Can Medical Humanities Take Root in Asia?
Correspondence Address :
Dr. P.Ravi Shankar, KIST Medical College P.O.Box 14142 Imadol, Lalitpur, Nepal. Phone: 0977-01-6916201 Fax: 00977-01-5201496. E-mail: ravi.dr.shankar@gmail.com
Medical humanities are a diverse group of disciplines. Literature, arts, music, drama, films, bioethics, medical anthropology, philosophy of medicine, history of medicine and medical sociology has been included in the group of medical humanities.
Asia is a huge continent and has the largest number of medical schools in the world. Recently, many new medical schools have been opened, predominantly in the private sector. English is the language of instruction in many medical schools.
Medical Humanities, as a discipline, is most developed in the United States of America. Strong programs also exist in the United Kingdom, Switzerland, Norway and Sweden. In Asia, the University of Tel Aviv in Israel conducts a course in âThe philosophy of medicineâ.
In the west, there has been strong support for Medical Humanities at an administrative level. A variety of methods are used to teach the subject, and learning is fun and is interesting. A number of journals publish articles related to Medical Humanities. Online journals and blogs make publishing easy, and online databases serve as a repository of material.
In Asia, the traditional hierarchical structure of the student-teacher relationship may be a problem towards widespread adoption of interactive, small-group learning. This is however, changing. English being the language of instruction, and lack of division of the medical curriculum into core areas and electives, may also be a problem. Interdisciplinary learning is not well developed. Voluntary modules offered to interested students can create a case for introduction of the humanities in the curriculum. The humanities will be helpful towards creating more âhumaneâ doctors.
What are the Medical Humanities?
The humanities are a diverse group of disciplines, and includes the theory of literature and art, history (including the history of ideas and the arts), theology and philosophy at the core.(1) Cultural studies, religious studies, postcolonial studies, feminist studies, cultural anthropology and social psychology can also be included.(1)
An agreed definition of what constitutes Medical Humanities is lacking.(2) Important differences exist in what is understood by MH, between institutions and countries.(2) The centre for Medical Humanities in London, England, defines MH as an interdisciplinary and increasingly international endeavour, that draws on the creative and intellectual strengths of diverse disciplines, including literature, art, creative writing, drama, film, music, philosophy, ethical decision making, anthropology and history in pursuit of medical educational goals.(2)
Literature, arts, music, drama and films have been included in Medical Humanities (MH) programmes in various medical schools. Bioethics, medical anthropology, philosophy of medicine, history of medicine and medical sociology has also been included. The Medical Humanities (MH) can be seen as the Humanities applied in a medical context.
Justification for teaching the Medical Humanities to medical students:Humanities aim to protect, nurture, and respect the innate humanity, dynamic imagination, and precious individuality of medical students. (3) MH can help students to become ethical, empathic and educated physicians.(3)
MH can play an instrumental role in the education of future doctors.(4) Literature can introduce students to unfamiliar and problematic life situations.(5) Drama can teach oral communication, and philosophy can teach the skill of analyses and argument.(5) Literature can be a source of case histories for medical students. The study of the history of medicine can underline the transient nature of much of the medical knowledge and emphasize the importance of keeping up to date.(5)
In Asia, most medical students enter medical school after a school education which focuses more on science and technical aspects. School education in the subjects of Physics, Chemistry and Biology, are a requirement for admission in most countries.
The Asian continent:
At the risk of sounding pedantic, let me state that Asia is a huge region extending from Siberia in the north, to the islands of Indonesia in the south, and from Turkey and Israel in the west, to Japan in the east. The continent has the largest percentage of the worldâs population and the largest number of medical schools.
In South Asia, in recent years, a number of new medical schools have been opened.(6), (7) Many of the schools/colleges are in the private sector. Medical schools in China have started undergraduate medical courses in the English language, aimed predominantly at South Asian students.(8)
Medical Humanities around the world:United States of America was the pioneer in starting MH programmes in the modern sense. The Northeastern Ohio Universities College of Medicine had started the âHuman values in medicineâ program more than 30 years ago.(9) At present, at Ohio, students are required to contribute 120 hours to Medical Humanities. The University of California, Irvine, College of Medicine, started a program in Medical Humanities and Arts in 1997.(10) The program aimed to enhance aspects of professionalism like empathy, altruism, compassion, caring towards patients, and to hone co
Medical Humanities is an interdisciplinary area. Medicine and the Arts, Philosophy of Medicine, Medical Anthropology, Medical Sociology and Bioethics, are among the various disciplines constituting the Medical Humanities. Asia is a huge continent and has diversity of cultures, but with certain shared values. A number of medical schools have been opened in Asia. Medical Humanities first took root in the United States. Strong programs also exist in the UK, Europe, Israel and Argentina. Administrative support, financial and technical backing, and sharing of resources are among the many factors which led to the success of programs in the west. Many hurdles exist towards starting MH programs in Asia, but these can be overcome. A voluntary module might be a good approach to initiate MH learning.
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