title: Medical student dreams about medical school: the unconscious developmental process of becoming a physician.
abstract: This paper is a report on a collection of almost four hundred dreams of medical students and postgraduate trainees with the manifest content about medical training. It is a unique dream collection from a defined population that experiences a developmental sequence of observable, reality events. The reality events appear in the manifest content of the dreams along with their symbolic alterations. The dreams are used as a psychodynamic database. The data may illustrate which reality experiences seem psychologically formative, their emotional developmental sequences and their specific emotional content. This is a pilot project exploring whether dream material collected from a discrete task group might give information about a group's emotional adaptation. The dreams seem to show an unconscious developmental process in response to medical training and becoming a physician that unfolds in overlapping stages as trainees learn to master skills and tolerate care-giving responsibility for human life. A progressive, unconscious hero-healer fantasy seems to form. It becomes elaborated in masochistic and then sadistic fantasies. These fantasies are evoked by, and used as a defense against, inevitable but painful anxieties of emotional adaptation to medical education experiences.
authors.affiliation: Columbia University Center for Psychoanalytic Training and Research, 1051 Riverside Drive, New York, NY 10032, USA. erm4@columbia.edu
authors.forename: Eric R
authors.initials: ER
authors.lastname: Marcus
mesh_terms: D000223:Adaptation, Psychological; D003674:Defense Mechanisms; D004325:Dreams; D005201:Fantasy; D006801:Humans; D007396:Internship and Residency; D009289:Narcissism; D012448:Sadism; D013337:Students, Medical; D013561:Symbolism; D014473:Unconscious, Psychology