Intercalated BA in Medical Humanities

We are now recruiting for our October 2011 intake of this innovative one-year degree programme, designed for medical students. It includes core modules with medical perspectives in philosophy, history and literature. Elective modules include poetry, critical theory and the philosophy of science. Students have the opportunity to apply their learning in these diverse fields through a substantive dissertation.

If you are a Bristol University student and wish to apply for this programme, you need to apply (using the generic intercalation form) to the Faculty Office no later than Friday 11th February 2011. (Applications to intercalate should be sent to Sue Kriefman at the Centre for Medical Education by Febuary 18th.) If you are eligible, we will send you an iBAMH application form by email. This should be returned to Jess Dunton at j.dunton@bristol.ac.uk by email no later than Friday 26th February 2010. We hold interview in the week starting 7th March, and hope to offer places before the end of the Spring Term.

Students from outside Bristol will be considered on an equal footing with Bristol students. Typically about 1/3 of students on the programme are from medical schools other than Bristol. Current students and graduates are available to talk about the programme.

Your first port of call for further information regarding the course should be either j.dunton@bristol.ac.uk on administrative matters or Dr. Polly Wood at pollywood@googlemail.com for any other questions

Programme description

Oliver Sacks, Awakenings
“In present-day medicine... there is an almost exclusively technical or mechanical emphasis, which has led to immense advances, but also to intellectual regression, and a lack of proper attention to the full needs and feelings of patients.”

Why humanities and medicine?

Medicine is a fascinating and challenging undertaking, marking a turbulent intersection between humanistic and scientific understandings of life. The advances in medical science, particularly in the last 150 years, have been extraordinary. These are reflected in a medical curriculum overflowing with basic and clinical science. However this success must not blind us to the wider view. What about, for instance, the personal dimension, which becomes so apparent when we, or our loved ones, become ill? Medical technologies are applied to ailing individuals for whom both their illness and its treatment is highly meaningful. We can also wonder about the nature of clinical science itself and the way it constructs knowledge about the medical universe. The medical humanities, as a disciplinary field, offers one route into this more mature understanding of illness and the scientific basis of its alleviation. It draws on a wide range of academic disciplines that have sought to portray and question the nature of medicine. Its principal fields are literature, philosophy, socioanthropology and history, to which many others could potentially be added. Their study provides a healthy complement to the standard scientific and clinical curriculum.

What is the BA Medical Humanities programme?

Here are the formal aims of the programme - read carefully!

The intercalated BA in Medical Humanities (iBAMH) programme offers you the opportunity of a year devoted to academic study in the humanities - intercalated within the main MB ChB programme, usually after the second year. It is located within the disciplines of English Literature and Philosophy - in particular the philosophy of science. There is a complementarity between these two - literature confronts students with a considered range of intimate human experience and philosophy demands students to step back and question the assumptions upon which medical science is based. Over the course of the BA, you will therefore learn to think in different intellectual systems with different sizes of “picture” - an important transferable skill for the physician.

For Bristol students, the degree builds on humanities exposure from the first two years of the MB ChB course - in particular the Human Basis of Medicine Unit which included sociology, anthropology, ethics and “Whole Person Care”.

Signing up, you formally transfer from the Faculty of Medicine to the Faculty of Arts. In the Arts Faculty, teaching is organised, not in terms, but in two twelve-week “teaching blocks” (TB1 and TB2). How we propose to ease students' transition to the Arts Faculty is covered below, first we introduce the Units.

Introducing the Units

Students engage in five modules of learning called “Units”. These have been carefully chosen (or newly created) to deliver the programme aims (see above). In TB1 there is a choice of one of two literature units otherwise units are compulsory.

Please note that the structure described above is currently going through an approval process.

Units accrue credit points of which you need at least 120 for a BA degree, of which 90 must be at “level H” - which is equivalent to third year undergraduate standard. What follows is a brief description of each of the units.

Philosophy and History of Medicine Core Unit

This unit surveys the “making” of modern medicine from the French Revolution to the AIDS pandemic. It explores some of the key epistemological frameworks of our medical world in their socio-historical context. It traces the creation in the nineteenth century of two new medical institutions, hospitals and laboratories, of new medical professionals working in them, and of new causal understandings of disease. Turning to the twentieth century, it then traces the formation of biomedicine and national health care systems, and examines the implications of efforts to standardize medical knowledge and practice through the clinical trial and evidence-based medicine. Throughout, the unit explores the tensions between the increasing objectification of medicine and the subjective dimensions of doctors’ knowledge and patients’ illness. Addressing the changing relationship between the doctor and patient, science and medicine, and concepts of health and disease, the unit critically assesses the nature and status of disease categories, medical expertise and medical knowledge. This unit is open to medical and philosophy students. If we establish a “Philosophy of Medicine” unit, this unit will become more purely historical.

