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CommentaryBlog CommentaryMedical Education Today: Is Science Enough?

Medical Education Today: Is Science Enough?

Blog Commentary

Pamela Powers Hannley, MPH, AJM Managing Editor
Pamela Powers Hannley, MPH, AJM Managing Editor

Educational trends swing back and forth like a pendulum. What is in vogue today, may not be in 10 or 20 years.

Twenty years ago, would-be medical students focused on the sciences in their baccalaureate education. Today, we see medical schools valuing students with a broader education and offering alternative educational opportunities to medical students. From the Wall Street Journal…

Medical schools are placing a growing emphasis on the humanities, including courses in writing, art and literature. The programs aim to teach students “right-brain” insights and skills they won’t learn dissecting cadavers or studying pathology slides.

Why branch out into writing, humanities, art, or music? The goal of offering young doctors expanded educational experiences is to improve their communication skills, help them be more empathic, and make them well-rounded individuals.Again, from the Wall Street Journal…

Schools hope the programs help to turn out a new generation of physicians better able to listen attentively to patients, show emotion and provide sensitive personal care…

“Emotional reasoning and clinical empathy isn’t about be-nice-to-the-patient. It’s about understanding the significance of illness and how it takes place in the context of their life, and any physician or caregiver who doesn’t have a sense of that cannot be effective,” says Felice Aull, founding editor of the literature, arts and medicine database at New York University…

“We ask about chest pain and shortness of breath, but the discussion rarely gets to what is going on in their lives and their experience of being a patient,” says Paul Gross, a family medicine physician at Montefiore Medical Center and Albert Einstein College of Medicine in the Bronx, N.Y. Dr. Gross holds a monthly session in narrative medicine, which encourages writing stories about patients to understand all the factors that affect them. He also edits a medical literary journal called “Pulse: Voices from the Heart of Medicine.”

Re-visioning Flexner: Educating Physicians to Be Clinical Scientists and Humanists by Doukas et al focused on the role of liberal arts in medical education in The American Journal of Medicine’s December 2010 issue. Referring to the 1910 Flexner Report on medical education, Doukas et al write:

Scientific study and thinking were not sufficient to make a capable physician; however, as Flexner well understood, the physician must have “insight and sympathy on a varied and enlarging cultural experience…scientific progress has greatly modified his ethical responsibility.” (1) The physician should be “culturally experienced,” and possess humanistic skills to serve the social good. (1)

A “broader more liberal arts education” provided the basis for these skills. (2) In the report, the college-based development of reflective, abstract thinking was cited as necessary before the secondary stage of medical education. (1) In his other writings, Flexner insisted that liberal arts education should be tailored toward each student’s future profession of choice and include both science and humanities to prepare a physician to fully develop the necessary skills. (2, 4, 5, 6)

Under the direction of Editor-in-chief Joseph S. Alpert, MD, and Specialty Editor Helle Mathiasen, Cand mag, PhD, AJM has promoted the role of humanities in medicine. The Journal’s Medical Humanities Perspectives section appears several times a year in both the print and online versions. If you are a physician who enjoys writing prose, you may consider submitting a Medical Humanities Perspectives article to be considered for publication.

— Pamela J. Powers, MPH, AJM Managing Editor

1- Flexner A. Medical education in the United States and Canada: a report to the Carnegie Foundation for the advancement of teaching (Bulletin No. 4). Boston, Mass: Updyke; 1910.

2- Zelenka MH. Educational philosophy of Abraham Flexner: creating cogency in medical education. Lewiston, NY: Edwin Mellen Press; 2008.

3- Cooke M, Irby DM, Sullivan W, Ludmerer KM. American medical education 100 years after the Flexner report. N Engl J Med. 2006;355:1339–1344.

4- Flexner A. Purpose in the American college. School and Society. 1925;22:729–736.

5- Flexner A. The problem of college pedagogy. Atl Mon. 1909;103:838–844.

6- Flexner A. The American college: a criticism. New York, NY: The Century Co; 1908.

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