How Medical School Transforms You into a Charming, but Cold-Hearted Sociopath

After more than 3 years of medical school, I am strongly convinced that medical school is good training for sociopathy. If you’re a normal, empathetic person, you may graduate with sociopathic tendencies. If you’re a full-blown sociopath (i.e. you cannot emotionally relate to others, you lie and cheat without remorse, your goal justifies your means, you torture animals for fun, etc.), you may learn how to fit perfectly in society.

If you’re a sociopath, it makes sense to become a doctor. When you become a doctor, people will automatically trust you … since you are some kind of authority figure. If people trust you, you can more easily deceive them. Failing to become real authority figures, some sociopaths would even fake their credentials.

You’re probably asking how I would know. Maybe you think I am a sociopath. Well, I certainly am not. (Even if I was, would I admit it?)

But, lemme ease your mind with a personal story …

When I was around 9 years old, I watched a movie, Free Willy. Since the movie is already really, really old (which also makes me really, really old), I have no problems spoiling the plot. Heck, with the title, Free Willy, what do you think happens at the end?

The movie is about a whale, Willy, who has been captured by evil men. They were going to bring him to an amusement park and make lots of money. When big Willy was entangled in the net, he was powerless to do anything. So he cried.

My young self thought, “You can’t do that to Willy. That’s abuse!” It was at that moment that my heart broke and I teared. I wasn’t bawling like a baby, but one tiny tear flowed from the corner of my eye and onto my cheeks. I’m glad the room was dark so I could wipe my tear without being seen.

I am an empath. I can relate to others’ emotions — even if they’re literally animals.

Now, I find that my compassion and empathy for others have subsided greatly. You won’t see me shedding a tear for a captive Orca whale. Chances are … you will lose a bit of former self in medical school. That is why students who first start medical school are so full of excitement and hope for the good they can do for society. But by the end, their excitement and hope has been transformed into a primal need to thrive.

The desire to do good and to treat the sick has been replaced by the desire to become the best. That means you will do whatever you can to get the right grades, to get into the right residency, and to make the most money.

Why? Due to the perverse nature of medical training …

3 Ways Medical School Turns Your Heart into Ice

There are 3 main ways that medical school will suck the compassion and empathy out of you.

1. It enslaves you with debt.

When a medical student first begins school, she is full of dreams and wonder. She counts her blessings, because she is so fortunate that someone has selected her to be among the elite. But slowly by slowly, over the course of a few years, her dreams fade away to give room to reality. She can no longer afford to go abroad and give free medical care. She can no longer treat the homeless and uninsured. She has to pay back her school loans. (Because if she defaults, she can lose her medical license! All that hard work, time, and money go swirling down the drain.)

Reality means that she needs money. She wants to buy a house, settle down, raise a family, and pay off that burdensome loan. So all that talk about helping out the poor, giving medical care to the needy … that falls to the way side. She’ll do it another day. But another day never arrives.

2. It promotes memorization over compassion.

Science is essentially cold, hard facts. Thus, there is only one right answer. Never mind that the next research will be obsolete or refuted in 5 years. Never mind that the medical knowledge will change drastically in 10 years. All you need to do is focus on the present. Memorize, regurgitate, and repeat until you’re at the top of the class.

To get A’s in your first two years, it doesn’t pay to be kind. It doesn’t hurt, but it doesn’t pay. Instead, it is best to concentrate your efforts on memorizing everything. Know every minutiae and every trivia.

Will memorizing everything help you become a better doctor? No.

To get high scores on your licensing exams, it doesn’t pay to be empathetic. All you have to do is … know everything. Know every minutiae and every trivia.

Will knowing trivia help you become a better doctor? No.

But think about it this way …

Will kindness help you get into competitive residencies? No.

Will higher grades help you get into competitive residencies? Yes.

So now you know what you gotta focus on.

Doctors who excel in this type of environment are brilliant when it comes to retrieving stored information. They’re like a walking computer. But place them with a crying patient, and they’ll scurry out of the room.

I guess that is why doctors still need to be reminded that they’re treating patients, not textbook illnesses. You’ve most likely heard of the common saying, “Treat the patient, not the disease.” Now you know why that sentence is commonly used.

Well, sometimes, you just can’t teach an old dog a new trick.

3. It forces emotional detachment.

To be good at procedures and surgeries, you will need to distance yourself from your patients. Every time you make a cut with a scalpel, you cannot think of the pain. Same thing when you staple the patient’s scalp shut, giving a shot, do a shave biopsy, or whatnot. You cannot think about it from the patient’s point of view.

Or else you may not do good work. I still remember when I used a metal blade (lancet) to prick patients’ fingers for diabetes day. Every time I manually pricked their fingers, I just kept imagining the pain. So after pricking 5 patients, I stopped and let the nurse do it. Safe to say, I didn’t do a good job that day.

