Social Science and Humanities Research in MD–PhD Training

To the Editor: As three of the few MD–PhD students completing PhDs in social science and humanities disciplines, we would like to add our voices to those of Ryan O’Mara and colleagues1 in calling on MD–PhD programs to train graduates in disciplines beyond the biomedical and clinical sciences. The authors convincingly argue that clinician–researchers trained in diverse disciplines such as public policy, management, and social sciences can promote health and health equity specifically through addressing their social determinants. To improve health and health equity for our patients, we must also train physicians in the knowledge and expertise to properly achieve these ends. We would like to highlight two ways that social science and humanities research in MD–PhD training can contribute. First, as a research community we must answer the question, what are the components of physician knowledge and expertise? The components surely include clinical reasoning, clinical judgment, narrative competency, empathy, professional and ethical behavior, leadership, and advocacy. Many of these elements are considered part of the ineffable art of medicine, elusive and resistant to analysis. Yet they are in fact researchable by social scientists and humanities scholars.2 Psychologists, bioethicists, and philosophers of medicine study clinical reasoning and judgment; English and narrative medicine scholars study narrative competency and empathy; and finally, historians of medicine, medical anthropologists, and medial sociologists study professional, cultural, and ethical norms, the politics of practice, and the origins of health inequalities. Second, educators need research on how to best train physicians in this knowledge and skill set, including how it is acquired in medical education, how the culture of training influences its uptake, and the effectiveness of various strategies to teach and assess it. Here again these questions can be answered through a social science lens, using theory and methodologies—experimental, observational, quantitative, qualitative—from various disciplines. As medical students and future physicians, MD–PhD trainees have a unique perspective from which to undertake these two types of research and are well positioned to become future leaders in education who will help train a medical community in the diverse knowledge and expertise needed to promote good health for all. Jonathan Fuller MD–PhD student, University of Toronto, Toronto, Ontario, Canada; [email protected] Tavis Apramian, MA, MSc MD–PhD student, Western University, London, Ontario, Canada. Cynthia Min MD–PhD student, University of British Columbia, Vancouver, British Columbia, Canada.

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