Why a Medical Humanities curriculum in graduate medical education?

A few personal thoughts …

After residency at the Yale New Haven Hospital, I was in the private practice of obstetrics and gynecology (OB/GYN) in Northampton, Massachusetts for 13 years. I really enjoyed working with our patients, staff, and my three partners. We paid our staff at the top of the city’s scale, accepted Medicaid, and we (physicians) were never aware of our patients’ insurance. We personally answered all messages before we went home at night. If we referred a patient to the emergency room, we always went there to see her personally. It was a great practice! We were adequately compensated, though in the lower half for our specialty in the state, but we got great satisfaction out of our work and the appreciation our patients showered upon us. The practice was very popular, caring for about 80% of the women in the city. I am still close friends with my partners.

I loved my practice, but I also appreciated that life was finite and wanted to have professional experiences in more than one setting.

In 1987, I was recruited to the OB/GYN department at Reading Hospital, as its first full-time physician, Chair and Program Director of the 50- year- old residency program. I welcomed 9

the opportunity for teaching and administrative work, while establishing a small clinical practice. As Department Chair and Residency Program Director, I developed an interest in medical ethics, chairing Reading Hospital’s Ethics Committee for approximately 20 years. I also chaired the American College of OB/GYN ‘s Committee on Ethics, and now chair the American Medical Association ‘s Council on Ethical and Judicial Affairs.

I have loved my career!

So, how do I understand my colleagues who talk about being burned out? How do I understand my colleagues who talk about the need for work-life balance when, to me, they’ve always been inseparable?

I conclude that “burn out” is the result of the loss of joy in the practice of medicine, the joy of helping people with illness or in pain, the joy of working with our colleagues in medical teams. I believe the need for “work-life” balance becomes a need when work is not joyful, but other aspects of “life” are.

I recognized that many medical schools had begun to teach Medical Humanities. I also recognized that although medical students may experience significant interpersonal challenges, they generally don’t appreciate the tensions that have swept much of the joy out of practicing medicine. Those challenges begin in residency and continue on in practice. So, if we can understand the problem as diminished joy from the human relationships of medical practice, perhaps the solution, or at least an inroad into the solution, is to enhance those relationships.

With instant access to databases, the internet and the advent of augmented intelligence, there is less of a need to spend time memorizing inordinate amounts of material. Perhaps we can rescue some of that time from the graduate medical education curriculum to enhance humanism in medicine. With that in mind and after some research, I created a list of topics that might be valuable in a Medical Humanities curriculum. It was easy to create excitement for the concept. Our Medical Humanities Curriculum Committee fine-tuned the list of topics to include medical ethics, professionalism, communication skills, personal development, narrative medicine, diversity, equity and inclusion, spirituality and medicine, and the history of medicine.

The creation of a medical arts journal to showcase the artistic talent of the people with whom we work was discussed with Dr. Olapeju Simoyan, who had been the Editor in Chief of a similar journal at another institution. The goal of Silver Linings is to bring the joy of the arts back into the lives of so many of us whose commitment to science has essentially divorced the arts from our lives. The Medical Humanities curriculum brings learners from different disciplines together to enhance collegiality and will utilize a variety of educational modalities. We are dedicated to making the curriculum one of active participation and experiential learning.

We are well on our way! We have had five presentations and experiences as of this writing, and the publication of this journal marks another milestone! Many more medical humanities experiences are planned for the second year as the leadership has been transferred to Caitlyn Moss, M.D, the director of curricular development for Reading Hospital’s internal medicine residency program. The members of our committee have been enriched in preparing the curriculum and we anticipate our learners will experience career- enhancing enrichment. The success of this initiative will be a major achievement of my career.

Peter A. Schwartz M.D. Chair Emeritus, Dept of OB/GYN, Reading Hospital – Tower Health Chair, American Medical Association (AMA) Council on ethical and judicial affairs