Empathy and sympathy are two words you hear thrown around plenty, especially in the lead-up to medical school interviews, as being able to differentiate between the two is a typical question candidates often get. But what do each of these terms mean and how are they different from one another? This difference, albeit subtle at first, is something that confuses a lot of people, leading to these terms’ incorrectly interchangeable use. The reason for this confusion is that in their core, both of these actions deal with our way of handling the emotions of others.

Before we dive into the definitions of both terms and showing how they are different from each other, we first need to address the question of why it is important to understand these two concepts and what bearing they have on the expectations of you as a medical student.

A lot of prospective medical students expect that a big part of their education and training will be focused on gaining tons of theoretical knowledge on anatomy, physiology, and pathology, and rightly so. Amongst other topics of medicine, this will lay the foundation for their clinical practice after graduation. However, not many realise the amount of work put in by medical schools to train their students in the softer skills required for excellent practice, such as communication and empathy. This already may be giving you a slight hint of what the difference between the terms empathy and sympathy would be, as we often talk about mastering the skill of empathy in medical school, but not that of sympathy.

The reason why it is so crucial that we master these non-academic skills before we start practicing medicine is that the medical field is an incredibly socially-oriented vocation. Yes, you will help people by hearing a list of diagnosis and being able to correctly reason a list of differentials, order the appropriate tests and outline the most effective course of treatment. But think about how you will get to your diagnosis? You won’t be provided with a presentation slide listing all the classical symptoms of a disease. You will have to take the history from the patient and the better you are at communicating with them, putting them at ease, allowing them to open up and honestly discuss their concerns, the more accurate information you will receive that will help you treat them successfully. That said, these softer skills can sometimes be even more important than anything else you will learn in medical school.

This is why when first interviewing for a place at your chosen university, you may come across being able to reason what empathy and what sympathy are and how they tie in with providing excellent care and being a great doctor. So keep in mind the implications such a question may have on practice during the interview and remember the rule of thumb - all questions asked at an interview, however random or unexpected they might be, aim to assess your suitability for medicine. So don’t forget that you always need to bring your answer back to a reflection of why such a skill or quality makes a better physician and how you have shown to possess it.

Empathy vs Sympathy

Let’s start first by defining the two words. According to Cambridge Dictionary, sympathy is “the expression of understanding and care for someone else’s suffering”, whereas empathy is “the ability to share someone else’s feelings or experiences by imagining what it would be like to be in that situation”. Pretty similar-sounding huh?

In simple terms, sympathy is the ability to recognise and understand someone’s sadness, whereas empathy is the ability to relate to someone else’s feelings as if you were experiencing them yourself. Whilst both of these are useful qualities to have, empathy goes much deeper than sympathy, as sympathy is feeling sorrow for someone else, showing commiseration and compassion to their experiences.

Empathy, on the other hand, allows you to draw on your own personal experiences in order to experience the feelings that the other person’s feeling. For example, think about the sympathy cards that people send to friends and relatives during difficult times - they essentially say “I understand and I feel for you”. Even though it is very important to be able to show such compassion, sympathy without empathy in the context of medicine could possibly at times make the other person feel pitied as opposed to fully understood, which can make the doctor-patient relationship more one-sided. For this reason, empathy is more valuable in medicine and is essential for doctors in getting the best outcome for their patients.

Why is empathy such a buzzword in medicine?

Being able to empathise with patients is essential to being a good doctor. It enables you to see the patient as a whole - not only a constellation of symptoms and complaints, but all their concerns and issues that they are going through, whether that is their pain, or the way their condition has affected their life at work, at home, or their hobbies. Having this overarching understanding can then help you decide on a more holistic approach when planning their treatment - yes, they might need immediate analgesia and a planned imaging for investigation of underlying causes, but arranging a carer for them several times a day or offering counselling at appropriate facilities are other, incredibly important, ways in which doctors can help their patients. This would only be possible if the doctor was empathetic and was truly able to appreciate their patient’s concerns and difficulties. Holistic care is another very important term you should be familiar with and is a buzzword at interviews. The ability to be empathetic informs the ability to provide holistic care. So remember to reflect on your answer about the importance of being empathetic and relate back why this would make you a better doctor during an interview question.

