Medicine has long been considered both an art and a science. Albert Einstein said "all religions, arts and sciences are branches of the same tree" because they all serve the same larger purpose - to uplift the lives of human beings - a principle with roots in the Renaissance.
This is a message that is often shared by David J. Skorton, M.D., the president and CEO of the Association of American Medical Colleges (AAMC), who served as the keynote speaker for UNR Med's Class of 2021 Doctor of Medicine Academic Hooding. The AAMC is a not-for-profit association that represents the nation's 155 accredited medical schools, 17 accredited medical schools in Canada, as well as more than 400 teaching hospitals and health systems, and more than 70 academic societies.
Prior to joining the AAMC in 2019, Dr. Skorton led the Smithsonian as its secretary for four years. He has been described as a Renaissance man - a cardiologist who plays flute and saxophone and hosted a jazz radio show. Skorton also serves as one of seven volunteers appointed by the Biden-Harris Administration transition team to the arts and humanities agency review team, responsible for reviewing the Corporation for Public Broadcasting, the National Endowment for the Arts, the National Endowment for the Humanities, the National Science Foundation and the Smithsonian Institution.
Following is a Q&A with Skorton, edited for length and clarity, on what's to come and advice for the Class of 2021's graduating medical students.
Q: You're a strong advocate for the arts and humanities being essential to our welfare - and even our survival. What are a few examples and resources for integrating the arts and humanities with STEM disciplines?
A: I feel very deeply that the humanities have helped me become a better physician, researcher and educator. These disciplines help shape the ethical foundations upon which we practice medicine.
Miki Calderon, a medical student, submitted a poem she wrote about what it's like to treat patients while wearing a mask during this global pandemic. She wrote: "I've learned to smile with my eyes so that they can see that I have a soul." It's important not to forget that throughout your medical career.
Many resources can be useful in thinking about this. The AAMC has partnered with StoryCorp and the National Endowment for the Arts to collect oral and written stories and poetry from health care professionals like Miki, related to their experiences with COVID, racism and persistent health inequities in America.
Additionally, the AAMC has launched the Fundamental Role of Arts & Humanities in Medical Education to provide resources for medical educators develop and improve the use of the arts and humanities in their teaching. Another resource from the National Academies of Sciences, Engineering, and Medicine is a 2018 report on integrating the arts and humanities with the STEM disciplines. The report, "Branches from the Same Tree," is available from the National Academy Press and includes many examples of how the humanities have been successfully integrated with the medical disciplines to aid in healing in medical care.
Q: What are some ways that health care professionals can use the arts and humanities to heal during these difficult times?
A: Learning about the arts and humanities and expressing our souls through music, through writing and through art can help us heal ourselves and feel less alone, even when we're actually alone, social distancing. The arts and humanities can and really do help us listen and connect more effectively with each other, as well as with our patients and their families. At our annual Learn, Serve, Lead meeting of the AAMC, we were honored to have Elvis Francois, M.D., the singing orthopedic surgeon, perform a very emotional rendition of John Lennon's song, "Imagine." Watching him sing in scrubs reminded me that during a time when we've been relying on doctors more than ever amid a global pandemic, we can't forget that doctors are people, too. They're feeling the emotions of the pandemic along with everyone. The more we connect with each other, the more effective a response will be.
Q: As President of the Association of American Medical Colleges, what is your vision for how the AAMC can promote health equity and diversity in medicine?
A: This is one of the biggest issues the generation graduating from medical school will face. So much of a person's and a community's health are unrelated to genetics or even medical care, but rather a product of the social determinants of health. Rough estimates are that perhaps 20% of our health is determined by our genetic makeup and another 20% by health care. That means that most of what determines our health are social determinants: where we live and whether we have affordable access to health care services and other resources.
If we hope to make meaningful progress and achieve our mission at the AAMC of improving the health of people everywhere, we have to tackle the social determinants of health and the upstream causes - systemic racism and poverty - to make a difference in health equity.
The AAMC has added a fourth pillar, "community collaborations," to academic medicine's traditional tripartite mission of research, education and clinical care. This means focusing on two-way community dialogues, appreciating community assets, listening to needs, listening to lived experiences and perspectives of patients, families and communities. This approach, as well as a new entity called the AAMC Center for Health Justice, are woven into the AAMC's "10-point plan to make it happen."
Q: What are the most crucial things new residents should be doing and focusing on in their first 100 days on the job?
A: As you reflect on your training so far and what the future holds, consider the educational disruptions and missed experiences as an opportunity for education and training. Although we're members of an evidence-based profession, sometimes we fail to realize the evidence that supports our own resilience. You're superbly equipped to make a successful transition to residency. You made it through 2020 with resilience and innovation, and those traits will continue to serve you well. You're not on your own to figure out what happens next. The AAMC worked with several other organizations to develop guidance and resources to assist in the transition of graduates into their first post-graduate year, the Transition in a Time of Disruption toolkit.
Q: Are there any questions you ask yourself that you would encourage newly graduated physicians to ask themselves, as they transition to residency, in order to help frame their days?
A: I'm a strong believer in the importance of a particular Zen Buddhist concept called Beginner's Mind. Shunryu Suzuki Sōtō, Zen monk and Zen Buddhism teacher, said, "In the beginner's mind, there are many possibilities. In an expert's mind, there are few."
Refuse to believe there are only a couple ways to do things. Retain your beginner's mind to ask yourself: "Am I connecting with others across the community who have experiences and backgrounds different than mine so I can learn from them? And have I dedicated myself not just to becoming an expert on science and disease, but becoming an expert on people by listening to them, their needs and lived experiences?"
Q: What can we all do to help make 2021, and the future, brighter for all?
A: Support each other as people who are also vulnerable. Check in with your colleagues about how they're doing. The medical profession can be very high stress, in particular during training, and especially with a pandemic on top of it. Please know that asking for help is a sign of strength and wisdom. The very best thing we can do for each other throughout our lives, including in medicine, is to check in, listen and support each other. Despite the obstacles we've all faced this year, I'm optimistic for the future, especially if we continue to work together.
One Martin Luther King Jr. quote I love says, "If I cannot do great things, I can do small things in a great way." Every single graduate of UNR Med can do small things in a great way and build up to big things. Do that. Go get 'em! This is a wonderful time to take a role in leading the country. Take care of yourselves and each other.