Modern Medical Education Fails to Teach the History of Medicine
As strange as it may seem, our present system of medical education has never been subjected to scientific study or evaluation to determine if it actually produces physicians who possess the qualities necessary to practice medicine effectively. In fact, students of medicine have generally been trained according to the needs of the system, rather than the needs of the students or their future patients.
Our present system of training medical students is driven partly by economics, partly by politics, and partly by traditions which date back to the early years of our country. This patchwork system, altered by giant corporate and governmental forces, has resulted in the present creaky and chaotic medical-industrial complex.
Modern medical students have little contact with professors educated in medical history or traditional medical systems. Even more rare are those instructors who have actually developed some skill and experience using the tools of the traditional systems.
In traditional medical systems, training proceeds upon different lines than those we have chosen in the West, and there is value in seeing how other societies have successfully solved the many challenges of transforming students into physicians. Technical skills such as surgery and prescribing, as well as the ethical systems of traditional medical systems, bear close examination in these days of inquiry into the future of medical practice and medical education.
Alternative Medical Education or Culture Specific Training No Longer an Option
I have offered electives in traditional Oriental medicine to medical students at CWRU school of medicine for the past 15 years. I am not a paid instructor at Case, but have always felt that students needed to be aware of subjects that have clinical relevance, but are not available in the standard curriculum. Initially strong, support by the administration of the medical school for this approach has been decreasing in recent years, and I have also noted that medical students have become more passive and less capable of independent thinking.
This is one result of selecting students who are best suited to maintain a docile and pliable physician workforce, and in addition, few students have the knowledge or courage to challenge the narrow viewpoints of many of the faculty regarding so called "alternative" medicine.
In 2003, several students who participated in the Tribal Medicine elective demonstrated a level of diminished personal integrity that frankly surprised me. Students did not finish assignments they had agreed to, and some failed to meet attendance requirements. As a result, for the first time in 15 years of teaching, for these few students I gave out "unsatisfactory" evaluations. These students were offended that they were being held to minimal standards and vociferously complained.
I expected that the Deans of the medical school would be concerned that some students did not have enough character to tell the truth and be reliable at such an early stage of their careers, but this proved to be idealistic. None of the faculty responsible for the elective program showed any concern when provided with documentation of specific shortcomings in responsibility, character, and honesty by certain students.
I have been informed by a clerk in the elective office that approval for all of the electives I have conducted on Oriental medicine have been "withdrawn". The Dean responsible has himself not had the character to explain the reason for this decision or even respond to my request for an explanation.
If there is no integrity at the top of an organization, it is rare to see it at lower levels. In my experience, I have found that the most capable physicians are not necessarily the best at taking tests or generating income, but are those who practice with good character and integrity. There is no reason to think that these attributes are any less valuable or necessary in modern times.
These three elective courses were, until 2004, offered to medical students through CWRU School of Medicine:
Tribal Medicine
CODE: GEOM 5002
TITLE: Tribal Medicine,
DESCRIPTION: Traditional medical practice is primarily embedded in a tribal model of social interaction. In Asian cultures, this cultural fact is central to the physician-patient relationship. However, in the West this cultural aspect is not part of the training of medical students, despite the increasing interest in aspects of traditional medicines, such as acupuncture and "herbal" medicine. A Western-trained physician's effective application of these techniques can be increased by insight into the social relationship between physician and patient as members of a tribal group.
This elective will help the student understand the nature of traditional tribal medicines through an examination of three tribal lineages: the tantric yogic medicine of the Ngakpas of Tibet, a modern Japanese asymptomatic medicine lineage, and the shamanistic system of the physicians of the West African Yoruba. One goal of the elective is to enhance the student's inter-cultural sensitivity as well as increase their familiarity with patients' expectations in the increasingly cosmopolitan world of medicine.
