Between two worlds
OBJECTIVE: Residents frequently use humor and slang at the expense of patients on the clinical wards. We studied how medical students react to and interpret the “appropriateness” of derogatory and cynical humor and slang in a clinical setting.
DESIGN: Semistructured, in-depth interviews.
SETTING: Informal meeting spaces.
PARTICIPANTS: Thirty-three medical students.
MEASUREMENTS: Qualitative content analysis of interview transcriptions.
MAIN RESULTS: Students’ descriptions of the humorous stories and their responses reveal that students are able to take the perspective of both outsiders and insiders in the medical culture. Students’ responses to these stories show that they can identify the outsider’s perspective both by seeing themselves in the outsider’s role and by identifying with patients. Students can also see the insider’s perspective, in that they identify with residents’ frustrations and disappointments and therefore try to explain why residents use this kind of humor. Their participation in the humor and slang—often with reservations—further reveals their ability to identify with the perspective of an insider.
CONCLUSIONS: Medical students describe a number of conflicting reactions to hospital humor that may enhance and exacerbate tensions that are already an inevitable part of training for many students. This phenomenon requires greater attention by medical educators.
Key wordsmedical education ethics qualitative interview medical students medical humor
- 1.Shem S. The House of God. New York, NY: Richard Marek Publishers; 1978.Google Scholar
- 5.Goffman E. The Presentation of Self in Everyday Life. Garden City, NJ: Anchor-Doubleday; 1959.Google Scholar
- 6.Hughes EC. The Sociological Eye: Selected Papers on Work, Self and Society. Chicago, Ill: The University of Chicago Press; 1971.Google Scholar
- 7.Becker HS, Geer B, Hughes EC, Strauss AL. The Boys in White: Student Culture in Medical School. Chicago, Ill: The University of Chicago Press; 1961.Google Scholar
- 9.Schwarz H. A person is a person and a shpos is not. Man Med. 1980;5:226–8.Google Scholar
- 11.Brim JA, Spain DH. Research Design in Anthropology: Paradigms and Pragmatics in the Testing of Hypotheses. New York: Holt, Rinehart and Winston; 1974.Google Scholar
- 15.Mizrahi T. Getting Rid of Patients: Contradictions in the Socialization of Physicians. New Brunswick, NJ: Rutgers University Press; 1986.Google Scholar
- 17.Lief HI, Fox RC. Training for detached concern in medical students. In: Lief HI, ed. The Psychological Basis of Medical Practice. New York, NY: Hoeber Medical Division, Harper and Row; 1963:12–35.Google Scholar
- 18.Konner M. Becoming a Doctor: A Journey of Initiation in Medical School. New York, NY: Viking; 1987.Google Scholar