Literature and Medicine Core Unit

This unit will explore the interrelation between medicine and literature across a range of literary genres and historical periods. Drawing on this historical perspective, it will explore the changing literary representations of patients, illness and the medical profession. Topics will include: the body in literature; the complex interaction of literature and psychoanalysis; illness and the nature of artistic experience; Shakespeare and medicine; literary constructions of physical and mental illness; and illness as metaphor. Open to both English and Medical Students, the unit will expose students to the challenges of interdisciplinarity. The unit comprises a weekly two hour seminar underpinned by a wide range of textual and critical sources and is assessed by two essays of 2,000 and 4,000 words respectively.

English option 1 - Critical issues (in English Literature) Unit

This unit introduces students to some central issues and debates in literary criticism and theory. These will be encountered in the context of the study of certain prescribed texts: four novels, and one play. By considering these texts in the light of designated topics, students will become acquainted with the guiding ideas (and, to an extent, with the specialized vocabularies) of some of the most influential schools of criticism and theory in the twentieth century, such as feminism, narratology, psychoanalysis, post-colonialism, nationalism, and new-historicism. The unit comprises a weekly two hour seminar underpinned by a wide range of textual and critical sources and is assessed by two essays of 2,000 and 4,000 words respectively.

English option 2 - Approaches to Poetry Unit

Approaches to Poetry provides an introduction to a wide range of English poetry from the Middle Ages to the present, and to some of the principal forms, styles and genres in which English verse has been written, including various comic, elegiac, epic and mock epic, erotic, lyric, pastoral and satiric forms. An introduction is provided to several common verse techniques, including enjambment, conceit, metaphor, repetition, and several forms of scansion. The Unit also introduces some critical problems relating to the reading and discussion of poetical texts, and to some general notions of the nature and function of poetic form. Subjects discussed include classical myth and English poetry, poetry and history, the figure of the poet, poetry and song, poetic translation and transmission, the place of women in poetry, poetry and painting, poetic inspiration, and poetic endings. The unit, while complete in itself, provides a foundation for further study of poetry. Particular attention will be given to scholarly standards of writing and presentation. The unit comprises a weekly two hour seminar underpinned by a wide range of textual and critical sources and is assessed by two essays of 2,000 and 4,000 words respectively.

Philosophy of Science/Philosophy of Medicine Unit

In its first three years, the iBAMH has offered students a unit in the Philosophy of Science. This is a pre-existing unit open to Year 2 Philosophy Students and its aim is to expose the student to some of the technical debates in the philosophy of science. Some of the main questions we will be looking at are: What kinds of relations exist between theories? Can new theories explain the success of their predecessors? Is science progressing towards unification? What do we mean by the term 'probability'? What is the relationship between confirmation and explanation? Does the successful prediction of a hitherto unforeseen event provide more confirmation than the successful prediction of a well-known one? Can medicine be called a science? What do we mean by 'health' and 'disease'? What is the role and evidential import of randomised controlled trials? This unit is assessed by an end of year 3hr examination. The Steering Committee of the iBAMH is currently considering the creation of a new unit entitled the “Philosophy of Medicine” that might replace the Philosophy of Science option in TB2. It would still cover important ideas in the Philosophy of Science (e.g. induction, paradigms, discovery) but merge these with more overtly medical considerations such as the nature of disease, responses to suffering, medical epistemology and moral philosophy applied to medicine. We will not know until May 2009 if this new unit will run as it depends upon our securing some additional funding. Meantime the existing option of Philosophy of Science has proved both challenging and popular.

Dissertation Unit

This dissertation unit, unique to iBAMH, is designed to allow students to demonstrate their ability to integrate their learning from the other units of the programme. Students write a dissertaton of 6,500 to 8,000 words (including quotations and notes, excluding bibliography) on a subject of their own choice, agreed by the Unit Director and a supervisor from the departments of English or Philosophy. The topic of the dissertation must include some aspect of the medical humanities and draw on learning in other units in the programme. Depending on the topic, additional supervision from a clinician may be available. Students meet regularly with their supervisor(s), prepare plans of work, demonstrate abilities to search and assimilate information from a variety of sources and produce a well reasoned account in clear academic prose. Topics for dissertations in 2008 included: The Making of Schizophrenia from the Nineteenth Century to the Present Day; Sleeplessness in Medicine and Literature from the Nineteenth Century to the Present Day; Lovesickness in Literature and Biomedicine; The Royal Navy, Cholera and Quarantine in the Nineteenth Century; Death without God in Tennyson’s In Memoriam; Dracula in Literature and Medicine;Hippocrates: Fact or Fiction, Father or Fraud?