When you show empathy to your patients, it means they are more likely to feel understood and as a consequence, emotionally connected to you as their doctor. This is important for a number of reasons; it makes for a better doctor-patient relationship, which means that the patient will have a better experience and leave happy, the patient is also more likely to divulge sensitive information, which they may not have felt comfortable doing before. This can be vital in ensuring the treatment you are providing is the best it can be for the patient. Patients are also more likely to listen to the doctor and follow their treatment plan if they feel that they have fully listened to them and that they understand their individual concerns.

Is there more than one type of empathy?

There are, in fact, multiple types of empathy - and you will score a lot more points and show a lot more insight into the topic if you were able to briefly discuss them during your interview. Let’s have a look at the two most commonly discussed types of empathy and ensure that we understand what each means and when they are used.

Cognitive empathy, which is also known as perspective-taking, is the first kind of empathy we will talk about. As the name might suggest, cognitive empathy is one’s ability to take someone else’s perspective, understand their feelings and their thoughts while staying out of judgement or essentially - really put themselves in their shoes and imagine what it’s like to be them. This is a more cognitive ability and does not necessarily convey sharing their feelings, but a more logical way of empathising by thought.

Emotional empathy, also known as affective empathy, on the other hand, is much more emotionally engaging, as its name might suggest. When you exhibit emotional empathy, you are literally feeling the same emotions that the other person is going through. If your sibling has just received amazing news and is jumping from happiness, you feel that happiness yourself. you aren’t simply understanding why they are happy because you know that if you put yourself in their shoes, you would be able to understand their emotions - that would be cognitive empathy. But you are truly sharing their feelings with them, instead - that is emotional empathy. Similarly, if your partner is upset because of something that has happened at work, you may feel upset seeing them this way, too - thus once again exhibiting emotional empathy.

Having emotional empathy can be a very positive thing in medicine, as it allows us to connect to our patients and truly empathise with them, but has the potential to be a negative, too, if we allow it to overcome us, thus rendering us unable to provide effective care. This is why medicine is such a challenging profession and you still need to find ways to detach yourself from certain situations in order to be able to think clearly for the benefit of your patients. It is also exactly the reason why we as doctors are not allowed to be involved in the care of our relatives!

How do you go about showing empathy?

Showing empathy is something that comes naturally to most people for the most part, however there are things you can do to enhance this, especially in a clinical setting. Showing the patient that you are actively listening through non-verbal communication is a great way to show empathy before you have even said anything. Examples of non-verbal communication include nodding at appropriate times and maintaining eye contact to ensure that the patient continues to feel listened to. By doing these small gestures you show the person across from you that they have your full attention and you are genuinely interested in hearing their story. It makes them feel more at ease during an already uneasy situation and helps them open up better and share details that they may otherwise have had difficulties with.

Other ways in which you can show empathy are your body language - facing the other person with your feet pointing towards them, leaning slightly forward and having your arms uncrossed are a few common tips to follow if you wish to present yourself as a more open listener who’s welcoming the information coming your way. To build on this, consider also your facial expressions while listening to the person’s story. You don’t have to be smiling from ear to ear the entire time, which can be very inappropriate, especially if the conversation is sensitive, but you can still maintain an interested and calm appearance. Be mindful if your face automatically changes expressions when you are focused and correct those if you naturally veer off towards a frown.

Lastly, try to maintain your tone of voice level and calm, which can even help distraught individuals - when we are having a dialogue we subconsciously mimic the other person, so by maintaining your speech at a slow and level tone may help the person across from you feel more grounded and naturally relax. Ask the person across from you open-ended questions, which would encourage them to provide details about their problem and show that you have been listening to them throughout your interaction.

Emphasising the importance of empathy

As you can see from this whole post, sympathy and empathy are both important qualities to have and as prospective medical students and future doctors, these are qualities we should be nurturing and developing all the time. We as doctors have the incredible privilege of being present for often pivotal moments in patients’ lives when they are at their most vulnerable and they open themselves up to us in ways they would not to others. In exchange for this, we need to treat them with respect and provide them with the care they deserve and empathising with them is integral to doing this.

We have come to the end of our blog about sympathy and empathy. Hopefully we have clarified a few things for you and you have a strong grasp of these definitions and will be able to apply them in practice during your medical school interview preparation. A great place to start this is our live online interview course, where you will be taught by medical doctors and students on important concepts about structure and content of your interview answers and provided with plenty of opportunity to practice mock questions.