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Narrative Medicine GME Certificate Syllabus

·9 mins·Megan Dupuis and Chase Webber
Table of Contents

Location: MRB-IV Room 1230 

Welcome to the Medical Humanities GME Certificate Program!

We are thrilled and excited to help you develop your interest and skills in disciplines that are not typically covered within the traditional clinical curriculum of medical training. We recognize that these fields cannot be covered comprehensively within a 9-month time span, but want to provide you with the tools to build a firm foundation in Narrative medicine, oral history, history of medicine, or the arts and humanities.  

 

Following our first meeting, you will be asked to select a major and minor field of study, to guide selection of reading lists and capstone project–the choices are oral history and narrative medicine. You will also be asked to sign up for 2 one-week inpatient rotations (details below). All readings and seminars are the same for seminars (regardless of what field you select), and evening seminars will cover the discussion points and themes brought about over the course of each session-specific reading list.  

 

Structure of the course #

There will be didactic, seminar, and clinical/community-based elements of the course, including: 

  1.  Monday lunchtime meetings to write, discuss what we’ve learned, reflect on readings, and have shared community. Dates of the Monday Meetings (all held from 1-2 PM, room assignments may vary and will be on your outlook calendar invites):  
  • 10/3/22 - 415 (A&B) Light Hall  
  • 11/7/22 - 431 Light Hall  
  • 12/5/22 - Room TBD 
  • 1/9/23   - 306 (A&B) Light Hall  
  • 2/13/23 - 306 (A&B) Light Hall  
  • 3/13/23 - 306 (A&B) LIght Hall  
  • 4/3/23   - Room TBD  
  • 5/1/23   - Room TBD   
  1. Thursday Evening Seminars to dive into topics in depth. These seminars will take place from 6:00-7:30 PM and will serve dinner. The first session will take place 9/29 in MRB-IV 1230 (12th floor). The following sessions will take place in the EBL Boardroom (Eskind Biomed Library 334).  Each session will see the presence of a guest faculty member, and we will ask two residents/fellows to sign up ahead of time for each session to serve as discussants/leaders, using our guided prompt questions. There are assigned readings associated with each seminar. Please see below for details.   
  2. Independent Readings will be assigned for each of the seminars.  
  3. Independent Writing Assignments will be assigned at each of the Monday Lunchtime Meetings. Assignments may include reflecting upon patient encounters, documentation of an oral history, written appraisal of assigned readings or passages, critically reading and reflecting upon written sources of your choice, and/or quick journaling. Some of these will begin to build your writing portfolio, perhaps for editing and submission for publication. Others will be shared with the group during subsequent Monday seminars. Finally, some may just be for you - to digest, consider, and ponder.   
  4. Inpatient Rotation at either the VA or at VUMC will be a part of your training. This will consist of at least 1 week of mainly half days, rotating on an inpatient service to obtain, digest, and document the illness narratives of some of our most ill and vulnerable patients. This rotation is expected to be light on the hours but heavy on the reflection! There will be a separate note where you may document the patient’s illness narrative in the chart. We will go over expectations, assigned attending and service, and time commitments with each of you separately, as we need to work within the individual bounds of your training programs.   
  5. Capstone Project - at the end of the year, you will have a portfolio of work that demonstrates your command of your desired concentration (Narrative Medicine, Oral History). We would like you to submit one of these pieces for possible publication.  

Textbook: Charon, Rita et al. The Principles and Practice of Narrative Medicine. New York, Oxford University Press. 2017.  

Policies and Expectations #

  1. Attendance: We appreciate that you are all busy trainees who are taking time out of your lives to join this new endeavor. You have rotations, families, and personal lives and we respect that. As such, we would like you to attend 6/9 Monday writing sessions and 4/6 Thursday seminars. We understand that schedule conflicts arise, you rotate on night shifts, go on vacation, etc!  
  2. Communication: Please let us know ahead of time if you will be absent from a writing session, seminar, or inpatient day.  
  3. Assignments: Please complete the assigned work by the suggested date associated with that assignment. There is no punishment if it is late, and we do not want this to feel like it is drudgery. But the more you practice (by doing the work), the better you will get at close reading, attentive listening, and thoughtful writing. For now, you may submit the assignments via email; we are working on a website which will allow you to submit your assignments there in the near future.   
  4. Notebooks: We will provide you with pocket notebooks. If you do nothing else during the week, please begin to build the habit of writing in your notebook every day. It can be a 6 word story, a few musings, a quote from a patient, etc.  
  5. Inpatient Rotations: This is a very light rotation, so we expect you to be present all of the days that there are patients to see. We expect you to honor the stories of the patients who are gracious enough to share them, and to document them with empathy and fidelity. If you cannot be present during the rotation, please notify us.   
  6. Safety and Boundaries: This is a space of safety. What is said and discussed in these sessions should remain in these sessions. We will respect each others’ feelings, stories, and identities without judgment. Just as we are learning to actively listen to our patients, we will also actively listen to each other. We would like you to feel comfortable sharing your own written works with the group, but we understand this can be an emotionally vulnerable act. We will not force anyone to share a work they are uncomfortable with sharing.  

Evening Seminar Session Details #

Curiosity, Discovery, Existence–Introduction to Narrative Medicine #

9/29/22 6-7:30 pm, MRB-IV 1230 (12th Floor)

  • Primary learning objectives
    • Demonstrate the two signature methods of narrative medicine: close reading and attentive listening.
    • Conduct critical analysis of written works and oral histories.
    • Define relationality between author/reader or characters and apply it to the physician/patient dyad through reading and written works.
  • Reading list:
  • Reflection prompt questions:
    • Will be assigned and collected ahead of time online.  

