Robin Downie

Literature and medicine: a short course for medical students

Summary. A course on literature and medicine for medical students is described. A wide range of books, plays and poems were used with medical and non‐medical themes. Students enjoyed the course and particularly welcomed the non‐medical components. The staff learned at least as much as the students. Several book lists were developed with input from the students. Such a course might have a part to play in several parts of the medical course, such as in the teaching of ethics.

Humanizing medicine: a special study module

As medical schools begin to implement their new curricula under the guidance of Tomorrows Doctors, the authors wish to raise some discussion on the form and content of the special study module (SSM) component. In order to do this they put forward in this paper proposals for an SSM in Medicine and Literature. This course has been designed jointly and will be run concurrently in three Scottish medical schools: Glasgow, Aberdeen and Dundee. Arguments for the courses acceptability to faculties of medicine and to students are discussed and its inclusion in the curriculum in terms of its educational impact, skills training, effect on personal development and broadening of the students perspective are justified. The course structure, content and assessment procedures are described and a reading list proposed. The General Medical Council points out that SSMs should be seen as opportunities for innovation and this course demands a different educational approach from the standard objectives‐led approach of most medical education. A process‐led model is more appropriate as it stresses the way that students develop while taking the course rather than the end point reached at its finish.

Education and training in medicine

Summary. Education and training are terms which are often used loosely, interchangeably, and require definition. Training is often seen as a series of activities which are related to the acquisition of specific skills and may be narrowly based. Education, on the other hand, has an important value base and is broader in concept. The arguments for and against an ‘educated’ doctor or a ‘trained’ doctor are considered, and it is concluded that for medical practice both education and training are required. The implication of this for the preparation of doctors and for their continuing learning is considered.

Choosing life, choosing death: the tyranny of autonomy in medical ethics and law

of the material, which focuses on how emotions are orchestrated by good design. The need for an interdisciplinary team to provide holistic care is an acknowledged cornerstone of palliative care and this book shows why an architect should be fully integrated into the team. The book is short, well referenced, and clearly structured. Photographs illustrate key ideas, and most aspects of the design process are addressed. The focus is always on the potential for enhancing the patient experience: For instance, biographical quotes are used to describe the experiences of waiting in healthcare environments, showing how waiting can be either an exercise in cruel punishment or an opportunity to gather together inner resources, followed by a discussion of how architecture can tip the balance one way or another. My main criticism would be that the book is a little too kind to the hospice movement. Although bland designs, the potential for single rooms to lead to the isolation of patients and the tensions raised by changing religious and spiritual values are touched on, they are not truly addressed. The remit of this book is wider than that suggested by the title. It highlights the growing network of Maggie’s centres for people with cancer and discusses the needs of the elderly dying in hospital. It made me reflect on the influence of space and design on the care provided to patients and their families in a new way. It should be required reading for anyone who is considering commissioning the refurbishment, rebuilding or building of a hospice.