Medical student reflections on geriatrics: Moral distress, empathy, ethics and end of life

Medical students’ early clinical encounters may influence their perceptions of geriatrics. This study examines reflective essays written by 3^rd-year medical students on required clinical rotations. Using content analysis, the authors analyzed the essays’ thematic content. The authors then used chi-squared analysis to compare themes with geriatric patients (age 60+) to themes with other age groups. One hundred twenty out of 802 essays described a geriatric patient. The most common geriatric themes were (1) death and dying, (2) decision making, (3) meaningful physician–patient interactions, (4) quality of care, and (5) professional development. Geriatric essays were more likely to discuss death/dying and risk–benefit themes and less likely to discuss abuse. Geriatric essays were more likely to describe students’ moral distress. Geriatric essays with moral distress were more likely to include empathy themes compared to geriatric essays without moral distress. Geriatric patients may pose unique ethical challenges for early clinical students.