Dr. Grotte has researched the botanical medicines of Tibet, India and China both in the U.S.A. and on field research in each of those countries. He has studied the Tibetan system under the tutelage of a senior Tibetan yogi, as well as two of the senior personal physicians to the present Dalai Lama, and has also worked closely with one of the foremost authorities on Islamic medicine, Shakyh Hakim Moinuddin al -Chishti. He is the first Western physician to be given permission to study the inner mysteries of Yoruba medicine and was the first physician in Ohio to be board certified in Chinese Acupuncture and Chinese Herbology.
The class will meet for two hours, weekly on Wednesday from 4:00 to 6:00 p.m. at the Sponsor's office in Lyndhurst.
Learning Objectives
- Describe three tribal roles appropriate for traditional as well as modern physicians.
- Describe four reasons "alternative" medicine has become widely accepted in the United States
- Analyze and present two contrasts between our present medical system and any of the three traditional tribal models examined in the elective.
Introduction to Japanese Acupuncture
CODE: 6002-224
TITLE: Japanese Medicine: Acupuncture
DESCRIPTION: The Oriental systems of medicine are the most accessible for the more than one billion people living in China, Tibet, India, Japan, Vietnam, and Thailand. Over the past 2500 years these techniques have been perfected and modified by over a hundred generations of physicians.
The Japanese, more than any other culture, incorporated the traditional techniques of acupuncture and herbalism into the Westernized system of medicine installed following W.W. II. Advantages of acupuncture as a medical tool include the ability to induce rapid changes in the neuroendocrine axes at very little risk to the patient, and the technique is relatively simple. The rudiments can be easily learned by medical personnel.
This elective will introduce students to the Japanese style of acupuncture and its use to treat a variety of common complaints. We will also examine the diagnostic systems of pulse, tongue, and hara analysis.
Though mastery of these techniques takes decades, it is my belief that students can pick up the fundamentals in a relatively short time. However, the only satisfactory text presently is relatively expensive ($40), and due to the unfamiliarity of this system for most American students, there usually is a need for considerable outside study of the text. Students would also benefit if they practice pulse diagnosis and locating acupuncture points on their own.
Students will learn the techniques of needle manipulation on each other under the supervision of the instructor.
The instructor recommends that students interested in this elective contact him before signing up.
Learning Objectives
- Describe the anatomic, internal organ, and functional relationships of 2 of 6 of the primary meridian trajectories.
- List 3 types of neuroendocrine disorders that might be treated through the acupuncture meridians.
- Know one of the two major indications for the use of moxibustion.
Introduction to Tibetan Medicine
CODE: 15022-180
TITLE: Introduction to Tibetan Medicine
DESCRIPTION: Every civilization and culture has developed a traditional system of medicine; that is, one that involves a specialized practice of diagnosis and therapy applied by individuals recognized by members of that culture as physicians. The Tibetan system has existed in a sophisticated form for at least 12 centuries and, like ours, can trace parts of its heritage to Greek practitioners.
This elective will examine the Tibetan approach to disease and healing, both to broaden the students' perspective and to explore the values and techniques of Tibetan medicine for contemporary physicians.
Special emphasis will include: Basis for health and normal physiology; Origins of disease: psychologic etiologies; behavioral etiologies; dietary etiologies; environmental etiologies; systems of diagnosis and therapy. Though our time is necessarily limited in such an introductory course, additional areas of specific student interest may be explored.
The text, which is required reading, is Health Through Balance, by Dr. Yeshe Dhonden. I recommend strongly that you obtain and review this text before you consider this elective. It can be obtained from Snow Lion Publications, PO Box 6483, Ithaca, NY 14851. Study of the text will be necessary to benefit from the lecture schedule. Regular reading assignments will be provided.
The class will meet for two hours, weekly.
Learning Objectives
- Contrast the training priorities of the American Medical School with that of the Tibetan system of training physicians.
- List the behavioral, dietary and environmental advice for one of the three major humoral disorders: rLung, mKris-pa, or Be-gan.
- Know the single most valuable tool available to the physician