Nikki Nabavi and Callum Phillips look at the value for aspiring medics of studying the humanities
New data from UCAS show that medical school applicants have studied a narrow range of A level subjects, despite significant expansion in the range of A levels that medical schools will accept. Ninety four per cent of accepted applicants to medicine and dentistry courses (in England, Wales, and Northern Ireland) hold A levels or equivalent in biology and chemistry, with 64% holding A levels in biology, chemistry, and maths. What does this mean for the diversity of incoming cohorts of medical students? Our patients come from a vast variety of different backgrounds; does this exclusion of the humanities, and focus on pure science from the age of 16, show that the medical community is inappropriately bottlenecking themselves?
It’s a common perception that you need a science background to become a doctor. To an extent, perhaps this is or once was true, but at least 34 medicine courses in the UK state that A level chemistry is not required, and at least 46 courses do not require A level biology. There may be more choice for aspiring medics in what they can study than an out of date perception leads them to believe, and making the most of this opportunity for diversity will only strengthen the workforce.
Some readers may be thinking that if the first few years of medical school are all about the basic science, and memorising the Krebs cycle, then shouldn’t we be encouraging students to pursue science A levels? Yet, arguably, a good medical school will allow you to learn all the relevant “clinical science” you need to be a good doctor, which is a wholly separate entity to that contained within A level curriculums.
As medical students, we would both consider medicine to be a humanity, rather than a science, and think we should encourage practitioners from diverse backgrounds. In fact, the GMC’s Outcome for Graduates specifically highlights how medical students will need to apply social science and psychological principles, as well as health promotion and illness prevention, to the individual patient—a hard task for someone who lacks understanding of the sphere of influence that society and culture plays on an individual. Whether you want to be a surgeon or a psychiatrist, there is value in the communication skills, critical thinking and analysis, reading and writing, or creativity and empathy you develop in humanities courses. Studying different schools of thought and expression helps us to look at our patients holistically as an individual person—rather than just a list of pathophysiological symptoms.
Between us, we have studied music, drama, French, law, religious studies, philosophy, and ethics to an advanced level, and both of us believe these subjects have had a far reaching impact in shaping the skills we’ll need to become the doctors we hope to be.
A level drama teaches you the importance of body language and a greater awareness of how to use it: how to engage with people and make them feel seen, as well as how to use your voice to communicate details, rather than being the student who nods and says “sure, sure” when a patient tells you something awful. Studying music, or training with an orchestra, makes you disciplined and patient, as well as instilling an appreciation of the value of practice and working in harmony with your colleagues within a large team. Even doing another degree before pursuing a career in medicine gives you “valuable life experience” and a different approach to problem solving.
Studying ethics can offer you a unique opportunity to learn how to evaluate moral judgments, and gives you a framework for defining right from wrong, which is arguably the backbone of medicine. You are taught to write academically, think critically, and structure an argument. By studying philosophy or religion, you gain an academic insight into logic and reason, and how to question or critically analyse—not accepting facts at face value. In any service role, such as being patient facing, you will encounter people from different faiths and walks of life, and there is a benefit to understanding or appreciating their values or beliefs, especially given the role of a doctor to instigate change in someone’s life.
Studying languages can allow you to begin embracing different cultural perspectives, and leave you armed with a unique ability to appreciate and connect with people. At its core, medicine needs doctors who can help each patient to make a decision that is right for their life and their desired objectives, rather than issuing a paternalistic edict focused purely on biological understanding. That cannot be learnt from NADH or Acetyl-CoA.
Although science based, medicine is all about being able to navigate sensitive interactions with other people, including those who are feeling extremely vulnerable and who may be facing their worst fears. Remembering your shared humanity with patients (or your colleagues!) is mandatory for being a good doctor.
So, what actually makes a good doctor, or a successful F1? Arguably, it’s not someone who can recite the periodic table, but someone who can connect with a patient in need to make them feel secure and safe, allowing them to build a sufficient rapport so that they can take a strong history with a good examination. None of that strictly requires an exclusive knowledge of chemistry or biology, but it does need people skills and a level of cultural awareness.
In logic and mathematics, necessity and sufficiency are terms used to describe a conditional or implicational relationship between two statements. Much in the same way, although having a good understanding of medical science is a necessity for being a doctor, this alone is not sufficient.
Nikki Nabavi, editorial scholar, The BMJ, and fourth year medical student, University of Manchester.
Callum Phillips, Clegg scholar, The BMJ, and final year medical student, Southampton University.
Competing interests: none declared.