Assessing the Units

Though formative assessment may involve presentations, summative assessment is through essay writing, dissertation, take home exams (shorter essays written over a week or so) and one 3h exam paper with essay-style answers.

Supporting your transition to the Arts Faculty

The learning culture of the Arts Faculty is different to that of the Medical Faculty. Though medics may joke about the easy life of the arts student, their overall workload is roughly equivalent. The big difference is that learning in the Arts Faculty is primarily self-directed and requires considerable independent reading. There is relatively little direct contact time with teaching staff. That said, lectures will be crucial to developing your understanding of this sometimes complex material. Seminars are small teaching groups. By comparison to medicine, a much higher level of preparedness is expected for Arts seminars and active participation is mandatory. We have specifically designed the programme to give the iBAMH a real sense of being part of the Arts Faculty and we also recognise the challenges that come with that shift. To support you we have put in the following:

1.  The Oakhill Group. This is a forum in which you will have opportunity to integrate your learning and build bridges to your future clinical life. It is described in further detail below.
2. Introductory Seminars. The English units in TB1 are actually year one units and and therefore intrinscially introductory. For philosophy there will be either one or two introductory seminars in preparation for the “Philosophy and History of Medicine” core unit.
3. Integrated learning. By this we mean that you will be learning alongside arts students most of the time. All units (except the dissertation) are open to arts students. This is a unique feature of the Bristol iBAMH.
4. Introductory reading. You will be provided with a range of reading materials that you should address in the summer prior to starting the iBAMH. See below for details.
5. Academic support. Arts Faculty academics offer to read and give you feedback on your academic writing prior to formal submissions.

Oakhill Group

During TB1 and TB2 a study group will be run every two weeks solely for intercalating students from MB ChB or equivalent programmes. These tutorials will be facilitated by staff from the Department of Community Based Medicine. The purpose of the group is to a) support students in relation to the main units and help them “own” and integrate their learning b) help forge links between the medical humanities and clinical medicine and c) provide a safe forum for students' personal and artistic development. The work of the group is informal and will not be formally assessed. Student's will be encouraged to keep a portfolio of their work, and to keep a written record of their own progress. This will contribute to both to self and peer, assessment and feedback.

Career benefits of joining the programme

The programme will be of value to anyone who wants to practice clinical medicine - particularly those interested in general practice, psychiatry or palliative medicine - where the human factor is most evident. The literary and historical aspects of the programme will equip students with insights into the many ways in which medicine shapes and is shaped by the cultures and societies in which it is practiced. Since all physicians rely on both narrative and history in their practice, and the study of both will only strengthen this aspect of clinical work. The philosophy of science will be of direct value to anyone who enters research, and will also foster critical skills in the interpretation of medical research. The programme will connect future medical educators to rich resources in the humanities. The course will be of inestimable benefit to those who pursue careers in medical writing - such as journal editors and medical journalists – or those who value the clear communication of medical ideas to patients, the public and the profession. Along with these skills, the degree may also transform your outlook on medicine and life in a more general sense.

Deciding if this programme is for you

Prospective students should carefully consider the merits of the programme in light of the other options available. For students who are seriously interested in the degree, it will be possible to provide email address contacts for current iBAMH students.

Gaining a place on the programme

The purpose of the selection process is to ensure that we enrol students who are likely to enjoy the programme and cope with its academic rigours.

General requirements to intercalate (in any subject)

Most medical schools have rules about who can and who cannot intercalate. These are designed to dissuade students from applying who need to focus on their core medical studies - perhaps due to poor prior exam performance. For Bristol applicants about 40% of the year are deemed eligible to intercalate - though we did accept onto the iBAMH two exceptional students who had for particular personal reasons fallen below this threshold. Non-Bristol students must seek approval from their Pre-Clinical or Clinical Deans before applying to Bristol.

