Grief and Coping Education in US Preclinical Medical Curricula: Findings from an Exploratory Survey

Physicians frequently experience emotional distress and grief in response to patient suffering and death. Collective professional experience suggests that while these emotions may be burdensome, the skills needed to cope with these emotional realities develop gradually, through repeated exposure and structured reflection. Although many US medical schools now include end-of-life (EOL) teaching in their preclinical curricula, much less attention is paid to how medical trainees learn to develop healthy coping strategies to address these emotions.

This exploratory survey examined how US medical schools address physician grief and coping during the preclinical years, defined as the educational phase before supervised clinical settings or clerkships.

A 30-item questionnaire was sent to a course director, academic dean, or other curricular leader at 192 Liaison Committee on Medical Education (LCME) accredited M.D. and Commission on Osteopathic College Accreditation (COCA) accredited D.O. schools in the US between November and December 2024. Survey items addressed the prevalence, format and depth of grief and coping-related instruction, as well as a broader EOL education. Responses were summarized using descriptive statistics.

Ten institutions provided completed responses (response rate 5.2%). Among the responding institutions, 70% reported integrating EOL content into required courses, however instruction on physician grief and coping was limited. In total, 60% of respondents provided fewer than five hours devoted to coping, and most lacked a structured curriculum on the topic. Opportunities for reflection and faculty-led discussions about student well-being varied. Only one institution reported a curriculum committee on physician grief and coping.

Among responding institutions, structured grief and coping education in the preclinical years appears limited relative to the broader inclusion of EOL education. Our findings highlight variability in how US medical schools address the emotional dimensions of medicine and suggest opportunities for further investigation and curricular development. Integrating grief and coping education into preclinical curricula may ultimately support both professional identity formation and physician wellbeing.