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Humanism and Premedical Education

Scholarship, Humanism, and the Young Physician

Ronald H. Fishbein, M.D.

Abstract — It is time to understand the value of broad liberal education for those college students who aim to be physicians, both because the medical curriculum is becoming more humanistic (such a liberal education would support) and because three enormous challenges confront physicians and educators alike: the relentless tide of biomedical discoveries, the great financial burden that medical care imposes, and the public’s desperate plea for physicians who are more caring and communicative. A liberal education — meaning a course of study that is largely unrestricted and that attempts to sample the entire breadth of human knowledge — can help the premedical student cultivate, ripen, and enrich fundamental proficiencies such as accurate recording of observations, communicating ideas well, dealing with human emotions and becoming sensitive to human frailties, learning to listen and respond appropriately, learning to make sound judgments, and cultivating empathy and compassion. These are all skills that a liberal education can help the young student learn early rather than late, skills that prepare the student for dealing later with complex social, ethical and clinical issues as a physician.

A liberal education also can help prepare the student to take advantage of other general educational opportunities that are available in the small, closed community of residency, such a learning to both assume and delegate responsibility, to participate in rational debate while respecting the opinions of others, and to exercise mature judgment, civility, empathy and compassion.

While a liberal education will not necessarily make the student a more technically proficient doctor, for some it will be essential to awaken and sharpen those essential skills that a physician needs to rise to the top of a profession that never fails to recognize excellence and humanity. (Acad. Med. 1999;74:646-651)

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Abstract — For decades it has been known that students who major in non-science  fields perform as well as science majors who go to medical school.  Yet the  overwhelming majority of future medical students still major in biology or chemistry, and organic chemistry has come to be the defining premedical science course. This article traces the history of the liberal arts tradition, discusses its importance for medicine, and urges that readers think about the medical college in the age of the university. The author believes that the medical faculties should take a lead in helping to reshape the premedical as well as the medical education of future doctors.    (Acad. Med. 1999;74:1217-1221)

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Introduction — The question of whether medicine is an art or a science is an important one to ask if students are to be educated in undergraduate school as well as medical school.  If medicine is an art, then the training that students receive may still be appropriate.  However, if medicine is a science, then students must be educated and not merely trained.  Training and education are not the same thing.  Training mainly involves the transfer of knowledge (i.e., information) to students; whereas, education involves, in addition to the transfer of knowledge, learning concepts and acquiring problem solving skills.  Medical school training has not changed much over the past century; while there has been new information and even new disciplines added to the curriculum, there has not been a new pedagogy.  Students have a multitude of facts to memorize. They have done this admirably, over the years, but they have less success with problem solving, a skill they must have in their medical practice.  A physician brings together a variety of information and observations about a patient’s symptoms and draws a conclusion about the patient’s problem. To gain admission to medical school, a student has to excel academically as measured by the undergraduate grade point average and test scores, and have strong recommendations, service or health experience, etc.  Therefore, one would assume that these students can think and readily solve problems.    Unfortunately, a significant number of medical students cannot solve problems.  To address this, many medical schools now use a problem-based learning approach, or something similar.   Yet,  medical   students  seem most   capable of regurgitation and taking tests (e.g., MCATs) where they must be able to determine which one of the four or five answers  correctly correlates with the information given in the questions.  In our society, we have come to believe that the ability to regurgitate facts is an excellent sign of one’s capabilities.  But is this really true?  Statements by employers, both in the press and on the Internet, indicating dissatisfaction with the quality of students graduating from our high schools and colleges, suggest it is not.  Most of these comments relate to the inability of individuals to problem solve (i.e., think).  Does this mean that merely learning facts and regurgitating them is insufficient?  In the past 10 years alone, we have had a burgeoning of biomedical information.  Thus, it seems more necessary to cram even more information into the heads of medical students.  Is this the way to handle this increase in information?

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