Requirements for iBAMH

Applicants must demonstrate that they are capable of coping with the intellectual demands of the programme including the ability to undertake the reading of a wide range of primary and secondary literary, historical and philosophical sources; to think conceptually and write coherently. Applicants may for example:

1. Have studied and passed a humanities subject up to either A or AS level
2. Have passed their Social Science (Bristol - HBoM) units, with merit or distinction
3. Have shown particular interest and competence in arts-related SSCs in year 2.
4. Engage in some aspect of the humanities as extra-curricular activity

Selection process

Bristol students will need to obtain permission to intercalate and demonstrate that their marks are strong enough for them to leave medicine for a year. Non-Bristol students must seek approval from their Pre-Clinical or Clinical Deans before applying to Bristol, but we do not need written permission until an offer has been made.

Bristol students must apply to the Faculty Office by Friday 11th February 2011 using the generic intercalation application form. Once we have checked that you are eligible to intercalate, we will provide you with a special iBAMH application form by email. The application form should be submitted to Jess Dunton by email no later than Friday 26th February 2011. We hold interviews in the week starting 7th March 2011 -- probably on the morning of Monday 7th, so please make preparations to be excused from your normal teaching on this day. The interview process will include a simulated seminar and a short interview. Both will be based on matters arising from your application and no presentations are expected, We should hope to be able to offer places before the end of the Bristol spring term on 1st April.

Students from outside Bristol will be considered on an equal footing with Bristol students. Typically about 1/3 of students on the programme are from medical schools other than Bristol. Current students and graduates are available to talk about the programme -- contact Jess for more information.

Your first port of call for further information regarding the course should be either Jess Dunton at j.dunton@bristol.ac.uk on administrative matters or Dr Polly Wood at Polly.Wood@bristol.ac.uk for any other questions.

Pre-course preparation

Successful applicants will receive help in preparation for the academic year. There will be an informal meeting in June (students from outside Bristol will come if they can) and various preparative reading materials will be suggested by the unit leaders. Some of this may be “required” so be prepared to do some reading in the long vacation.

Books to be read before staring the iBAMH

BOOKS IN RELATION TO PHILOSOPHY AND HISTORY OF MEDICINE

Philosophy

• **Collins and Pinch Dr. olem: How to Think About Medicine. University of Chicago Press 2005. This is a robustly reasoned but relatively lightweight romp through some very important issues. The book will prime your thinking for some of the main topics of the PaHoM Unit.
• *Ludwik Fleck, Genesis and Development of a Scientific Fact, Chicago: University of Chicago Press, 1979(1935). A pioneering analysis in the history and philosophy of medicine that inspired one of most important philosophers of science, Thomas Kuhn. Challenging, but worth the effort.

History

• *Roy Porter. The Greatest Benefit to Mankind. Fontana 1997. This a key reference work in the history of medicine. A long encyclopedic read, but rarely a dull one. Read it twice if you can and take some notes.
• **David Wooton, Bad Medicine: Doctors Doing Harm Since Hippocrates, Oxford: OUP, 2006. This is a lucid historical critique of the idea of medical progress. It defends the controversial thesis that medicine only became “effective” in 1865! An excellent counter-point to Porter.
• *Deborah Brunton (Ed) Medicine Transformed.. Open University Press. 2004. This is a textbook in the true sense – including exercises and discussion points. It provides however an exceptional overview of the rise of modern medicine from different authors and with reference (in a separate text also worth getting) to primary historical materials. Creates a useful counterfoil to Porter and its subject headings are more easily grasped.

BOOKS IN RELATION TO THE PHILSOPHY OF SCIENCE

You will appreciate the strength of Bristol Philosophy of Science scholarship when you discover that the three books below (which are widely read beyond Bristol) are all written by current members of the Bristol department.

• **Philosophy of Science: A Very Short Introduction. Okasha. Oxford Paperbacks 2002. This is the place to start with the philsophy of science.
• *Understanding Philosophy of Science. Ladyman. Routledge 2004. Or
• *Philosophy of Science. Bird. Routledge 1998. Previous students have found either of these texts essential to easing themselves into the sometimes complex discourses of the philosophy of science. Best to go to a bookshop and decide for yourself which appeals.

