Moral dilemmas of medical students : a study of ethical aspects of medical training

This study examines the ethical reality of medical students, and ethical curricular aspects of medical school. The 'received curriculum' is analysed using a combined interdisciplinary theoretical framework of 'Ethics' and 'Curriculum'. Defined in terms of students' experience of the curriculum, and the participants' perceived moral reality, the study was framed within a phenomenological-interpretive research paradigm. Content analysis of the 'narrative corpus' obtained by 38 open questionnaires addressed to sixth-year medical students, and by 21 interviews with medical students and senior faculty members, was conducted. Based on students' interviews, holistic 'ethical profiles' were produced, and proved to be significantly informative. The study shows that during their clinical training years, medical students cope with daily contextual moral dilemmas that relate to their culture and status and involve subtle, elaborately-calculated decisions. The student's authentic, reflective and analytical accounts of their ethical dilemmas, lead to the novel concept of students' 'moral awareness'. This increasing awareness of ethical dilemmas complexity sheds light on an adult ethical-cognitive stage, characterised by pragmatic thinking focused on content, and by internalisation of relativism and contradictions. The study further demonstrates the significance of students' experience for viewing and evaluating curriculum: the students, who perceived their ethics 'received curriculum' in its totality, consequently offered important insights concerning ethical processes, thus enriching the 'traditional' medical school curricular thought