Emotional detachment is vital for doing procedures. But after a few years in a detached state, you may very well lose the ability to relate. Surgery and OB/GYN doctors didn’t get their negative reputation for nothing.

This case from my surgery rotation will show you what I mean …

It was early in the morning and the patients have been wheeled into the pre-operative room. I introduced myself to one of the patients, since I was gonna scrub into her case in an hour.

I asked her, “What surgery are you getting today?”

Removal of a sebaceous cyst on her back.

She was ashamed of her condition, because the cyst constantly released an unpleasant odor. She took showers 3 or 4 times a day, but the smell keeps on coming back.

I told her that I have seen and smelled worse things in the OR (which is true), so she should have nothing to be shamed about. I’m in the medical profession, so I do not expect everything to smell like roses.

She smiled at me and thanked me. I finished the pre-operative note and headed to the OR.

After 30 minutes, I scrubbed in with a certified, grade-A bitch of a resident. I don’t think any of the medical students liked her. Still, I was on my best behavior and tried to help out as much as I can.

The nurses wheeled in the patient. The anesthesiologist gave her local pain-killers, but did not induce her. Therefore, the patient was wide awake.

The resident was doing the cutting, while the attending was supervising. I was assisting however I can. Upon the first cut, cottage-cheese-like pus squirted out of the cyst and got onto the resident. She was all gowned up, so it’s not a problem. Things like this are expected to happen in surgeries.

The resident then said, “I hate removing sebaceous cysts the most. I hate the pus and the smell. It is even worse than resecting a poop-filled bowel.” This was loud enough for the patient to hear.

All I could think of at the moment is how the poor patient must have felt. She had absolute no control of her condition. And not only does she have to go through surgery, she has to go through it with the doctor’s bitching.

What patient, right? It’s just a sebaceous cyst.

How Medical School Teaches You to Fit in Without Giving a Damn

Medical school not only teaches you how to be cold-hearted. It also teaches you how to be charming. This way, you can blend into society, like a wolf covered in sheepskin.

The best way to teach you how to blend in is to force you to conform to societal standards. If you don’t, you fail. This is where rotations and the COMLEX 2-PE comes in …


I have written extensively about rotations here and here. Overall, the 3rd and 4th year on rotations are a huge waste of time when it comes to learning medicine. However, it is great for learning about deception. The hallmark of a skilled sociopath is deception. The better she is at it, the less likely she is to get caught.

Let me give you a real-life example of how future doctors can learn deception.

By the middle of the 3rd year, you should have a pretty good idea what specialty you want to go into. So one of the most common questions you’ll face is: What specialty are you going into?

There are the honest people. And then there are those who want to get on the good side of the doctor through whatever means possible. If the doctor is a surgeon, she’ll say surgery. If the doctor is a cardiologist, she’ll say cardiology. You get the drift. Basically, she is hoping to be liked by contorting herself to please whoever is in charge.

It is actually a very good tactic, one that is grounded in social psychology. You will generally like a similar person more. This describes racism, nationalism, ethnocentricity, and the way people interact.

It is dishonest, but it works. This is exactly what a smart sociopath would do — get you to like her.

That example is just the tip of the iceberg. I’m not gonna dig into it. You’ll learn about it during your rotations.


In my opinion, Step 2-PE is totally unnecessary and totally stupid. Its main purpose is to enrich NBOME (the organization that runs the licensing exams) under the guise of training compassionate doctors.

The PE is good for training you to pretend you care. Since the standardized patients are all acting, they don’t really have the illnesses. Therefore, how could you really care for something that isn’t real?

You can’t.

But what you can do is show that you care, without actually caring at all. You learn how to be deceitful. The better you are at it, the better your score will be. (And the better sociopath you’ll be.)

If the “patient” is pretending to hack up a lung, you can gently touch her shoulder and ask if she could use a glass of water.

If the “patient” has a temper tantrum, treat her with kid gloves. In the exam, you say, “Oh ok, we’ll talk about this another day then when you’re feeling better.” But in real life, you would kick the patient out of your practice.

Not only is the PE good training for future doctors, it is also good for future politicians. Talk a good talk, but only walk the walk when it suits you. As long as you say it in a way that is convincing enough and politically correct enough, no one will think twice about your “good” intentions.

A Wolf Will Never Admit to Eating Sheep

Don’t expect doctors or medical students to corroborate what I say. Most won’t even realize what they’re learning. And if they do realize it, why would they spoil their sterling image and admit to it?

You’ll hear all the neatly-packaged and carefully-edited marketing stories: selfless volunteer services, heartfelt patient care, and pioneer research which paves new ways to better health.

“Deceitful? No, not me,” says the most cunning and ruthless sociopaths. “I went to medical school. And even took a course on professionalism.” As she shakes your hand and kisses you on the cheeks, she won’t hesitate to plunge a knife in your back. She’s already done it to countless others.

