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A Sociologist and a Philosopher Talk Medical Education · Health Ethics Podcast

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Welcome to the COVID Ethics Series podcast, a conversation with leading experts about bioethical
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issues that have been exacerbated due to the COVID nineteen pandemic. I'm Brian Pilkington,
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and I teach bioethics at Setonhall University and at the Hackensack Marinian School of
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Medicine. I moderate the COVID Ethics Series in cooperation with the IHS Library and
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IHS Student Life. This podcast is a spin off collaboration with the IHS Library
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where we'll have the opportunity to go deep with the experts from our series.
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Thanks for joining our conversation. Thank you for joining us. This is the
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COVID Ethics Series podcast. My name is Brian Pilkington, and I teach ethics
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at the Hackensack Meridian School of Medicine and at Seton Hall University in the School
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of Health, of Medical Sciences and the College of Nursing. It is my
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great pleasure to be speaking with Frederick Hafferty today. Fred Hafferty is Professor Emeritus
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of Medical Education at the Mayo Clinic. He's also Professor of Meritus at the
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University of Minnesota Medical School. Adjunct professor at Yale University and currently Senior Fellow
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at the ACGM. Fred, thank you for joining me. My pleasure,
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Brian, looking forward to the conversation. So, Fred, you have written
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a ton and so much around medical education. But I am sure that just
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about everybody who pops on this call, students, faculty, folks interested in
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ethical questions around COVID, will know you, for better or worse, as
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the person the father of the person who found the hidden and created the hidden
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curriculum in medical education. So you drew medical age educator. There's attention to
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this geez over thirty years ago now, and I think at least one in
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three, anecdotally, one in three conversations I have about what we can do
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to fix medical education always comes back to the hidden curriculum. So the impact
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has been overwhelming. Because of the kind of podcast this is. I want
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to ask a sort of broader question which is coming out of this What does
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sociology broadly have to do with medical education and can it fix medical education?
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Not much? I don't know if you want me to be sustinct in terms
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of answering the question, what does it have? What does sociology have to
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do with medical education formally speaking, in other words, does it have a
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formal presence? And I think the answer is no. And in terms of
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fixing again that people in medical education turning to either sociologist or sociological frameworks for
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fixing medical education, I think the answer is no. There as well,
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that wasn't always the case. In the nineteen fifties, sociology as sociology and
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sociologist as sociologist meaning identified as a sort of card caring members faculty in sociology
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departments were very much involved in issues of medical education, both in terms of
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contributing to its subject wise, but also in terms of studying it. So
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two very notable sociologists, not medical sociologists that didn't exist yet, sociologist Robert
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K. Merton from Columbia and Howard Becker, were involved in major studies of
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medical education. But what sometimes gets overlooked is that Merton and his team and
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his team spawned a number of very notable medical sociologist Sam Bloom in a Fox,
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how Gear was looking at medical education as a place from which to examine
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the theoretical framework of structural functionalism. Meanwhile, I ever see Hughes and under
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him Howard Becker wound up doing the same kind of study different school Kansas,
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from a symbolic interactionist perspectives. So you had these two major studies that did
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have a lot of impact on medical education, but they were headed up by
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medical sociologists that Becker in many respects and Merton in many respects never returned to
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issues of medical education. It is just the place where they were looking to
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examine issues for me, in structural functionalism, Pubecker symbolic interaction and this sort
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of warring frameworks or competing frameworks for examining social phenomena in this case medical education.
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So heavy involvement early on and then in the late nineteen sixties early nineteen
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seventies, and I'm almost identifying a sociological way of thinking about things that starts
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with history. How do we locate whatever it is we're talking about, where
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did it come from? And one of the places that anything comes from has
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to do with time. There was an effort by Robert Strauss in setting up
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the first department of behavioral science in a medical school in the country at the
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Universe City of Minnesota, and Bob had a particular vision and version of what
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would represent this thing that he liked to refer to in a singular as behavioral
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science, not the behavioral sciences, but behavioral science. And that was a
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framework while looking at issues of health, social factors and health and the like,
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using three primary disciplines sociology, anthropology, and clinical psychology. And Bob
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structured his department around those three disciplines and faculty representing those three disciplines. And
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it was Bob's hope that over time this thing, behavioral science would populate across
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medical schools in the US and come to represent a way that the sciences social
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sciences within medicine medical education would be represented by a departmental structure, so having
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a physical and organizational place in the medical schools. And long story short,
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as far as I'm concerned, it didn't work. There was a rise,
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There was a national organization Association Behavioral Science and Medical Education. There was a
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journal associated with that organization. There was population national boards had a behavioral science
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segment. All these kinds of institutionalization factors that said things were moving in the
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right action. But over time and for a variety of reasons that it lacked
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traction, and bit by bit it disappeared There is only now one department of
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behavioral science left in the country, and that's at the University of Kentucky.
