Should medical students be required to study the arts? Yes
The way medicine is taught and the contents of curriculums are always under scrutiny. Giskin Day and Matthew Rinaldi say students are missing a valuable lesson by not studying the arts, but Jane Macnaughton (doi:10.1136/sbmj.f5056) says including the arts in medical education has failed to meet its objectives
“Young men ought to come well prepared for the study of Medicine, by having their minds enriched with all the aids they can receive from the languages, the liberal arts.” This, with the proviso that it applies to women too, is as relevant today as it was when it was written in the 18th century. Yet the skills associated with the arts are generally regarded as knowledge that can be “caught” rather than “taught,” to the detriment of the medical profession. The time has come to take the arts seriously in medical education.
Colour me creative
Creativity has been shown to be an important predictor of success in medical students. Yet most medical curriculums make little or no time or space in which students can be creative. As medical knowledge has increased, the curriculum has become focused on students needing to internalise vast amounts of data. Although book learning is obviously important, we live in a world full of opportunities for inspiring students of which we should take better advantage. There is little point in cramming huge quantities of information—often forgotten within days of the exam—that can easily be accessed by the swipe and tap of a screen when needed. Education shouldn’t mean passively sitting in a lecture theatre being exposed to PowerPoint slides. Instead, we should be encouraging a more dynamic form of learning that involves innovative approaches to problem solving—one that puts creativity at the heart of education for everyone. Studying the arts stimulates imaginative thinking, changing the emphasis from memory based to experiential learning.
As well as allowing students to study the arts from a scholarly point of view, they should be given the opportunity to practise them. We tend to treat artistic ability as an innate talent, but this is nonsense. Given a basic understanding of technique and a bit of practice, even the clumsiest of students can come to reap the rewards of a new found creativity. Sculpture and life drawing can increase the understanding of anatomical structures and textures. Spatial recognition and manual dexterity are vital techniques, especially in surgery. The arts teach skills well.
Studying the arts hones skills that are crucial to medicine. Consider the debt medical education owes to illustration. We tend to take observation for granted, but the act of looking is not nearly as objective as it seems—it is shaped by a visual framework influenced by our culture and previous assumptions. In Vesalius’s anatomical atlas, the vagina drawn from dissection looks identical to a penis at first glance. Vesalius’s idea of female anatomy was inextricably bound up with Galen’s insistence that “a woman is a man turned outside in.” An understanding of the role of visual culture in medicine helps us “untake for granted” the notion that images are a direct relay to truth, in everything from pharmaceutical advertisements to magnetic resonance image scans. This is of particular importance in modern anatomical teaching where we are moving away from cadaveric dissection and illustration towards interpretation of rendered 3D diagrams.
More than 80% of diagnoses depend on the patient’s story. Studying poetry and literature can enhance students’ narrative competence and improve their ability to relate to different cultures and groups in society. Listening carefully to a patient’s metaphorical framework for their understanding of their symptoms helps doctors tailor communication to fit with how patients make sense of their condition.
Sadly, many medical students tend to feel nervous when faced with the arts. “But there is no right answer” they protest, as if this was somehow an affront to the integrity of their intellectual pursuit. But this ambiguity is precisely why the arts are so valuable and an illogical fear they must overcome. Although medical education, understandably, focuses on “what we know,” medicine is practised in a messy environment of high uncertainty. No matter how many protocols are put in place, how many mnemonics students memorise, the ability to make decisions when there are multiple “unknowns” is vital to being a good doctor. In the absence of one right answer, it comes down to the most defensible interpretation—and the arts are great for honing this skill, which ultimately could save the health service money. Studies have found that doctors who are less tolerant of ambiguity tend to order more tests and additional treatments for patients, often entirely unnecessarily.
Tackle the “energy drink culture”
Medical students are more prone to burnout and mental health problems than other students. The phrase “energy drink culture” sums up the pressure on students to work 24 hours a day, seven days a week for five years. Austin O’Carroll has written about the benefits of arts education to help students become more reflective and overcome the cynicism that often accompanies undergraduate medical education. Any artist—beginner through to professional—will tell you of the cathartic effect of art in processing emotion. Surely this is something that should be promoted for people who are often exposed to extreme trauma before the morning coffee break?
Countless students come into medical school with a passion for the arts. But the perceived incompatibility of the arts with science, and the emphasis on science A levels for entry into medical school, discourages many medical students from developing their artistic skills. Instead, they begrudgingly fall into line on the conveyer belt to consultancy, often blinkered to life outside the hospital.
We need to change how we teach in response to the changing qualities valued in doctors. Should the arts be required in medical education? Absolutely and unequivocally, yes.Giskin Day, course director, medical humanities1, Matthew Rinaldi, sixth year medical student1
1Imperial College London
Correspondence to: firstname.lastname@example.org
Competing interests: None declared.
Provenance and peer review: Commissioned; not externally peer reviewed.
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- Dyrbye LN, Thomas MR, Massie FS, Power DV, Eacker A, Harper W, et al. Burnout and suicidal ideation among US medical students. Ann Intern Med 2008;149:334-41.
- O’Caroll A. A marriage of apparent opposites: the arts in medical education. artsandhealth.ie, 2013. http://www.artsandhealth.ie/perspectives/a-marriage-of-apparent-opposites-the-arts-in-medical-education/.
Cite this as: Student BMJ 2013;21:f5055