Perspectives and understanding of empathy development amongst junior doctors in Pakistan:Challenges and opportunities

Background: Evidence suggests empathy, an essential component of holistic patientcare, may be declining amongst medical students and residents. Yet there are only a few qualitative studies, mostly from West, exploring this phenomenon.Objective: This is a qualitative study of the learning environments of a tertiary care hospital of Pakistan, aimed to understand how junior doctors perceive and develop empathy and articulate the challenges faced by them.Methods: This case study adopted constructivist theoretical perspectives and was conducted from January 2019 to June 2019. Data was gathered from three focus group discussions and analyzed by thematic analysis. Patterns were identified and reported to generate codes, basic and organizing themes.Results: The participants were cognizant of empathy and its significance in patient management. Seniors as role models, first-hand knowledge of patients’ plights, active involvement in patient care and witnessing illnesses in dear ones were facets positively influencing empathy. Salient hindrances included enormous work load, gender bias, past negative experiences, language and literacy barriers. Some participants felt like devising their own strategies to cope with workload and providing empathetic care. There is pivotal role of workplace based learning; enabling junior doctors to handle multi-dimensional doctor-patient relationship.Conclusion: Clinical environments are significant for junior doctors’ grooming in attainment of empathetic patient care. Exhibiting empathy may be different in eastern and western diaspora. Faculty development could promote refined understanding of empathy and strategies to convey empathetic patientcare ensuring safe medical practice.