East Carolina University

The Department of Medical Humanities at the Brody School of Medicine at East Carolina University began in 1978 and is now internationally recognized for its scholarship and for it integration of medical humanities into all years of medical school and residency. For example, the prestigious journal Academic Medicine has asked the founding chair, Loretta M. Kopelman, to write up the program numerous times, most recently in October 2003.

The primary goals of the program are to help

identify moral, philosophical, and social issues in health care or research
learn central concepts of medical ethics
reflect on their responsibilities
understand relevant legal, cultural, and historical perspectives
appreciate diverse views
develop the ability to formulate, evaluate, and defend particular positions
recognize problems they are likely to encounter

To foster these goals the department seeks a free exchange of ideas in open discussion. The faculty combine case review and theory, concentrate on readings from prominent medical and scientific journals, and use small-group instruction with co-instructors from ECU clinical faculty and basic science faculty, hundreds of whom have participated. Hundreds of physicians and scientists have taught in the program over the last 25 years. Team teaching keeps the medical humanities courses focused on issues of importance to clinicians and basic science faculty, promotes faculty development, and supports the goal of integration of material within the curriculum.

During the first half of each of the first two years of medical school, students take a required course on moral and social issues in medicine; both are graded and have 24 contact hours. In the first year, students examine professional duties, basic concepts in medical ethics, patient’s rights, controversies at the beginning and end of life, and research ethics. The second-year course topics include justice issues in the allocation of basic and scarce resources, discrimination, and controversies about new technologies. These courses are team-taught by a member of the humanities department and a physician. In the third year, students meet in small groups with humanities faculty members as a required part of most clinical rotations to discuss topics based on their own patient encounters. These one to two hour sessions also include a systematic review of the topics covered in years one and two. Fourth-year medical students participate in a daylong program on a specific topic. Past topics have included physician-assisted suicide and religion and medicine. Fourth-year students may take humanities electives including: History of Medicine, Literature and Medicine, Death and Dying, Law and Medicine, Women’s Studies, War and Medicine, Clinical Ethics, Human Genetics, Foundations of Medicine, or student- designed courses. About one third of each graduating class takes two electives.

The Medical Humanities Department sponsors other programs: Students enrolled in school of medicine PhD programs must take a course in research ethics. Also, members of the faculty and five clinical chairs meet with all their respective residents to discuss recent cases. Fellows and faculty often attend these discussions as well. These “Chairs’ Ethics Rounds” fulfill the new ACGME requirement that residency programs provide systematic review of relevant ethical, legal, social, economic and cost-containment issues. The Bioethics Center offers additional educational programs and ethics review in the teaching hospital.

Dates: 1978-present