The Task of the Physician-Writer, Medicine-Literature #

11/17/22 6-7:30 pm, EBL 334 (Boardroom)

  • Primary learning objectives:
    • TBD
  • Reading list:
    • See list below
  • Reflection prompt questions:
    • Will be assigned and collected ahead of time online.

Humanity in the Face of Illness and Metaphor #

12/15/22 6-7:30 pm, EBL 334 (Boardroom)

  • Primary learning objectives:
    • TBD
  • Reading list:
    • See list below
  • Reflection prompt questions:
    • Will be assigned and collected ahead of time online.

Galen, Asklepion, the Socratic Roots of Healing #

1/26/23 6-7:30 pm, EBL 334 (Boardroom)

  • Primary learning objectives:
    • TBD
  • Reading list:
    • See list below
  • Reflection prompt questions:
    • Will be assigned and collected ahead of time online.

Preparing for Publication: Modern Forums for Submission #

3/2/23 6-7:30 pm, EBL 334 (Boardroom)

  • Primary learning objectives:
    • Describe the ethical and legal implications of writing about and with real patients.
  • Reading list:
    • See list below
  • Reflection prompt questions:
    • Will be assigned and collected ahead of time online.

The Creative and Destructive Power of the Clinical Encounter #

4/13/23 6-7:30 pm, EBL 334 (Boardroom)

  • Primary learning objectives:
    • TBD
  • Reading list:
    • See list below
  • Reflection prompt questions:
    • Will be assigned and collected ahead of time online.

Final Capstone Symposium Session and Dinner #

June 2023, time TBD, EBL 334 (Boardroom)

  • Primary learning objectives:

    • TBD

  • Reading list:

    • Final Capstones

  • Reflection prompt questions:

    • Will be assigned and collected ahead of time online.

GME Medical Humanities Seminar Reading List  #

“The trouble is that science can tell us what human beings are, as collections of atoms or products of evolution since the Big Bang, but science as such can neither tell us who we are nor provide the moral compass for where we should be going, given that we are here… As we persist in fouling our own nest in the relentless quest for power upon power and resource upon resource, as we ramp up the apocalyptic lethality of our weaponry, as the march of technology continues to transform even human nature itself, we will in this coming century have to confront the question, “to be or not to be” — and what does it mean to be human upon this earth? If we cannot feel the force of that question, we won’t even get started with an answer.”  

– Gregory Fried, PhD, Suffolk University

   

Curiosity, Discovery, Existence—Introduction to Narrative Medicine   #

  • Charon, Rita. “Doctor-Patient/Reader-Writer: Learning to Find the Text” Soundings: An Interdiscliplinary Journal, Vol.72, No 1 (Spring 1989), 137-152.  
  • Charon, Rita. “Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust” JAMA. 2001;286(15):1897-1902. Doi:10.1001/jama.286.15.1897.   
  • Charon, Rita et al. Definition of Narrative Medicine (excerpt), Principles and Practice of Narrative Medicine.Oxford Univ Press, 2017.   
  • Christman, Brian. “Burnout” Annals of Internal Medicine, 174:3(2021).   
  • Christman, Brian. “Standing Waves” Annals of Internal Medicine, 172: 2(2020).    
  • Fitzgerald, Faith T. “Curiosity” Annals of Internal Medicine, 130:1(1999).   
  • LaCombe, Brian. “Playing God” Annals of Internal Medicine, 116:2(1992).   
  • Kovalchik, Michael. “‘Playing God’ as an Act of Hope’” Annals of Internal Medicine (1992)   
  • Izmaylov, Michelle. “Your Soul is Not Concrete (Survive, Anyway)” Academic Medicine. 91(12):1640-1641 (2016).   
  • “Narrative Medicine: Every Patient Has a Story” (AAMC.org). https://www.aamc.org/news-insights/narrative-medicine-every-patient-has-story.  
  • Examples of Six-Word Stories  

The Task of the Physician-Writer, Medicine-Literature   #

  • Charon, Rita et al. “Dualism and Its Discontents II: Philosophical Tinctures” Principles and Practice of Narrative Medicine. Oxford Univ Press, 2017.   
  • Chekhov, Anton. “Letter to Alexander Chekhov” 10 May 1886 [Objectivity]   
  • Keats, John. “Letter to George and Thomas Keats” 28 December 1817 [Negative Capability]  
  • McLellan, Faith. “Literature and medicine: physician-writers” Lancet. 349:564-67, (1997).   
  • Rousseau, G.S. “Literature and Medicine: Towards a Simultaneity of Theory and Practice” Literature and Medicine, 5:152-181(1986).   
  • “Reflective writing for physicians: The 55-word story”   

Humanity in the Face of Illness and Metaphor   #

Galen, Asklepion, the Socratic Roots of Healing    #

  • Bailey, James. “Socrates’s Last Words to the Physician Asklepios: An Ancient Call for a Healing Ethos in Civic Life” Cureus 10(12):e3789.   
  • Leder, Drew. “Clinical Interpretation: The Hermeneutics of Medicine” Theoretical Medicine 11:9-24, (1990).   
  • Wirth, Mathias. “Phenomenology and its relevance to medical humanities: the example of Hermann Schmitz’s theory of feelings as half-things” Medical Humanities. 45:346-352 (2019).   
  • Bynam, William, Varpio Lara. “When I say … hermeneutic phenomenology” Medical Education. 52:252-253(2018).   
  • Preparing for Publication:  Modern Forums for Submission  

The Creative and Destructive Power of the Clinical Encounter   #

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