Beyond ‘born not made’: challenging character, emotions and professionalism in undergraduate medical education

Abstract

In this article we explore the historical antecedents and ongoing perpetuation of the idea that medical professionals must adhere to a specific ‘character’. In the late nineteenth century, an ideal of the medical student as ‘born not made’ was substantiated through medical school opening addresses and other medical literature. An understanding prevailed that students would have a natural inclination that would suit them to medical work, which was predicated on class structures. As we move into the twentieth-century context, we see that such underpinnings remained, even if the idea of ‘character’ becomes ‘characteristics’. This was articulated through emerging psychological and sociological perspectives on education, as well as medical school admission processes. The significance ascribed to character and characteristics-based suitability continues to exclude and limits who can access medical careers. In the final part of the article, we argue that a framework of uncertainty can and should be mobilised to re-evaluate the role of doctors’ education and critique long-standing notions of professional identity, via the integration of medical humanities and clearer professionalism teaching within medical curricula.