1st and 2nd Year Medical Student Curriculum

The Cultural Formation of the Physician: Self Awareness and Cultural Identity*
Faculty: Linda Barnes PhD, MA, MTS; Irving Allen MD, Lana Habash MD
Course scheduled to begin in Spring 2004

This course explores and reflects on the culture of biomedicine into which students are being socialized. Students explore the values they bring into the profession and how these values influence their personal and professional lives, including responses to diverse patient cultures. The course is taught in both large and small group sessions. In addition to interactive large group sessions, there are small group exercises designed to illustrate our underlying assumptions about ourselves and others upon which relationships are based. These experiences do not offer formulaic approaches to different identified groups, but help students approach and successfully interact with any person, regardless of differences. As this learning is a life-long process, the course models a commitment to self-awareness and introspection, fundamental to the process of developing healing partnerships with patients and colleagues alike.

The course has the following goals:

1) To develop an understanding of biomedicine as a cultural, political, economic and social system. Students will experience their socialization into this system differently, which will provide a rich template to explore the racial, ethnic, class, and other dimensions of their cultural backgrounds.

2) To develop a flexible-working model that includes an understanding of context, culture, privilege and oppression, and that enables students to discern the dynamics that generate prejudice of multiple kinds. This working model will be of necessity individually crafted, as the course does not wish to promulgate a "politically correct" agenda. Each person's model should offer a strategy with which
a) To enter a new setting and be able to understand how a "different" patient is like all patients, like some patients and like no other patient. This will require a negotiation of power in the patient/professional health care provider relationship such that patients can teach professional health care providers about their models of illness and healing.
b) To remain conscious of one's own cultural responses.
c) To expand one's capacity for negotiating differences and discover connections.

3) To develop students' understanding of their own cultural backgrounds, particularly as these inform their ideas about self, illness, intervention, and healing.

4) To develop students' personal resilience and capacity to resist the more dehumanizing dimensions of biomedical training and the constraints of managed care.

5) To train students in self-assessment, and in the skills related to developing appropriate methods for stepping back and looking at a series of interactions in a systemic way.

6) To engage the students as co-teachers.

*This course is based on a course developed and taught at Harvard Medical School by Irving Allen MD, Linda Barnes PhD, Daniel Goodenough PhD, Roxana Llerena-Quinn PhD, and Ann Hallward MD.