This article is part of the How to Survive Medical School series. Click on the link if you want more tips and hints about surviving academic hell.


  1. Cang Dang says:

    Wow, is this the reality of medicine. It’s not as I heard and expected >.<

    • Alex Ding says:

      Yes, it is the reality. There is a lot more politics than you would think. And you know how politicians are.

      But if you want to go into medicine, don’t despair. You can still be caring and empathetic. What I have described is the general environment, but it really is up to the individual to change or not change.

  2. I have been married for four years and together for five. My husband is a spine surgeon recentantly graduated in July 2014, who I supported financially and emotionally during his residency and fellowship years… He lived in my house,drove my cars and enjoyed the nice living I as a working single mother had to offer in return of marring the most amazing man ever!He was from California, and had come to Long Island to complete his residency program for five years.For four and half years I paid his bills and took care of all his needs… Always with a promise of a great future ahead…
    I gave up on my eighteen year old business, left my house in Long Island in July 2013 to follow him to a freezing year in Minnesota for his fellowship…I took my daughter,my dog and all my furniture,what I couldn’t take with me I left behind. I sacrificed everything I had for him,but truly not seeing any immediate return or even gratitude. On his graduation speech he said how much he loved me and how I helped him and how grateful he was… It was the most moving and sincere speech a ever heard!
    Two weeks later July 2014 he moved us to Florida where he was hired to start as a spine surgeon, he told me to give all my furniture away, he was buying me a two million dollar house furnished. On his very first paycheck he opened a bank account in his name only and told me “sorry sweetie I will control the money!”
    He then started to torture me immediately after started his new job with abusive words and disrespect. For the next thirty days he continuously said I don’t love you anymore, I feel like vomiting when I am next to you,I hate you etc… I had just giving up my business for over a year by moving to Mn, I had depleted all I had during the last five years together, I was living in a furnished rental apartment and the remaining left from my life belongings were in storage.
    He continue to feel powerful and continuously mistreated me to the point of hitting and bruising me,he attended events and parties without me, he went on a radio show spoke for one hour about his personal journey and never once said my name or that he was married. He left me and took all his clothes one night after work while I was in church,closed our bank account,stopped paying the bills and never once called to say why.
    I received a email from him where he called me manipulative,abusive, dishonest etc…
    he somehow turned the story around and made it sound I was the one who acted that way, but he forgot to cover up his cold thinking of planing to divorce me inFlorida and destroy my life… He told me on the email that he fantasized while living with me in Mn of how life was going to be amazing without me in Florida and yet he made me give all my furniture away, told me to close down my business and let my house go, I wasn’t going to need it.
    I now came back to Ny few weeks ago with open toes shoes and summer dress on when its winter… My daughter and I have nothing to were or a bed to lay on it. We lost everything…He refuses to give me the code to the pod where our winter cloths is and no matter how many texts or emails I sent bagging him he refuses to allow me to even have a coat n my back… I was a woman with everything,a business and a beautiful home, after marring my husband “the spine surgeon to be” I literally am left without a thing except his debt… which he calculated to be half my responsibility just before he hit the millions … he decided to crippled my life and he even told me he wants to deport me.
    Earlier in the marriage I knew soothing was wrong when I told him my hair was thinning and he told me he did not care if I was bolding from stress, he often said during an argument: ” Not even your own father loved you” he clearly knew I had pain from my dad leaving me when I was a child. He also punished often by not speaking to me for hours and days… He never says I am sorry! He was always angry and constantly aggressive but in front of others he is a calm, loving and caring doctor. I am about to go thru a divorce with a person who in my opinion fits the category of a sociopath perfectly. His goal all along was not only to use me for paying for the time he needed help but to leave me right after his first paycheck as a surgeon in practice and to make sure he destroyed my life to the point of not even having a roof over my head. The plan is so good that I must wait at least six months to receive any monetary help in Florida.
    My heart hurts and I am suffering when at this very moment I am suppose to be in a sunny and beautiful home waiting for my husband to come home after work. I was used and abused for five years for nothing. He has no conscience he cut me out, erased my daughter of his life and abandoned us couple moths after his graduation day… I am trying to make sense of my life and how my husband could have the heart and courage to do this to me…

    • Hey Mrs. O.,

      I am very glad you wrote in about your story. As I read it, I cannot help but feel for you.

      From your description, he sounds like a sociopath. Lots of surgeons have sociopathic traits.

      You should not have gone through what you went through. But you have a clutch … You married him.

      So that means if you divorce him, you may receive alimony for some years. And depending on how old your daughter is, you may also get child support. Since he’s making the big money now, your alimony and child support will be quite substantial as well.

