Methods: A total of 30 students, residents and attending physicians at the
American University of Beirut Medical Center were invited to participate. All
participants underwent semi-structured interviews that were recorded, transcribed
and then analyzed for common themes.
Results: More negative emotions were expressed among participants than positive
ones. Negative emotions were more frequently expressed among medical
students, interns and residents than attending physicians. Cynicism in the ED was
commonly reported however, maintenance of professionalism and adequate
patient care were underscored. While empathy was recurrently found among
participants, a trend towards a decrease in empathy with career progression was
noted among attending physicians. Further, negative feelings towards patient families were prominent. Participants tended to categorize patients based on
willingness to cooperate, gender, age, case acuity, ethnic origins and social status.
Conclusions: Cynicism emerged as a prominent theme among medical students
and staff in our study. However, participants were also empathetic. These attitudes
were generally attributed to the peculiar stressors associated with the Lebanese
culture, low acuity cases and “VIP” patients. It is crucial to explore methods in
order to decrease cynicism and improve patient care. Also, the implications of
these attitudes on patient care remain to be discovered.
The sample consisted of 11 medical students (6 fourth year and 5 third year – in a
four year program), 6 interns, 7 residents, and 6 attending physicians for a total of
30 participants (60% males and 40% females) with an average age of 27.5 years.