This project explores the extent to which medical history, a distinctly interdisciplinary subject, has become established within undergraduate and postgraduate teaching in the arts, social sciences and medicine, and whether the teaching and assessment of such modules reflects the heterogeneous character of its student cohort.
The teaching of medical history has greatly expanded since 2000, when an evaluation of the Wellcome Trust History of Medicine programme found that the history of medicine did not possess ‘a constituency of history of medicine students at undergraduate level’.[i] In a web-based survey of UK higher education institutions carried out late in 2008, I identified 195 distinctly history of medicine modules, of which 96 are undergraduate courses. When the parameters of the enquiry were extended to include modules closely related to or incorporating a significant history of medicine component, a total of 380 courses were counted.
Medical history courses at undergraduate or taught Masters level were offered at 49 institutions. Some were taught within history departments where no specialised history of medicine degree programmes or pathways existed. Others were offered by history departments where a specialised history of medicine degree pathway was available, often provided by a dedicated research centre or group. A number of courses were taught by staff based in science faculties to medical students, often forming part of an intercalated degree. In some institutions, history of medicine modules were taught by a research centre based outside of a history department to either a diverse undergraduate population or a distinct taught Masters programme. Finally, I identified a number of courses taught by philosophy departments, often forming part of a medical humanities or history and philosophy of science degree programme.
As the number of history of medicine modules offered to undergraduates and postgraduates have expanded, what trends can be discerned in the types of course offered? The conventional ‘history of medicine’ course, which explores changes in medical practice in social, economic, political and cultural contexts over a set chronology, still flourishes. Such courses, which offer a framework of knowledge, skills and understanding that enable students to pursue more specialised history of medicine courses, now co-exist in history departments alongside modules that merge medical history with histories of the body, sexuality, gender, death and deviancy. Still other modules combine the history of medicine with the history, sociology and philosophy of science and technology; this latter group of courses are often to be found in departments of philosophy and sociology or in autonomous history of medicine centres. The growing diversity of courses offered in part reflects broadening research agendas in the field of medical history.
The teaching of medical history to medical students appears to have developed along distinctive lines, informed by objectives and learning methods specific to this cohort of students. The inclusion of medical history within the undergraduate medical curriculum was fuelled by the 1993 General Medical Council Report, Tomorrow’s Doctors: Recommendations on Undergraduate Medical Education, which urged a greater emphasis on evidence-based medicine and self-directed learning. Participants at an earlier HEA session on teaching medical history to medical students suggested that learning the history of medicine could help make medical students better doctors, capable of empathising with patients and handling scientific information in a more discriminating manner.[ii] With these considerations in mind, participants suggested that it was important to identify changes in attitude, using viva examinations and diaries or log books of learning experiences. Medical students were also found to need more assistance than history students with study skills and training to use source materials.
The emergence and growth of the medical humanities may well influence the shape of history of medicine teaching in the future. Defined by the Durham Centre as ‘an emerging field of enquiry in which the perspectives of humanities and social science disciplines converge on the exploration of the human side of medicine’,[iii] medical humanities programmes typically merge history of medicine modules with modules on literature and philosophy, or combine perspectives from the history of medicine in interdisciplinary modules.
Questionnaires will be used to trace how these developments have affected teaching methods and students’ experiences of learning history of medicine. A report which synthesises the quantitative and qualitative evidence gathered to present a picture of the teaching and assessment of the history of medicine will be published on the Subject Centre website in April 2010.
[i] Wellcome Trust, Evaluation of the Wellcome Trust History of Medicine Programme (2000), p. 43.
[ii] G. Goody, ‘Teaching the History of Medicine to Medical Students Workshop Report’, consulted at http://prs.heacademy.ac.uk/view.html/prsdocuments/95 on 08/06/09.