BOOKS IN RELATION TO LITERATURE

• **Bennett, Andrew, and Nicholas Royle, An Introduction to Literature, Criticism and Theory, 2nd edn (Harlow: Prentice Hall, 1999). This is a key text for Critical Issues and should be read by everyone doing the iBAMH course. It is a very readable introduction to literary theory divided into topics (such as culture, gender, race, voice, suspense, desire, the uncanny and power). Wisely read in conjunction with illustrative novels.
• *John Lennard, The Poetry Handbook: A Guide to Reading Poetry for Pleasure and Practical Criticism (Oxford: Oxford University Press, 2005). This is an excellent introduction to reading and interpreting poetry. It includes chapters on metre, form, punctuation, and rhyme.
• *Philip Hobsbaum, Metre, Rhythm and Verse Form, The New Critical Idiom (London and New York: Routledge, 1996 and 1988). The Lennard or the Hobsbaum are required reading if you are doing the Approaches to Poetry Option

Primary texts for Critical Issues (note these will not all necessarily be drawn upon)

The core literary texts for Critical Issues vary from tutor to tutor. The following is a representational sample of what is taught on the course. All tutors teach the starred texts.

• *Joseph Conrad, Heart of Darkness (Norton Anthology, Vol. II)
• *Sophocles, Oedipus Rex, in The Three Theban Plays, trans. by Robert Fagles (Harmondsworth: Penguin Classics, 1982). This may be in the Classics section, rather than the English Penguin Classics section, of a bookshop. Confusingly, there are two Penguin Classics editions of the Theban Plays currently in print: please buy the Robert Fagles version, with notes by Bernard Knox, rather than the translation by E. F. Watling.
• George Eliot, Silas Marner, ed. D. Carroll, (Penguin Classics)
• F. Scott Fitzgerald, The Great Gatsby, intro. Tony Tanner (Penguin Twentieth-Century Classics Edition only)
• *Mary Shelley, Frankenstein (Harmondsworth: Penguin Classics, 1985)
• Aphra Behn, Oroonoko (Norton Anthology, Vol. I)
• Kate Chopin, The Awakening, ed. Margo Culley, 2nd edn (New York: Norton Critical Edition, 1994)
• Don DeLillo, White Noise (Penguin Books, 1991).
• Dickens, David Copperfield (Oxford Classics edition only)

Primary texts for Literature and Medicine (note these will not all necessarily be drawn upon)

• William Shakespeare, Hamlet
• Mary Shelley, Frankenstein
• Robert Louis Stevenson, Dr. Jekyll and Mr. Hyde
• **George Eliot, Middlemarch [several students strongly recommended reading this]
• Kazuo Ishiguro, Never Let Me Go

Primary texts for Approaches to Poetry

• John Donne, ‘The Sun Rising’;
• Ben Jonson, ‘On My First Son’;
• John Milton, ‘Lycidas’;
• George Herbert, ‘The Altar’;
• Alexander Pope, ‘The Rape of the Lock’;
• Jonathan Swift, ‘Verses on the Death of Dr Swift’;
• William Blake, ‘The Chimney Sweeper’, ‘The Tyger’;
• William Wordsworth, ‘Simon Lee’, ‘Expostulation and Reply’;
• John Keats, ‘Ode to a Nightingale’; Coleridge, ‘The Eolian Harp’, ‘Kubla Khan’;
• Alfred Tennyson, The Lotos-Eaters’, ‘The Lady of Shallot’;
• Robert Browning, ‘My Last Duchess’;
• T. S. Eliot, ‘The Love Song of J. Alfred Prufrock’;
• Matthew Arnold, ‘Dover Beach’;
• Sylvia Plath, ‘Daddy’;
• Geoffrey Hill, ‘September Song’;
• John Ashbery, ‘Self-Portrait in a Convex Mirror’;
• Adrienne Rich, ‘Nora’s Gaze’.

GENERAL BOOKS

Here are some books that are just generally stimulating without being onerous.

• Blood and Guts R. Porter (Penguin) [short introduction to the History of Medicine]. A very quick intro the History of Medicine but useful for getting your bearings.
• What Good Are the Arts? John Carey. Faber and Faber 2006. A great polemic which puts the boot into artistic pretensions.
• Sophie's World: A Novel About the History of Philosophy. Gaarder and Moller. Phoenix 1996. Don’t consider yourself above this contrived but eclectic tour. The combination of history and philosophy makes it particularly relevant.
• Think: A Compelling Introduction to Philosophy. Blackburn. Oxford Paperbacks 2001. Simple language but complex ideas. A good way of working yourself into the fascination of philosophy. Read it!

• Your first port of call for further information regarding the course should be:
  Dr Trevor Thompson
  Consultant Senior Lecturer
  Academic Unit of Primary Health Care
  University of Bristol
  25 Belgrave Road
  Bristol BS8 2AA
  trevor.thompson@bris.ac.uk
  T: 0117 331 3819 (no message facility)
  M: 07947 211 411 (if no reply txt is best)
  F: 0117 331 3815
  UoB Days Mon, Tues and Fri