Humanism in Medical School

One of the reasons that I chose my med school over some other very attractive options was the genuine concern they expressed for students, even during the application process. There has been a strong emphasis on life balance in every stage of recruitment during this last year, and our first official week has proven to be in line with this priority. I know there are physicians out there who see the toughness of their own experiences as med students as having been formative in their becoming professionals, and I think there's probably some truth to that. However, I also know many physicians are unhappy with their work, feel underappreciated and even sometimes undercompensated for what they have endured. The approach at my school seems to be less one of "enduring" training to claim one's reward at the top and more one of enjoying the journey. We are actively encouraged to explore non-medical interests, maintain commitments to family and be social as a class. This is all with the understanding that we must meet our academic and clinical responsibilities unequivocally, but with a pass/fail basic sciences curriculum we only have to hit 70% to be undifferentiated "successful" students in the first two years. Even without internal competition and rankings our three-year old campus has had 100% pass rates on USMLE Step 1 (the first and most critical licensing exam for MDs applying for residency) for the life of the school and above average scores for the last two years. Our match list (the list of residency assignments for new graduates) for the first graduating class (2011) included placements at Massachusetts General (Harvard), Cleveland Clinic, Mayo Clinic and many other highly competitive sites. It seems clear to me that any benefit that comes from a more humanistic medical school curriculum does not come at the expense of lower performance on the more academics-driven residency matching process.

So what is the point of expanding a medical student's focus from raw quantitative science into the ethereal realms of self-care, emotional intelligence and qualitative understanding of illness and experience? Well, first and foremost I would never dream of entering a service profession (which medicine certainly is) that didn't at least make an obligatory nod to the existence and importance of these factors to health, not to mention the greater human experience of which health is but one piece. A patient is not a problem to be solved, if only because their own awareness of that problem innately entangles their own emotions, spiritual resources and sociocultural influences, all factors that are virtually impossible to differentiate on a digital printout. Even a non-communicative (e.g. comatose) patient has an internal world that is both influential upon and influenced by these factors, whether or not there is any feasible way to assess them. I can't think of a scenario in which this information would be completely accessible, even to a very skilled interviewing physician with an extensive support team, nor is that a realistic objective. Rather, I see it as more of a critical part of the history and physical (H&P) process to help determine the best course of treatment for each patient.

To those of you with a social sciences background this may seem like common knowledge, but the "typical" medical student (a term that is getting more difficult to define with each application cycle) med school is an extension of years of rigorous scientific study, often accompanied by even more extensive lab work. There is a standard requirement of volunteer work in a medical setting, but that 1-2 hour commitment per week pales in comparison to the 20-40 hours of study and research they are logging in order to pump up their application enough to be competitive. Luckily my class, although very impressive academically also has a diverse array of backgrounds and academic interests, having both chosen to apply to this humanistic program and having been chosen by it in return. I admit a strong bias in favor of my own school as well as some ignorance about other programs that I will not likely ever be deeply involved with as a student. However, I can say after in-depth research of many, many allopathic (MD) schools across the US during my own application cycle, as well as interviews at nine of those programs, our situation here is unique and the care for the student is equal to or greater than any other school at which I personally interviewed. I feel cared for, but I also feel personally responsible for thoroughly understanding and applying vast amounts of information and techniques that may someday save a patient's life. This is perhaps the greatest argument for a humanistic approach to medical education. I am not just mastering this material because I should try to be the best in the field for my own benefit. I am doing so because I should care deeply and want to do the best I can for my patients, a principle that so far has been central in the curriculum and modeled daily by our staff and instructors.