Before they treat humans, doctors should study the humanities

As we begin the new school year, we faculty are meeting freshmen and hearing of their plans for their lives. For those of us in biology and chemistry, a large proportion of these students express a wish to enter medical school.

Their sincerity is impressive. But very soon, these pre-meds become convinced that they must only take science courses. It is extremely difficult to convince them that a strong grounding in the humanities will make them better physicians, to say nothing of better human beings.

The value of humanities courses is that they teach students about the human condition, which is the core problem that physicians need to deal with. While some training in the sciences is needed, I think it is more important that students entering medical school first have a broad view of what it means to be a human being, especially why and how we suffer, why good people sometimes do bad things, and why bad people sometimes do good things.

Such a broad understanding of people is probably the single most important attribute of a successful primary care physician. I suspect the reason for the dearth of primary care physicians is that pre-med students begin on a path of extreme specialization in chemistry or cell biology almost from the moment they set foot in college. This extreme specialization as an undergraduate may carry over to choosing specialization in medical school rather than the broad training required for family medicine and primary care. Medical schools now need to offer courses in ethics, communication skills and human relationships to offset this undergraduate specialization in the sciences -- but, for many students, by then it may be too late.

Why is it so difficult to persuade pre-meds to take a broad suite of courses with greater emphasis on the humanities? Much of the blame must still lie with the medical schools themselves.

Although they claim they want applicants to have broad backgrounds, medical schools still look at grades in weed-out courses of questionable value to the practice of medicine, such as calculus or even organic chemistry. And pre-meds know that whether they get into any medical school depends on doing well on the MCATs, which are almost entirely a test of scientific knowledge. So it is no wonder that the pre-med thinks a broad view of what it means to be a human being is a complete waste of time.

In 1979, Dr. Lewis Thomas, then director of Sloan-Kettering Cancer Research Institute in New York, published an essay entitled "How to Fix the Premedical School Curriculum" in his book "The Medusa and the Snail." His primary recommendations were that any student who declares himself or herself "pre-med" not be admitted, and that any colleges which maintain pre-med curricula and pre-med advisers not be recognized by the medical schools.

Thomas recommends that the best undergraduate preparation for physicians is a sound knowledge of classical Greek and the classics. After all, the Odyssey is the story of a veteran returning from a brutal war and not recognizing the home he left. This sounds like many of the young men and women returning today from Iraq and Afghanistan. The health care of these young people is one of the most difficult problems facing today's physicians. Medical schools would do well to consider Thomas' advice.

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John Pastor, a biology professor at the University of Minnesota Duluth, is a source in MPR's Public Insight Network.

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