A three-year-old was newly diagnosed with a brain tumor called a medulloblastoma. The pediatric oncologist, aware of the steep odds against the child’s survival, explained the diagnosis and counseled the family. The doctor performed a bone marrow biopsy while singing the alphabet to soothe the child. Eventually, she comforted the family when their child died, tears in her eyes. As a medical student who was new to witnessing death, I could feel the grief of both the family and the physician. Later, as a doctor in training, I actively cared for a child with congenital heart disease as he died of multi-system organ failure. Eventually, when I became the doctor in charge, I determined the treatment course and was responsible for guiding the conversation when a patient’s death was imminent.
Recently, I told these stories in an introductory undergraduate religion class that asked the students to consider how best to support a patient who is dying. Do you cry with the patient? Is it acceptable to be detached? Is it OK to resume your life and laugh a few hours later? Further: How, where, and from whom do you learn these skills? Most of the students were science majors and hoping to become doctors. They understood the general idea that how you experience death and dying changes over time, and is not the same process for everyone. But they also wanted to know what makes a good doctor.
As a philosophy major in college before medical school, I believe I learned what it means to be a good doctor equally from my humanities classes as from my science classes. Studying the humanities helps students develop critical-thinking skills, understand the viewpoints of others and different cultures, foster a just conscience, build a capacity for empathy, and become wise about emotions such as grief and loss. These are all characteristics that define a good doctor.
The National Academies of Sciences, Engineering, and Medicine recently released a report arguing for the integration of STEM with the arts and the humanities. Given the projected increase in STEM jobs, the need for a workforce to fill them, and the prospect of a well-paying job, it’s not surprising that students are encouraged to pursue STEM fields.
At the same time, the important role of humanities in medicine is emphasized in scores of programs in the United States and around the world, including Stanford University, Northwestern University’s Feinberg School of Medicine, the University of California–San Francisco, and King’s College London. Meanwhile, some medical schools are reworking their curricula, and peer-reviewed journals such as Medical Humanities and the Journal of Medical Humanities publish work that emphasizes the importance of the humanities for doctors.
This emphasis on the humanities in medical school trains future doctors to become proficient in the social and cultural context of health care, beyond what they learn from the hard sciences. Both skills are necessary to promote and improve the health of a society that depends on scientific innovation but also needs desperately to tackle the social determinants of health.
The research suggests that this focus needs to start earlier, in future physicians’ undergraduate years.
Only 3.5 percent of medical school applicants major in humanities, but their acceptance rate is higher (50 percent) than the overall rate (41 percent).
A 2009 study found that, once they reach medical school, students who majored in humanities as college students perform just as well as, if not better than, their peers with science backgrounds. Furthermore, a 2010 study assessed the medical school performance of humanities and social science majors who omitted traditional science classes in college, versus those who had a traditional pre-medical preparation. Both groups of students performed at an equivalent level in medical school based on clerkship grades. Another study suggested that formal art observation training can improve a medical student’s capacity to make accurate observations of physical findings in a patient.
A more recent study from earlier this year shows that medical students who are exposed to the humanities demonstrate higher levels of positive skills and qualities such as empathy, tolerance for ambiguity, wisdom, emotional appraisal, self-efficacy, and spatial reasoning—all important in being a competent, good doctor.
The same study found that humanities exposure is inversely correlated with negative qualities that can be detrimental to physician well-being, such as intolerance to ambiguity, physical fatigue, emotional exhaustion, and cognitive weariness.
Humanities majors may be more likely to pursue residencies in primary care and psychiatry—both areas where there is tremendous need.
Humanities exposure can arguably benefit patients by making better doctors and it may also be beneficial for the individual physician.
In this era of increasing dissatisfaction within the medical profession, a doctor also needs the tools to develop and nurture her own humanity so that she can continue her work, healthy in mind and body. Patients deserve a doctor who is thoughtful, professional, compassionate, understanding, humble, collaborative, wise, and knowledgeable. And while there are many factors in the development of a physician, humanities education is one important avenue toward making better doctors.
As you read this, students have secured positions in the freshman class of 2019 and are deciding what to study in college. Presumably, some aspiring doctors will look into the STEM fields. I suggest that all students should look to the humanities.
