What if we are training to be the problem?

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OPINION

By Bob Oscar Aweu

A medical student's reflection on how training shapes not just skill, but silence.

I came to medical school to save lives. That's what I told myself. What I didn't realise then was how medical school might quietly change the kind of person I was without ever asking for my consent. Not just by what it taught me, but by what it normalised. By what it punished, by what it rewarded, somewhere along the line, I started noticing how easy it was to become numb to suffering, to laugh off a patient's pain because a senior did, to treat a human being like a case file because "there's no time." And what troubled me most wasn't that this happened; it was how natural it began to feel.

This is not a critique from outside the system. I am inside it. I am part of it. And I am afraid that if I do not consciously resist, I will emerge not as a healer, but as yet another cog in a machine that prioritises protocol over personhood, tradition over truth, and survival over transformation.

It is easy to overlook the power of the hidden curriculum, the silent lessons we absorb about hierarchy, obedience, and emotional distance. We aren't told to silence our doubts, to swallow our empathy, or to downplay our values. We're shown how to do it. We see how the outspoken student gets labelled "difficult." How the one who lingers too long with a patient is told to stop wasting time. We watch as brilliant seniors go along with decisions they quietly disagree with because "that's just how things work here." And so, in the name of competence, we begin to amputate pieces of ourselves.

Somewhere between third-year ward rounds and final-year call duty, many of us learn that the safest posture is silence. That it is better to be wrong in the same way as everyone else than to be right alone. We learn to speak in passive voice. To say "the patient failed to improve" instead of "we didn't listen well enough." We learn to move on quickly. To rationalise suffering. To protect our grades, our reputations, our peace.

But what if, in doing all that, we are being trained into something dangerous?

What if we are becoming fluent in detachment? What if our capacity for compassion is being whittled down to clinical politeness? What if the system that once inspired us to heal is slowly shaping us into technicians, skilled, efficient, and obedient, but morally anaesthetised?

This is not a call for rebellion for its own sake. It is a call to stay awake. To remain disturbed by things worth being disturbed by. To resist the normalisation of apathy, not loudly always, but consciously. Because if we don't, we will become too good at surviving in the system and forget how to change it.

There is nothing inherently noble about suffering through medical training if it leaves you too broken or too scared to challenge the very structures that caused the suffering in the first place. Our silence becomes complicity. Our adaptation becomes endorsement.

And so, I write this not to indict, but to caution, and perhaps to confess. I am afraid of what I might become if I don't remain vigilant. Afraid that one day I'll look in the mirror and see not the idealistic student I once was, but someone who gave in. Someone who learned how to work the system and forgot how to question it.

Because if we are not careful, if we are not deliberate, we won't just be trained to treat patients. We will be trained to be the problem.

O B Aweu, MD. (MBChB- SUN)