Everything Old is New Again

On January 12, 2012 the Association of American Medical Colleges (AAMC) issued a report called "Behavioral and Social Science Foundation for Future Physicians."  This states that: "Understanding how lifestyle, behavior, and economic status affect health, and applying this knowledge to medical practice is vital for future physicians."  As always, good ideas are not always new ideas. 

In 1965, Hans Popper, MD, Ph.D. (below) published a paper called "A New Curriculum."1  This outlined the early plans for the nascent Mount Sinai School of Medicine, set to open in 1968.  Hans Popper was the Dean for Academic Affairs, Chairman of the Pathology Department, and one of the faculty most involved in the School's founding.  In this article Popper Hans 1967he described – very accurately – the directions in which he felt medicine was moving and some goals that a new medical curriculum must pursue.  He noted a "tremendous explosion of information" and that the advance of science was blurring the lines between the basic sciences.  He discussed the rise of "quantitative biology in medicine" and how technology had come to predominate diagnosis and therapy.  He also saw the changing role of the hospital and how medical students needed to be trained in out-patient settings.  Popper also pointed out the importance of community medicine, "which deals not only with continuous or comprehensive family care, but also with the establishment of patterns of medical care by physicians and nonphysican health workers with various levels of training."

Finally, Popper also stated that: "Human studies including social sciences and humanities should broaden the outlook of the specialist who, with the threatened vanishing of the family physician, must be better attuned to the mental and psychological needs of the patient and his family and to the problems of a changing society.  Neither modern technological methods nor multiplication of specialists will replace the continued need of the patient for the consideration of his personal and his family problems."1  Popper thought the best way to achieve this was to create a small Graduate School for Human Studies that would have departments of sociology, anthropology, economics and psychology.  There might also be small groups in law, art, history, or communications as well.2

Hans Popper's plans were never fully realized but there have been efforts over the years. The School did create a Department of Community Medicine under Kurt Deuschle, the first such department in an urban setting and today's Department of Preventive Medicine.  One of the original divisions of this department was Behavioral Sciences, led by Samuel Bloom, Ph.D., a pioneer medical sociologist.  A separate Human Studies graduate school was never created, but electives in many of these areas have been taught at various times.  Twenty-five years ago, Mount Sinai created the Humanities in Medicine admissions program that recognized the value of students who had been trained in the humanities. 

Perhaps the new AAMC report will induce another look at the value of the humanities in medical education, and the future as envisioned by Hans Popper almost 50 years ago.

 

1Hans Popper. A New Curriculum. Annals of the NY Acad of Sci, Sept. 27, 1965: v.128, art. 2, p. 552-560. (This is available online to Mount Sinai faculty and staff.)

2Hans Popper. The Mount Sinai Concept.  Clinical Research, 1965: v. 13, p. 500-504.

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