DRAWING ON MEDICAL STUDENTS' REPRESENTATIONS TO ILLUMINATE CONCEPTS OF  HUMANISM AND PROFESSIONALISM IN NEWBORN MEDICINE

Medicine is changing fast. It has become increasingly scientific, technological, commercialised  and commoditised (Starr and Bellman, 1992). Doctors are burdened by the knowledge dilemma, with medical knowledge doubling every five years, of which 85% is obsolete within fifteen years  (Robinson, 1993). Managed care, medical liability, cost control, the pressure to see more patients, and consuming paperwork have created significant stressors for doctors (Theodosakis and Feinberg, 2000). As a result, Pelligrino claims that the modern doctor has become deprofessionalised, bereft  of the essentials of the character traits associated with good doctoring (Pellegrino, 2002). This  hardening of the heart (Newton and O'Sullivan, 2008) seems to begin early in medical school when medical students are handed scalpels to dissect the cadaver, the ideal patient, since it can't be  killed, never complains and never sues (Fadiman, 1997, p. 23).    Medical curriculum designers, including those of the University College Cork (UCC) medical  school, have been addressing these issues, through a number of pathways. The first was  through an integrative curriculum that eliminated the barriers between subspecialties  (horizontal integration), and introduced a systematic apprenticeship-based clinical exposure  from the onset of medical training (vertical integration of basic sciences and clinical practice).  The second thrust, in response to the knowledge-overload dilemma, was towards improving  problem solving abilities and critical reasoning. The third focus intended to promote humanism  in emerging doctors by expanding and enhancing the role of the humanities in medicine and to explicitly address the so-called 'hidden curriculum' of medical professionalism.    Humanism, which generally refers to the quality of being human, is a particular approach to  medical professionalism. The ABC mnemonic (Altruism, Beneficence and Compassion) is useful  way to remember some of the positive qualities of the humanistic physician, who has been  defined by Louisa Coouts and John Rogers as one who:   •Respects patient's viewpoints and opinions in a shared partnership of care;  •