Studies show that ME/CFS represents a huge gap in medical education. A survey of medical students conducted in 2022 found that the students were generally unaware of ME/CFS, and had received little or no training related to the condition. However the students were very much interested in learning about it, and the study authors noted that this represents a new teaching opportunity for medical schools.1
“ME/CFS is a common and serious disease that many medical professionals are uneducated on… The results of the survey clearly emphasise the need for education on ME/CFS in medical schools in the UK”1
ME/CFS is a debilitating, incurable illness that affects at least 0.4% of the population. It is highly stigmatized, with patients complaining that they routinely receive inappropriate and even harmful medical advice from doctors.
Medical schools are aware that they aren’t doing a good enough job of teaching ME/CFS. A 2021 study, which consisted of questionnaires sent out to medical schools, found that 64% of the schools acknowledged a need for updated teaching on ME/CFS. 41% reported that they did not teach the condition at all. 64% of schools expressed a desire for teaching aids, particularly 20-30 minute videos, 30-60 minute e-learning modules, and 30-60 minute lectures by patient volunteers.2
“ME/CFS is not just yet another disease to add to overburdened curricula, it is unique in that there is a worsening of repeat cardiovascular exercise physiology, and exacerbation of disease symptoms on exertion. Patients with ME/CFS are an exception because the usual advice to exercise could cause harm.”1
A 2015 qualitative study explored medical students’ attitudes to ME/CFS. The students had little knowledge of the condition and had received no training on it, and reported that they felt ME/CFS would be a ‘difficult’, ‘frustrating’ or ‘intimidating’ condition to deal with. Some of the students expressed dismissive or hostile attitudes towards ME/CFS patients, describing them as time-wasters, malingerers, or simply lazy. They reported that they had picked up these attitudes from clinical tutors and from doctors who had trained them in clinical settings – doctors who they regarded with great trust and respect.3
History taking is essential in the diagnosis of ME/CFS and medical students are not being provided with the technical skills or the exposure to patients that is required to diagnose the disease.1
Changing entrenched attitudes can be difficult. On the other hand, there has been a wealth of new research and discoveries into the pathophysiology of ME/CFS in recent years. The NICE guidelines were changed in 2021 to reflect the scientific evidence, and the pandemic has brought greater awareness of the condition. ME/CFS will be included in the Medical Licensing Assessment that all new UK doctors will have to complete starting in 2024/2025. Now it’s up to medical schools to make the necessary changes to their teaching, so that their students will be prepared to deliver high quality medical care to patients with ME/CFS.
References
1. Investigating undergraduate medical education on myalgic encephalomyelitis/chronic fatigue syndrome Reid, Victoria Alice; Muirhead, Nina; The British Student Doctor Journal vol 6; issue 1; 1 December 2022 https://thebsdj.cardiffuniversitypress.org/articles/308
2. Muirhead N, Muirhead J, Lavery G, Marsh B. Medical School Education on Myalgic Encephalomyelitis. Medicina (Kaunas). 2021 May 28;57(6):542. doi: 10.3390/medicina57060542. PMID: 34071264; PMCID: PMC8230290 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230290/
3. Stenhoff AL, Sadreddini S, Peters S, Wearden A. Understanding medical students’ views of chronic fatigue syndrome: a qualitative study. J Health Psychol. 2015 Feb;20(2):198-209. Doi: 10.1177/1359105313501534 https://pubmed.ncbi.nlm.nih.gov/24058124/
ME/CFS Medical Education Campaign 