      Your best bet is to talk to a divorce lawyer and you’ll get good advice. Since you will become a thorn on his side, you should be careful around him. He will have no remorse in getting rid of you (in however way possible — paying you off, murder, make your life hell so you leave on your) if he can get away with it. So watch out!

      If you’re gonna leave him, at least get some money for the years of sacrifice.

  3. Hey Alex and Mrs. O, i’m a 1st year med student wee lil’ Malaysia and my dad’s a sociopath. Both my parents are doctors and sad as it is, my dad’s almost completely similar to Mrs. O’s description of her exhusband (pardon that I mention him). Sad really that med school makes sociopaths.

  4. Wow, yes. I think med school converted me from an empath to…not sure what. A loner? Anyway, I cried when Tom Hanks loses his pet volleyball Wilson. Indeed.

  5. I have been an ongoing patient in the Canadian healthcare system for 10 years now, having saw many, many doctors over that time period (more than 99.999% of people on earth have been to in a 10 year period), I have met many sociopathic doctors. I always wondered how one profession had so many sociopaths? Surely it seemed unlikely to me that such a large number of sociopaths chose medicine as their career either by chance or on purpose. Your article explains it and it all makes sense now, they learn their sociopathy during their time in medical school.

    I find many of them to be outright dishonest, and they often employ what is known as the “BATHE” technique to manipulate their patients into a) thinking that they listened b) that they care and c) that they are going to do something about the concern the patient has raised. But this is all a ploy to get the patient out of the room so that they can go onto the next patient(fee for service helps incentivize this). The patient often has no idea until they are half way home, that absolutely nothing has been done to change their situation and they are often in the exact same position, no better off than they were before they went to their doctor’s appointment.

    Many times, physicians only seem to have two priorities when it comes to patient care: 1) that you don’t die in the immediate future, and 2) that you don’t form addiction to anything. Once these two requirements are fullfilled, many often just don’t care about anything else. Sick and unable to function nearly everyday? No quality of life? Maybe I just screwed up your prescription and you had to go without or had to go running all over town to find a refill to fix my mistake? Side effects of any prescribed treatment? Cost of uninsured medications? Logistical considerations of any prescribed treatment or test? They don’t care. It seems many times that the only reason they cared about the immediate risk of death or addiction was solely due to the fact that those are pretty much the only two situations that most doctors could ever possibly be held accountable for, not because they actually had any empathy for the patient whatsoever.

    Many doctors often play hot potato with their patients here, tossing them back and forth from one doctor or specialist to the next with very little regard or concern for the patient’s recovery or what they are going through whatsoever. Doctor A will say it isn’t his job, it is doctor B’s job. Doctor B will say it isn’t his job, it is doctor C’s job. Doctor C will say it isn’t his job it is Doctor A’s job or another doctor entirely. This process of being tossed back and forth often takes place over many months, sometimes years, all during which the patient’s condition is just left to further deteriorate. None of the doctors end up doing any work whatsoever(all get paid of course), and the patient just gets screwed and left to save themselves. Even when confronted, none of the doctors seem to feel any guilt, pity or remorse for playing hot potato with the patient whatsoever, they feel no professional nor moral responsibility to help whatsoever, they just feel nothing at all. They will usually be smiling at you during this whole process in which you the patient get screwed.

  6. Phil Loren says:

    I have come across a couple of good doctors but most of them are uncaring and filled with greed and corruption. Facism is how I look at it. I say this because a doctor can see you suffering and just write you off they have the ultimate power here on earth my life has been in shambles to say the least. I’m not an academy award winning actor otherwise I’d be in Hollywood anxiety is crippling and not humorous at all after not sleeping good for two weeks I feel inhuman an alien from another planet. I told to Doctor this I’m a flesh and blood human being. And I’m suffering. Help me tell me what you want me to. The doctor will stare at me emotionless no compassion. Do doctors have a beating heart or a soul. I wonder. To show people your smarter and more educated by treating people is cold. Winter freezing cold doctors have people’s life’s in their hands and they treat it like storytime in grade school finding a good doctor is frustrating stressful and I’ve even thought if I have to live like this the rest of my life put a noose around my neck. To have doctors almost smile at me is disturbing maybe they should be serial killers or produce movies in the pornography business. Do doctors not worry about the next life. No because power and money is the main goal. This is the way hitler ran natzi Germany

  7. The doctor I know well is an ER doctor. She is a sociopath. Young. Pretty. Charming. But she was a sociopath long before med school. And she will lie right to your face. Blames childhood trauma. Also moved to Florida. It’s a long story. Admits that she truly is a sociopath. Uses illegal drugs to this day. This is the short version.

  8. john wright says:

    Do medical schools care? I now of a young sociopath currently enrolled in medical school. If he does as much harm to others post graduation as he has prior to medical school, should I inform the school or just let well enough alone?

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