Channeling Creativity: Medical Humanities in Medical School and Residency at UMass Chan

Anindita Deb, MD Hugh Silk, MD, MPH

Wherever the art of medicine is loved, there is also a love of humanity. — Hippocrates

Medical humanities are a powerful yet subtle tool for teaching many important aspects of medicine. The Association of American Medical Colleges (AAMC) reports that medical humanities foster teamwork, collaboration, personal insight, flexibility, understanding of other cultures, social advocacy, and support learner wellness and resilience (1). In addition, trainees and physicians can learn to be better observers and interpreters, deal with ambiguity, and build empathy and communication skills. Medicine is ultimately about people – caring for them, interacting with them, finding creative ways to motivate them, and understanding what they are enduring. Furthermore, healthcare is about caring for ourselves and other colleagues. We are humans dealing with humanity every day.

Eighty percent of medical schools in the United States have at least one offering in the medical humanities not including ethics. The top-ranked schools in the country offer multiple (2). There are various types of media being used, including art observation, creating art, music making and listening, writing prose and poetry, close reading of essays and other writings, history, photography, theater, use of podcasts and TED Talks, and many more.

At UMass Chan Medical School there have been significant efforts made to increase medical humanities offerings throughout undergraduate and graduate medical education programs. In the Family Medicine Residency, prior initiatives have included a medical humanities session during intern orientation, a bi-annual humanities retreat, and sessions offered at the Worcester Art Museum to learn to use art to improve teamwork, deal with uncertainty, and understand wellness.

Here we describe two recent initiatives. Hugh Silk, MD, MPH has worked with Shannon West (UMass Chan Medical School ’23) and Sara Shields, MD to infuse medical humanities into standard Tuesday afternoon residency core teaching sessions. This latest initiative acknowledges that medical humanities is not a novelty; but rather medical humanities have real value. To that end, the goal is to use medical humanities to deepen the learning of mandatory teaching topics such as hypertension management, domestic violence screening, and procedures like skin surgery. Faculty are offered “pairings” to go along with the topic of the session. For example, they may use a poem to understand family dynamics when caring for someone with congestive heart failure; a local blog entry to humanize and address cultural elements in a session on nephrolithiasis; or an art series portraying historical depictions of gout and other rheumatological disease (3,4,5). These pairings humanize the lesson of the day. It is one thing to learn the pathophysiology of the disease, it is yet another lesson to learn how the patient adjusts to the illness through suffering, coping, and enduring.

Faculty are offered the poem or art piece to use as they see fit. This student-led capstone project has developed into a broader initiative to create faculty development for these pairings and start an online database. Hugh Silk has teamed up with Philip Day, MD and Maine artist Augusta Sparks Farnum thanks to a grant from the Society of Teachers in Family Medicine to create this web-based repository. As a result, family medicine residencies around the country will be able to access this repository to enrich their teaching with media that offers different perspectives on core family medicine residency teaching topics.

In the undergraduate medical school curriculum at UMass Chan Medical School, medical humanities have been offered through various methods. There have been several student-led electives on music, art, and writing. Many courses require reflective writing and there has been a “meet the author” series. The new Vista curriculum for the Class of 2026 offers more opportunity for utilizing medical humanities. The Pathways program is a new addition as part of this curriculum and offers students seven different pathways to choose from, including but not limited to Entrepreneurship and Biomedical Innovation; Population; Community and Global Health; Structural

Inequity; Advocacy and Justice; and Clinical, Translational and Community Research. Anindita Deb, MD, in her role as the Pathways Director, has encouraged Pathways leaders to infuse medical humanities into pre-reading for sessions and within lectures. Additionally, a dedicated core session for the entire class will focus on medical humanities and include art, writing, and other modalities which will be discussed in the context of their specific pathways. Students are also encouraged to incorporate medical humanities into a four-year Pathways Longitudinal Project. Building on previous capstone projects, students may choose to use photography to document injustice in Worcester or create a podcast to memorialize the voices of people living in another country and the health issues they face.

Modern learners want to be challenged and engaged. Gone are the days of boring lectures. Students and residents learn better when a film or video is utilized to share the voice of a patient, or a painting is presented to guide the learners to solve together the story within. UMass Chan is finding ways to tap into the creativity of their faculty and students and take medical education to the next level with the use of medical humanities. +

Anindita Deb, MD is Associate Professor of Neurology, Co-Chief of Movement Disorders Division and Director of the UMass Chan Pathways Program.

Hugh Silk, MD, MPH is Professor and Vice Chair of Community Health in the Department of Family Medicine and Community Health and co-leader of the UMass Chan Medical Humanities Lab.

References

1. Howley L, Gaufberg E, King B. The Fundamental Role of the Arts and Humanities in Medical Education. Washington, DC: AAMC; 2020.

2. Howick, J, Zhao, L, McKaig, B, et al. Do medical schools teach medical humanities? Review of curricula in the United States, Canada and the United Kingdom. J Eval Clin Pract. 2022;28:86– 92.

3. Lee L. The sound of rain outlives us. Viewed on March 8, 2023 at: https://nataliejabbar.wordpress.com/tag/li-young-lee/

4. Xie A. As long as we communicate. The Interstitium. Sept 2019. Viewed on March 8 2023 at: https://theinterstitium. home.blog/2019/09/30/as-long-as-we-communicate/

5. Chatzidionysiou K. Rheumatic disease and artistic creativity. Mediterr J Rheumatol. 2019 Jun 29;30(2):103-109. doi: 10.31138/mjr.30.2.103.