Thursday, June 10, 2010

Are the humanities valuable in medical school?

Personal experience tells me that the answer to this question is "yes, of course!" As the editor of a popular science magazine and an occasional poet in college, I looked forward to the "touchy feely" humanities courses and activities during the first two years of medical school that many of my classmates ridiculed as, well, too touchy feely. Sandwiched in between dry, rote basic science classes such as Pathology and Anatomy, humanities subjects were my window to a richer world. Among other things, I wrote a heartfelt essay that described my first patient interview as an "empathic intrusion," discussed cross-cultural issues raised by Anne Fadiman's The Spirit Catches You and You Fall Down, took a four-week medical ethics elective, and co-founded a short-lived student literary magazine.

So it was with more than a little trepidation (and perhaps even some disdain) that I read a systematic review of the literature on the effect of the humanities in medical education in this month's issue of Academic Medicine that concludes: "Evidence on the positive long-term impacts of integrating humanities into undergraduate medical education is sparse." After carefully searching the literature for articles published between 2000 and 2008, the researchers found that only 9 articles out of 245 included in the study actually attempted to measure the positive impact of humanities curricula on professional behavior, clinical practice, or specialty choice. And even these few studies didn't find much to brag about. It seems that the evidence-based answer to the question posed in the title of this post is: Insufficient Evidence.

This study is a good example of taking a quantitative approach to medicine too far. If medicine is an art as well as a science, this approach is analogous to creating an algorithm for beauty. We know beautiful art when we see it. Similiarly, there are at least some qualities in a "humane" or "caring" doctor that can't be quantified, but patients know when they see (or experience) them. Clearly, we also want our physicians to learn and be evaluated on the science of health and disease, but to require that long-term benefits of humanities education be proven beyond a shadow of a doubt is to miss the point: this assessment can never be entirely objective, but will depend on the eye of the beholder. Subjectively, you validate the positive - but unmeasurable -value of my medical school humanities experience just by reading this blog.

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