All Good Things Must End - The End of the M3 Narrative Medicine Session for Medical Students

Bruce H. Campbell, MD FACS

Professor Emeritus of Otolaryngology and Communication Sciences

The Medical College of Wisconsin

December 22, 2025

First M3 session - December 2014

A challenge from the curriculum team

In late 2014, I was contacted to create a December educational session somehow related to my writing for the entire third-year class at MCW. I was intrigued. The session would occur at a fraught moment in the lives of these students six months into their full-time immersion into clinical work.

I tried to recall how I felt midway through my M3 year at Rush, having rotated through the surgical ICU, general surgery, and internal medicine. Even though I had the advantage of having worked as an orderly for a few years, I was unprepared for the onslaught of illness, death, emergencies, and suffering. I watched one  failed resuscitation after another. I gazed into the hollowed-out eyes of people with active TB, terminal cancer, and tertiary syphilis. I held pressure on close-range shotgun blasts to the abdomen, palpated colons obstructed by perforating tumors, and watched families crumple in the wake of tragedy. When I dared express an opinion, I was certain it would reveal my ignorance and inadequate preparation. I experienced the hidden hazing that defines medical training, sleeping intermittently, running on fumes, trying to remember what a weekend was, and feeling inadequate. Those six months still burned decades later.

Although times had changed, I knew my students were experiencing similar firehoses in the operating rooms, clinics, hospital wards, and emergency departments. Sure, information and technology had advanced. Educational philosophies had evolved. Despite the changes, they were still in a tough phase of life and acutely aware that it would still be eighteen months before they could write “MD” after their names. If all went well.

What could I do to help them?

Writing about difficult clinical experiences, in many ways, saved me. I proposed a session to help students launch their personal statements for their residency applications with the secondary goal of having them pause at this most unusual and remarkable point in their lives to assess how medicine, illness, loss, death, and disability were changing them and their views of what it means to be a physician. I hoped they might discover the healing power of narrative much as I had.

The sessions were built around a “create-your-own writing prompt” approach and encouraged participants to focus on details and facts rather than feelings. The core prompts remained consistent over the years, and the students picked the prompt most meaningful to them at the moment: “Write about the first patient who was truly your own.” “Write about a scary incident.” “Recall exactly what your mentor did/said that convinced you to pursue your specialty.” “Write about a time when you were surprised or astonished." “Write about your most meaningful patient.” “Write about a clinical encounter you hope you never forget.” "Write about a time when someone made you very uncomfortable.” “Write about something you have always wanted to write about.” They could write about a clinical or personal time. They did not have to turn in their work and were not required to read anything aloud. I did instruct them to share in small groups what it was like to recall whatever it was that they wrote about.

The narrative sessions

I ran the first session in December 2014 and waited anxiously for feedback. The written comments were heartwarming. Although a respondent or two every session wondered why the class was forced to reflect, the majority found the experience valuable and surprisingly helpful. Some realized they had already begun to forget details of seminal moments. Some reported remarkable personal insights into career choices and existential crises. Some commented that they had never taken a moment to grieve or thank or sit quietly.

I was invited back to repeat the sessions every June and December. The agenda evolved a bit over the years as I became more familiar with the Columbia approach to narrative medicine. Based on feedback, I reluctantly scaled the writing time back from twenty minutes to ten. I added close readings. I switched from in-person to virtual sessions when COVID-19 arrived in 2020. I added material on Large Language Models.

For eleven wonderful years, I had the privilege of running sessions. Wonderful colleagues and I wrote up and published our experiences.

Through the years, over 2200 adults at the cusp of their clinical lives in medicine sat for 90 minutes twice, pen in hand or fingers on keyboard, with time and space and no responsibilities other than to remember everything. This roomful (or screenful) of medical students, accustomed to rushing from one bedside to the next, was given the opportunity to pause—maybe for the first time—and dive into a single patient experience or life-changing pivotal event. Don’t stop, I told them. Pull up some more. Honor the story. Focus on details, details, details.

Tellingly, when I meet MCW graduates now, they might not remember me but they easily recall the writing sessions. Of course, they are nice and tell me it was valuable and unique, but they often go on to comment on how important and rare they found the experience.

Did they make a difference?

The final session was held last spring. I have to wonder how much difference the project had. I can point to neither a burgeoning shelf of physician writing nor to any specific impact on the new curriculum. Writing exercises exist, but they are not coordinated, rarely gather data, and are scattered over time and place. Nationally, humanities funding has been decimated. Clinician essays on sites like Doximity and KevinMD tend more toward financial planning, tech, burnout, conflicts, and early retirement strategies than the celebration of narratives. Kathi and I fund a narrative scholar at MCW, but it seems like a drop in the bucket and we cannot fund it forever.

I realize we never know how far our ripples will reach. Happily, several of my formal students have gone on to be excellent writers and narrative experts. Two former students, Brittany Bettendorf, MD and Elizabeth Fleming, MD, are the driving force behind the Midwest Physician Writer’s Retreat which, in turn, is inspiring the creation of a national organization of physician authors. Several former and current MCW students (looking at you Kira, Meg, Linda, Scott, and many others) inspire me and promise to keep in touch. Many physicians have asked whether I think they could write a book (of course, they can!) and I share what I know. I meet insightful physicians everywhere I go. Things will continue to evolve. But will it ever be enough?

I was sad when I realized this December will come and go without the opportunity to share time with these future physicians blazing their paths in clinical medicine and who are in the midst of the most challenging, narrative-rich, and seminal juncture in their lives and careers. I know they will be fine, but I really, really enjoyed the opportunity to accompany them, even for a little while.

Photo credit: Art Derse, MD JD

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All Good Things Must End - The End of the M3 Narrative Medicine Session for Medical Students