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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
Joshua Liao, MS IV
Baylor College of Medicine
Class of 2012
February 2012 Issue of IMpact