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But it's structured far differently than it was when Bob Strauss initially put this into
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action. So long story in which, at one point in time, sociology
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formally was to be part of a trilogy of academic disciplines that was supposed to
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have an important impact on both the content and the consequences of medical education,
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so sociologically informed graduates of medical school. But it didn't happen over time.
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Yeah, I think that the history is super helpful and clean this up for
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me. So I've got this sort of rough and ready sketch. We've got
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sociologists externally right, thinking about medical education as an interesting set of subject matter,
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sort of stage one, stage two. Then right, we've got actually
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this realization that future physicians, or maybe we'll speak more broadly, future healthcare
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practitioners would benefit from a sociological understanding. And then so it moves into and
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this is where I need the correction. It moves into the aims are for
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formal curriculum to involve or help students in framing the world sociologically. Is that
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yes, yes, and that was going to be the legitimation everything that you
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were just articulating and doing so much better than me. It's and I mean,
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this is super interesting now because you're talking about fifty sixties, seventies,
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and it's it's interesting to think about the role that and I know this is
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not a new concept, but maybe you can speak to it the role that
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the social determinants of health are playing now in medical education and broader ethics conversations
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with earlier roots, or even just the constant discussion within medical education of the
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importance of teams and TeamWorks in light of the idea that this is a little
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bit sloppy, but physicians, nurses, speech language pathologists aren't delivering carret.
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The team delivers the care. So it seems like, I mean, help
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us think through were these good ideas to have students thinking sociologically but didn't pan
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out? Did they sort of pendulum swing one way and then come back now?
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Sort of? Yeah, give us a take. That's a great way
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to flame it. Give us a take, because I don't think I have
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any particular deep insights, but your rearticulation and a better articulation than I gave
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you does take us back to the hidden curriculum framework, because what happened to
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Bob's dream, And again, it was a dream built around three different subject
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areas. And by the way, that first department, which was my first
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job, also did have somebody in it who taught ethics. It wasn't part
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of Bob's triumphrate, so to speak, of sociology, anthropolitan and clinical psychology,
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but it was there. But what went wrong? It ran into the
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hidden curriculum. It ran it behavioral science, ran into the structure and the
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culture of medical education. And in spite of the fact that Bob was able
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to get it, it behavioral science into the curriculum. Well, what else
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was in the curriculum? What was I teaching up against? Wow? I
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actually was teaching a course called medical sociology in my first job, because that
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course had already existed prior to my coming on board. But when was it
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scheduled? Scheduled against anatomy and biochemistry? Well, who's going to spend their
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time studying about medical sociology when there are all of these more important things?
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Well? Who said they were more important? The structure and the processes within
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the school itself? And so we had. There were so many different messaging
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that went on within the curriculum. We had a course called Conjoint Sciences and
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I can't remember, let's say it was once a month where all of the
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basic sciences and the clinician and a patient came together around some clinical problem,
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with everybody getting to weigh in on how their subject matter. So again,
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all of these discipline based subjects, biochemistry, physiology, pathology, what those
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subject areas had to say about this particular clinical scenario. Okay, when did
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behavioral science when was it slotted within that space last always? So did you
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always have time to talk? No, Sometimes that time just ran out,
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or you got to say, Van, there is behavioral science relevancy here and
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that was all you got to say. So maybe that's what got me interested
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in a very practical way. I'll give you another one since you were talking
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about ethics. But that's that's how I think Bob's dream came face to face
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with his success was being able to have the department, a formal department in
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the medical school. Good for him even for equal space and equal time and
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the curriculum, but the time versus how that time played itself out, And
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it's competing spaces made for a very uphill climb, so super helpful and it's
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really interesting, um, the interplay between sort of associate well and again being
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sloppy and forgive me, but sociological content and then the sociological reflections about sociological
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content of medical education, then the sociological reflections on medical education, and so
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yeah, the kinds of things you think about just when of course gets scheduled
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for right, things that seem so basic or what it's up against. What
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so suppose things had worked out differently? Oh see, there you go,
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right, So well, Louise, I'll take a step back because this is
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a sort of gazing in a way, But what if things had worked out
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differently, if they had gone well for your colleague's dream, What was supposed
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to be the benefit for future physicians? What was the good right? What
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was the virtue of medical education for having behavioral sciences? Or right? That's
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something else in the placeholder focus on sociology or ethics or professionalism. I mean,
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I'll tell you a story about how important it is for physicians to be
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ethical, and I think I have good arguments there, But what was thinking
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sociologically supposed to do? I think it was supposed as medicine was being both
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praised and criticized. This always in many cases I should say two sides to
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any particular story. So, as medicine was being praised for the wholescale advances
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in science, I was born and I am old. I was born before
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antibiotics were widely available within the public patient population. I mean they existed,
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for sure, but in terms of being widely available or born before polio vaccines
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or any so, the the imagination or what science could do was incredible back
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in the fifties and the sixties, and what we were going to be able
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to conquer and the impact on both life and well being within the counterveiling question
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of yes, but are we losing the human element? How are we going
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to connect science to society, to the different And it was recognized back then
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the differential impact of healthcare on different populations within society, so social factors in
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health and disease. That was one thing that the behavioral sciences were supposed to
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better inform, not just medical students, but medicine at large, to better
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appreciate that. As science dashed forward, it seems like everything was at the
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speed of light. That they not forget the social context within which all of
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this was supposed to play itself out. So we might come up with all
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kinds of cures, but how are we going to be able to deliver any
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of this? Fast forward two three years ago COVID and on the one hand,
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vaccine development incredible. Wow, how could it have been done faster?
