How literature can benefit medical schools

There was this one comment I remember vividly: "It was such a pleasant surprise to learn that there were so many Covid-19 doctors who have a knack for writing."

This reader articulated a sentiment I've held for a long time: many professionals in the medical field are adept writers and presenters.

Thus, I am far from surprised, and indeed agree, with the fact that four of the 27 medical schools use national literature test results in their admissions processes.

It is often overlooked, but the study of human nature is a common ground between the medical and literary fields. While medicine studies the human body in order to treat illnesses, literature describes and explains human behaviors in order to gain insight into the inner life.

The medical field's goal is to prevent physical harm, but in many cases, the psyche and one's interpersonal relationships are often a source of that harm. And medicine, particularly psychiatry and psychology, plays a crucial role in providing people with both physical and mental well-being, as well as balanced and positive emotions.

The case of Sigmund Freud, the world-famous psychiatrist, exemplifies the importance of studying psychology and the human psyche to treat mental illnesses. Before medical explanations were available, many great writers also foretold the existence of such diseases.

Authors such as the Frenchman Molière in his play "Le Malade imaginaire" and the Russian author Fyodor Dostoevsky in many of his works brought up mental health issues such as anxiety and epilepsy.

Many well-known authors, including Anton Chekhov (Russia), Friedrich Schiller (Germany), Lu Xun (China), are also medical professionals.

In Vietnam there once lived a brilliant doctor by the name of Hai Thuong Lan Ong. There is also Dr. Nguyen Khac Vien, who is both an author and a psychologist. Do Hong Ngoc, MD, is a modern hero who also happens to be a writer of romance. The qualities of a literary scholar do not preclude them from becoming doctors; indeed, they may even give them an edge in the difficult but rewarding work of saving lives.

The patient in front of us is a data set that includes numerous biological measurements. These measurements include height, weight, pulse, temperature, blood pressure, and others. But beyond these cold hard statistics, there is a whole person: someone with a unique life story, health concerns, and potential stressors from the outside world.

A doctor checks on a patient at the Ho Chi Minh City Medical University Hospital. Photo by Minh Tri

When a physician has deep insight and empathy for their patients, they are better able to provide care that is personalized, targeted, and even practical. In the medical field, one of the most prized qualities is the ability to empathize with patients and their families. Those who excel at literature, the study of human nature, tend to possess this trait.

In addition to empathy, writers who are also good doctors share other strengths, such as an eye for detail and the ability to convey that detail clearly in speech and writing. Not to mention, those fluent in multiple languages will have superior reading comprehension, which will streamline the delivery of critical medical records.

Opposition to including literature in medical examinations appears to stem primarily from the mistaken belief that those who study or write about literature are irrational dreamers. In addition, a lot of people think that if literature is included in medical admissions, that means people are only admitted to medical schools thanks to their literary skills. Indeed, while traditional medical subjects like chemistry and biology are mandatory in selecting medical students, literature has only been chosen by four universities as part of their admissions processes. Similar to the other subject combination options, literature could be a third choice.

For a long time, universities in Vietnam only admitted students into one of three main ability groups: A, B, or C. Group A consists of the hard sciences: mathematics, physics, and chemistry. Group B consists of math, chemistry and biology. Dreamers with a penchant for literature, history, and geography make up Group C.

This method of recruitment has remained largely unchanged for decades, leading many to believe that the division of human potential into these groups is indisputable. Many qualified people missed out on the chance to pursue careers in medicine because of this.

My view is not anything new. In the past, applicants with a background in literature were not discriminated against during the selection process for medical students. During the French colonial era in Vietnam, any high school graduate who met the prerequisites could enroll in a pre-medical course called a PCB course (Physique, Chimie, Biologie). My father graduated from high school with a philosophy background, went on to take and pass the PCB class, and eventually became a doctor. In time, he improved his medical skills and earned widespread praise from his patients. At such a time, no academic subject stood in the way of a student's pursuit of a career in medicine.

Present-day medical admissions practices in the U.S. are very similar. Students applying to colleges typically take the SAT or ACT, which includes reading and writing sections that are similar to what we refer to as literature.

They can study medicine after completing a bachelor's degree and passing the prerequisite course (Pre-med), which is similar to the old French PCB class. Pre-med courses therefore have students majoring in languages, psychology, sociology, and many other fields.

Reforming the admissions process is crucial to improving Vietnam's higher education system. With more students applying to medical school, more people than ever before can follow their dream of becoming a doctor. Universities providing medical education can use the "Pre-medical" model popular in the United States to guarantee the standard of their students' input.

As a result of a long-standing trend of mistrust, the inclusion of literature in medical school admissions has been met with such strong opposition in Vietnam. But perhaps such a shift is the first tentative step towards abandoning the old dogma.

The issue is not about what subjects teach, but rather how to recruit and educate future doctors so that they can serve the public with integrity.

*Quan The Dan is the vice director of the Tri Duc Thanh general hospital in Thanh Hoa in central Vietnam.