Researching medicine in context: the Arts and Humanities Medical Scholars Program.(Education And Debate)

In 2000, the Arts and Humanities Medical Scholars Program at Stanford University School of Medicine issued its first grants to medical students interested in researching an area of the medical arts or humanities in depth. To date, 34 projects have been funded, including renewals. The projects encompass a range of genres and topics, from a website on Asian American health and culture to an ethnographic study of women physicians in training in Spain. Two projects are highlighted here: an online history of medicine course and a poetry project. Students are mentored by faculty from a wide array of university departments and centres and submit completion documents to the committee overseeing the programme. Students are encouraged to present their work at conferences, such as the programme's annual symposium, as well as in publication or other appropriate formats. Future directions include integration with the scholarly concentrations initiative at the medical school.

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Involvement in the scientific process is an intensive experience, and a highly creative one, albeit stylised to test hypotheses using reproducible methods. Research experience during medical education provides training for physician-scientists, (1) stimulates self learning, (2) improves faculty research production, (3) enhances skills such as reading research literature, (4-6) and promotes interest in fields providing research opportunities. (7) Indeed, in an attempt to counteract the decreasing numbers of physician investigators in the United States, research programmes have been widely promoted. (8-10)

In 1980, Stanford University School of Medicine, long known as a research centred institution, initiated a Medical Scholars Program to encourage and enable Stanford medical student participation in the creation of new scientific knowledge. (11) This programme, which provides grant and academic credit for students to perform hypothesis driven projects in bench and clinical research, is taken advantage of by the majority of Stanford students.

In 2000, a new branch of the Medical Scholars Program, the Arts and Humanities Medical Scholars (AHMS) Program, was launched. Modelled on the intensive hands on research experience of the existing Medical Scholars Program, the establishment of the AHMS was driven by the desire to widen opportunities for medical students to engage in medicine in context, that is, medicine in broader frameworks such as the historical, the philosophical, and the cultural. This paper describes the first three years of that programme as well as briefly describing two student projects.

THE AHMS PROGRAM

Inception and organisation

In 1999, after networking with members of the School of Humanities and Sciences, three faculty physicians with interests in medical humanities submitted a proposal to the medical school to include arts and humanities in a planned expansion of the existing Medical Scholars Program. The successful proposal included: theoretical background to the AHMS programme; the rationale for its development, such as the need for students not only to recognise the human basis of medicine, but also critically to evaluate the culture of medicine using tools gleaned from various disciplines such as history, art, and literature; and the argument that the programme would provide an environment enabling better understanding of the "contextual implications of illness and therapeutic interventions for the individual patient" and society at large. Much of the proposal's theoretical background and programmatic structure were incorporated into the website's overview page. (12)

In January 2000 the first of a series of ongoing planning committee meetings took place. The committee comprises one medical student and eleven faculty members. Six faculty members are from various departments and centres of the medical school (anaesthesia, biomedical ethics, medicine, ophthalmology, psychiatry) and five are university affiliated (Asian languages and comparative literature, Cantor Center for the Visual Arts, history, human biology, music).

Proposal submission process, evaluation, and funding

Proposals are evaluated on five criteria: clarity …