 ultrasounds in just the past year, and referred to behavioral counseling dozens of times. I have been consoled for my woes, thanked for my forthrightness, congratulated for my efforts to improve my diet. I have received apologies when they need to lower my gown, press on my abdomen, or touch me with a cold stethoscope. Our encounters, which sometimes run as long as 40 minutes, end with the students giving me their diagnoses; detailing every test, treatment, and drug they want me to have; and then answering all of my questions without ever looking at their watch. Before leaving, they commend me for coming in and promise to check back in on me. It\u2019s a shame I have to feign an illness to get that kind of care.<\/p>\n
I learned about fake medical care four years ago when my son, an M.D.-Ph.D. student, mentioned that he was being graded on his skill at treating \u201cstandardized patients\u201d<\/a>: people who are paid to role-play illness. I\u2019m fascinated by the practice of medicine, so I found this notion irresistible. I applied for a job in the standardized-patient program<\/a> at the University of Massachusetts, and after two full days of training, plus a lot of reading and videos, I was ready to get started.<\/p>\n The practice of faking medical encounters for the sake of education dates back to 1963<\/a> at the University of Southern California, but UMass developed one of the first formalized programs<\/a> in 1982 and has been a model since. Such programs are now, well, standard: According to a count published in a 2023 review<\/a> of the practice, 187 of the 195 accredited medical schools in the U.S. describe the use of standardized patients on their websites.<\/p>\n Each specific case that an SP might inhabit\u2014and there are hundreds\u2014comes with a minimum of two hours of additional training in person or via Zoom, along with more reading. We\u2019re buried in a blizzard of unique details to memorize about the patients we portray. By the time I\u2019m ready for my fake exam, I can rattle off what vaccinations I\u2019ve had, how long I\u2019ve worked at my job, whether I\u2019ve had my tonsils out, when my mother died, how much weight I\u2019ve gained or lost in recent months, which vitamins I take, how much coffee I drink, how chatty I tend to be, and whether I\u2019ve traveled recently (and might have parasites!).<\/p>\n There\u2019s no script for my encounters, because you never know what the students might ask, say, and do. So I improvise most of my responses, in keeping with the facts I\u2019ve been given. What do I usually eat for breakfast? What do they make at the factory where I work? What sexual acts do my partner and I engage in? My ad-libs are acceptable, according to the grades I get from staff members who occasionally observe the encounters via camera. But many of my colleagues are professional actors, and their performances are superb. We sometimes work in pairs, and more than once I\u2019ve found myself deeply moved\u2014even to the verge of tears\u2014by my partner\u2019s fake suffering.<\/p>\n Of course, we SPs are not the only ones faking it in these sessions; the students are playing along, too. We score them on as many as 50 different elements, including their tone of voice (was it friendly but professional?), their body language (did they lean in to show engagement?), and their facility at palpating our spleens (did they dig in firmly in the right spot?). Most important, we are meant to check that they are learning empathy. Numerous studies have shown that more empathetic care is correlated with better clinical outcomes<\/a>, perhaps because it makes patients more inclined to share their full medical history, and more likely to stick with whatever treatment has been recommended. In one survey, orthopedic-surgery patients reported that a doctor\u2019s empathy was more central<\/a> to their satisfaction than the time it took to get an appointment, how long they were stuck in the waiting room, or even what sort of treatment they ended up receiving.<\/p>\n