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It’s “Classical Advice!” Why Medical Education Should Go Beyond Science

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Abstract

This article is a reflection on a new (but ancient) definition of medicine, which considers doctors and patients alike from their complex human experiences. It explores the doctor-patient relationship as well as the practice of medicine itself through an historical lens, by examining some of the scholarship of Galen of Pergamum, the ancient Greek doctor and philosopher of the second century CE. The intention is not to give a new, definite answer, but to use an example from the past to look at the matter from a different, perhaps unusual, perspective.

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Data Availability

Data availability is not applicable to this article as no new data were created or analysed in this study.

Notes

  1. The Art echoes Hippocrates’ little treatise called Περὶ τέχνης (De arte, “On the Art of Medicine”) referring to the art of medicine. For a recent study of the text, see Mann [54].

  2. In this regard, among the many studies that have been published in the past two years, see: Ofri [59], Moniz et al. [56], Petrou et al. [61], and Adams et al. [40].

  3. In this article, the terms “doctor” and “physician” are often used interchangeably. For a brief history about “doctor vs physician”, see Kao and Geraghty [51]. Although our focus is on medical education and practice, this can and should be expanded to the whole “healthcare professional” workforce. For a definition of “health professionals”, see Transforming and Scaling Up Health Professionals’ Education and Training: World Health Organization Guidelines [70]. Geneva: World Health Organization; 2013. Annex 1, Definition and list of health professionals. Available from: https://www.ncbi.nlm.nih.gov/books/NBK298950/. Accessed 3 Mar 2024.

  4. The authors’ decision to exclusively focus on doctors, rather than healthcare professionals in a broader sense, in the initial passages of the article is intentional. Although Galen’s perspective on medicine can now be extended beyond the sole figure of the physician to encompass everyone who works for the well-being of patients in the healthcare system, for the sake of historical accuracy, the narrow translation of the term seems to be more appropriate.

  5. In his Rede Lecture delivered in Cambridge in 1959, Snow talked about “the two cultures” for the first time; the lecture was published in the book The Two Cultures and the Scientific Revolution the same year. Snow claimed that the intellectual life of the western society has split science and humanities into two cultures: in his opinion, this division is a major handicap in solving the world’s problems.

  6. The medical humanities are today defined as the area of health humanities specifically dedicated to the application of the humanities, the social sciences, and the arts to medical education. The health humanities consider their application broadly to healthcare and clinical practice.

  7. For a discussion about a definition of ‘hard’ and ‘soft’ sciences, see VanLandingham [66]. Also: Storer [64]; Cassell [46].

  8. To review the historic and current state of arts and humanities integration into medical education in North America, see Howley et al. [50].

  9. National Academies of Sciences, Engineering, and Medicine. The Integration of the Humanities and Arts Sciences, Engineering, and Medicine in Higher Education: Branches from the Same Tree. Washington, DC: The National Academies Press; 2018. In the same report, “Studies on the integration of the arts and humanities with medicine show a positive impact on students. Studies of narrative medicine have demonstrated efficacy in increasing empathy, resilience, and teamwork [63], while the integration of arts observation—including philosophy—into medical training has been shown to improve visual diagnostic skills [10], increase tolerance for ambiguity, and interest in communications skills [53]. Students, who participated in a medical school curriculum at Harvard that incorporated psychosocial and humanistic concepts through problem-based learning, were more likely to pursue primary care and rated themselves higher on a scale rating their preparation to practice humanistic medicine and ability to manage patients with psychosocial problems [60].”

  10. 38 in 147 surveyed medical schools included the topic in either a required or an elective course in the 2017–2018 academic year; see: https://www.aamc.org/data-reports/curriculum-reports/interactive-data/content-documentation-required-courses-and-elective-courses. Accessed 3 Mar 2024.

  11. For the purpose of the historical example, the present study will limit our view to the Western medical tradition. Nonetheless, the authors are aware that a more comparative study is necessary to consider this issue from a more inclusive and exhaustive perspective.

  12. In this study, the terms ‘doctor’ and ‘physician’ are used interchangeably to describe any practitioner of medicine. To reflect upon the meaning of the Greek term ‘ἰατρικός’, iatrikós, and how it is translated into English as both ‘physician’ and ‘doctor’, see Nutton [57]. Also, Means [55].

  13. For bibliographical references, beyond the English translation, the Latin title of the Greek texts will be cited in our study (either full title or abbreviation according to OCD and CMG). Respectively, De libris propriis, De propriis placitis and Quod optimus medicus sit quoque philosophus. For a complete bibliography of the Corpus Galenicum, see Corpus Galenicum. Verzeichnis der galenischen und pseudogalenischen Schriften (version 2019/12).

  14. For an interesting biography, see King [52].

  15. Erasistratus was a famous Greek anatomist and the founder of a school of anatomy in Alexandria. See Nutton [58].

  16. See for example Arist. Sens. 436a-b: “It is further the duty of the natural philosopher to study the first principles of disease and health; for neither health nor disease can be properties of things deprived of life. Hence one may say that most natural philosophers, and those physicians who take a scientific interest in their art, have this in common: the former end by studying medicine, and the latter base their medical theories on the principles of natural science.”

  17. Among the several studies about how philosophical and medical strands have been combined in Galen’s thought, see Vegetti [67], who captured well the central role that Galen assigned to medicine regarding scientific and moral progress.

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  1. Monica Consolandi and Sara Agnelli contributed equally to this article.

Authors and Affiliations

  1. Center for Digital Health and Well Being, Fondazione Bruno Kessler, Povo, Trento, Italy

    Monica Consolandi

  2. One Health Center of Excellence for Research and Training, and Center for the Humanities and Public Sphere, University of Florida, Gainesville, FL, USA

    Sara Agnelli

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Monica Consolandi: project conception, project design, manuscript drafting and revision, final approval, agreement of accountability; Sara Agnelli: project conception, project design, manuscript drafting and revision, final approval, agreement of accountability.

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Correspondence to Sara Agnelli.

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Consolandi, M., Agnelli, S. It’s “Classical Advice!” Why Medical Education Should Go Beyond Science. Med.Sci.Educ. (2024). https://doi.org/10.1007/s40670-024-02023-x

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