Doctors Urged To Look Deeper Students Attend Conference About Domestic Violence

Douglas Skarada, a future doctor, can’t forget the scene in a North Carolina hospital, when a woman whose face had been bashed in by her husband was brought into an emergency room.

Skarada, a third-year student at Duke University’s Medical School, was sickened by what he saw. But he was even more troubled by the response of doctors treating her.

“She was surrounded by reconstructive surgeons saying, ‘We’ll rebuild her face. The rest is out of our hands,”’ Skarada said. “Residents and doctors are so focused on treating the injury, they just turn their backs on everything else.”

Skarada recalled that incident at a national conference here, the first of its kind, designed to educate medical students about domestic violence - and train them to help victims.

“We can’t duck this issue any longer,” said Dr. Donald G. Kassebaum, vice president of the Association of American Medical Colleges, which ran the conference. “We can no longer focus on the biomedical model of healing, while ignoring our responsibilities to help individuals who may only return home to face more injury.”

Kassebaum said the association, which oversees accredited medical schools and teaching hospitals, began its domestic violence effort in response to comments on annual surveys it does of 15,000 medical school graduates.

Over the past five years, Kassebaum said, about three-fifths of the graduates responding said they received little or no training about domestic violence, how to spot it or how to talk to patients about it.

While America’s awareness of domestic violence has been heightened in recent months, the association thinks this empathy hasn’t pierced the medical field.

“In many medical schools, the focus on clinical treatment is intense,” said Dr. Elaine J. Alpert, assistant dean for student affairs at Boston University’s medical school. “Courses that don’t quite fit into the norm are ignored. And if students don’t learn about family violence in school, there may not be much chance once they’re in practice.”

The doctor who sees a dislocated shoulder on a child, a bone that has been broken frequently, or a profoundly depressed woman with multiple bruises must, she said, take time to ask what happened.

“One empathic statement from a physician could be the first step toward safety,” said Alpert, who has developed a guidebook on spotting and treating domestic violence patients. “Often, it may be the first time anyone in an official capacity tells a patient that there’s help available.”

The association will eventually create a model course, including information about all types of family violence, for medical students.