Commentary Corner: The Importance of Medical Humanities
Medical humanities is an interdisciplinary field encompassing areas like literature, ethics, sociology, history, psychology, anthropology, and arts, as they relate to the practice of medicine. Though broad in topic area, it highlights the obvious but profound fact that doctoring cannot occur apart from the human condition; that clinical practice is sometimes as much about understanding suffering, joy, grief, and social responsibility as it is about learning the science of modern medicine. Though variable in implementation, it is driven by the belief that study of these fields will help develop crucial interpersonal skills, emphasize the empathy and self-reflection required for humane patient care, and underscore the need for physicians who are culturally and socially aware. And though often underemphasized in undergraduate medical education, medical humanities represents perhaps one of the most important lessons for students: the more that medicine is practiced with respect for these larger cultural, psychological, and social settings, the more holistically these settings will be able to promote health.
The holistic focus is certainly needed at the medical school level, as research continually affirms that students often graduate with more cynicism than they enter with and with diluted versions of the compassionate, service-minded attitudes that originally drew them to the profession. Although this issue is admittedly complex, a lack of uniform curricular emphasis on the goals championed by humanities is a potential contributing factor. For example, many goals within the competency of professionalism can be thoroughly addressed through medical humanities. So, although the field itself need not be the ultimate focus, its intentional inclusion (through narrative readings and writing, didactics on physician-writers, physician-historians, medical anthropology and sociology, and the like) can effectively promote other crucial competencies.
Admittedly, the problems mentioned above are not new, and medical humanities have been around for some time. But in realizing urgent areas for improvement in training professional, humane physicians, institutions around the country have begun rethinking curricula. In addition to offering electives in medical humanities, many have integrated required elements into their curricula. Some institutions have retooled their preclinical years to create more robust ways to use humanities to teach students to better understand the relationships with patients and communities. Others still have integrated elements of humanities into larger competencies. One such effort at my home institution, Baylor College of Medicine, Houston, Texas, has been the utilization of a recent grant from the Institute of Medicine As a Profession (IMAP) to champion professionalism through teaching innovation. The program centers on the creation of sequential, longitudinal interventions over the four years of undergraduate medical education, and it utilizes reflective writing and other methods to promote and assess curricular effectiveness in furthering humanistic, professional perspectives and behaviors.
Appropriately, this effort has not been limited to individual institutions. Larger organizations, such as the American Medical Student Association (AMSA), have also invested resources into promoting medical humanities through formal programming. AMSA holds an annual Medical Humanities Scholars Program, a six-month, intensive conference-based course focusing on different issues within the medical humanities with the goal of helping participants understand "the practice of medicine as [an] integration between science and [the] humanities" (1). Dedicated groups have also come together to form the Medical Humanities Community, a network started at New York University for sharing resources and a "directory of people and programs throughout North America and elsewhere engaged in various aspects of medical humanities work" (2). Several peer-reviewed journals with a humanities focus have encouraged student work on issues ranging from narratives and patient experiences to policy and the history of medicine. In addition, several innovative graduate medical education programs have been exploring the use of the humanities in teaching trainees important concepts of self-awareness and holistic biopsychosocial approaches to disease and health.
Regardless of mechanism, the effort is crucial. In view of the fact that medical humanities can be such a broad field, it is helpful that there are numerous ways to use specific subareas to address local needs. As the specifics of doctoring change along with emerging care delivery systems, and as the challenges facing these efforts increase along with new policies and technologic advances, educators and trainees alike must increasingly utilize medical humanities in different, developmentally-appropriate ways to cultivate conscientious, compassionate care providers.
Here are some resources for students interested in learning
about, and getting involved in, medical humanities
- American Medical Student Association Medical Humanities Scholars Program
- The Medical Humanities Community
Joshua Liao, MS IV