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Starting my third year of medical school in the hospital felt like being dropped in a foreign country. The "hidden curriculum" was everything not in my guide book--which was a lot. It was culture shock.

In addition to burnout, I have heard lots of discussion about loss of empathy and high rates of depression in medical students that occurs after medical students enter the wards. What role does the "hidden curriculum" have in these phenomena? While we're working to change the culture, how can we help students process their experiences in ways that acknowledge their challenges and build coping skills?