This (Feb 2024) edition of the Newsletter is highlighted by two essays that incorporate glimpses of how medical humanities affect our views of patients. Mattia Rosso, a neurology resident reviews the relationship between Rodin and Charcot suggesting how Rodin’s figures in his sculpture, Gates of Hell, may have been informed by drawings from some of Charcot’s patients in the “throes of hysteria.” Likewise, Ninad Bhat, a first year pediatric neurology resident, reflects on the power of myth and how that may allow for the reframing of a patient’s condition into the cyclic nature of an heroic journey.
Where do students and residents get opportunities to explore the medical humanities? A 2022 paper by Howick, et.al. reviewed curricula in 18 medical schools in Canada, 41 in the UK, and 154 in the US. Among these 56% of Canadian, 73% in the UK, and 80% in the US provided at least one medical humanities course other than medical ethics.1 Of the courses in the US one third were compulsory. Of the non-compulsory classes the rate of solicitation was not determined. Of the courses in the US 23% related to “history”. A 2021 paper by Moniz, et.al. conducted a scoping review of arts and humanities literature in medical education from 1991-2019.2 They identified 769 articles related to the use of the arts and humanities in medical education. The authors conclude that their review “demonstrate at a high level the extent, range, and nature of the published scholarship on the uses of the arts and humanities across the medical education continuum.” A third paper from 2023 evaluated the medical humanities curriculum in 31 of the top-ranked medical schools in the US.3 The authors observed that “65% of schools offered 10 or more paracurricular medical humanities events annually, while 68% of the institutions had more that 5 medical humanities student organizations. While elective, non-credit courses are available, only 3 schools required instruction in the arts and humanities, and comprehensive immersive experiences in the medical humanities were present in only 29% of the schools.”
Thus, it seems, according to these papers, that the medical humanities are being put forward and made available in the medical education of this new generation of physicians. Perhaps not as required course work in most cases, but made available to those students who want to indulge/pursue them. The fact that many students are taking advantage of these opportunities is made evident by the increasing number of submissions of abstracts from medical students for the AOS Annual Meeting. Of the 92 abstracts submitted this year, some 52 were from medical students or residents. It appears that at least to some extent, opportunities to think about the medical humanities are available and students are taking advantage of those opportunities.
The humanities in medical education enriches the learning experience by providing a broader understanding of the human aspects of healthcare. As Nikki Piemonte suggests, “future physicians might be brought back to themselves through a pedagogy that values the cultivation of the self, openness and humility, and a fuller conception of what it means to be a healer. ….cultivation of new ways of understanding and interpreting the world and the lived experiences of others can be taught—not didactically but “maieutically” - that is, by indirection, the way we learn from reading literature and poetry.”
1. Howick J, Ahao L, McKaig B, et.al. Do medical schools teach medical humanities” Review of curricula in the United States, Canada and the United Kingdom. J Eval Clin Pract 2022;28:86-92.
2. Moniz T, Golafshani M, Gaspar CM, et.al. How ar the arts and humanities used in medical education? Results of a scoping review. Acad Med 2021;96:1213-1222.
3. Anil J, Cunningham P, Dine CJ, et.al. The medical humanities at United States medical schools: a mixed method analysis of publicly accessable information on 31 schools. BMC Med Ed 2023;23:620-31.
4. Piemonte NM. Afflicted: How Vulnerability Can Heal Medical Education and Practice. The MIT Press, Cambridge, MA. 2018. p.xxiv.
By Michael Malloy
Michael Malloy is a native Texan and graduate of Texas A&M University and the University of Texas Medical Branch (UTMB). He interned in Virginia, returned to UTMB for Pediatric Residency, moved to UT Houston for Clinical Neonatology Fellowship and then on to Columbia in New York for Research Fellowship. Returning to UTMB as a Neonatology Faculty, he began work on a Masters in Epidemiology at the UT School of Public Health in Houston funded by a Public Health Service Grant. He then moved to the National Center for Health Statistics in Hyattsville, MD and then on to the Epidemiology Branch of the National Institute for Child Health and Human Development. After 6 years he returned to UTMB as a clinical neonatologist and epidemiologist. He became involved in medical education and headed the Pediatric Clerkship for 10 years and then became more interested in the medical humanities through the John P. McGovern Academy of Oslerian Medicine. He obtained a Certificate in the History of Medicine from Johns Hopkins and now focuses his research and interest on the medical humanities. On the side he is the Editor of the American Osler Society Oslerian Newsletter.