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And yes, I know there was foundations had been built all the way along
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blah blah blah blah blah blah. But where was the rub? The rub
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was in terms of setting up the distribution for vaccines. It was getting the
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supplies out there, It was convincing people that the vaccines were good. It
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was so many social even if you wanted to call it social engineering, but
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social factors was the rub. So here we are. Well, let's see
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fifty years post this notion that behavioral sciences and or social factors in health and
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disease are important, and we're still watching the social aspects of things being in
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some respects far more consequenceal or far more problematic than the science side of the
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equation. So we can come up with all kinds of elegant solutions, but
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we can't or we have more difficulty putting them into practice, and now that
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so much of healthcare has been politicized. On the one hand, it's a
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healthcare nitemia. On the end of hand, it's a sociological fantasy. It's
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like, wow, look at what we get to try and understand now,
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yeah, yeah, I mean, there's there's so much here. My questions
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are pulling me in two sort of very separate directions. One is sort of
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the medical education focus. So what kinds of things do we want medical students
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to know? In terms of this, right, where are the fights that
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the sociologically informed or even the sociologists who's interested in medical education wants to really
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say, no, no, I'm putting my foot down. This has to
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be in the formal curriculum them, right, the fight for actually what institutions
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say matters. So that's one set of questions, right what really needs to
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And the other set of questions has to do with broad questions of medicine and
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society. And I mean, should medical students, should physicians be worried about
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some of these kinds of things or is it just beyond their scope I mean,
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not official scope of practice, But isn't I mean, whether vaccines don't
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scientists develop the vaccines, and the delivery has to do with you know,
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folks who understand how supply chains work in all this interesting collective action problem.
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But it's yeah, So two sets of questions. Pick one. You want
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to go medical education and you want to fix the ills of society. First,
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I guess I feel more comfortable, but perhaps I shouldn't within medical education.
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And I'll try to be somewhat sociological and answering your question of is it
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important to have some understanding of the social determinants of health and disease? And
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then the operative word in there is some and how much and of what kind?
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Etc. And as you were asking the bigger questions, I wasn't don't
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know why. I was reflecting on how might it come to be that I
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would adopt And since I'm a sociologist, I'll just say sociological framework, but
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there could be anthropology and there there could be psychology. How might I come
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to do this well? With great difficulty, because if somehow I wanted to
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obtain some in depth or specialized insights into sociology and what they might have to
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say about issues of either medical education or health and disease, how would I
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go about doing it. I could get an mdphd. I could be a
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physician sociologist. Do you know how many mdphds there are with a PhD is
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in sociology relative to other kinds of disciplinary threads, And it's a rhetorical question
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which I can safely answer, not many. Do I know the numbers?
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No, I don't, But I do know that if you were to apply
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to an MD PhD program, which by the way, has benefits, and
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that now your tuition cost etc. Are for medical school or nil, you're
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part of a a financially supported degree track program mdphd. So I go looking
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around the sea. Because I really am interested in sociology, which makes me
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an odd vault to begin with, I go looking around for mdphd programs where
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I where that program track within the medical school has formal relations with the Department
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of sociology, and where I can pursue that track. Not many, many
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more opportunities within what I'm going to call the biomedical sciences and different aspects of
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genetics. So my ability to track in that direction is severely hampered by a
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lack of pathways. Oh well, fine, so let's just say and I
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have a bit of an academic orientation, and so I'm going to pick up
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a PhD in sociology post my medical training. Well, I've gone to medical
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school, I've gone to residency, and then because I have a bit of
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an academic orientation, somewhat subspecializing, and then I'm going to pick up a
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fellowship And now I'm seven years out and I have crushing let's use that word,
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crushing debt. And now I'm going to go out to where get a
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PhD in sociology and pay somebody else but that degree or it doesn't work there
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is the system isn't set up for me to be an MD PhD sociologist.
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So I can get some back to my words, some understanding of course here,
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of course there, But I can't. I can't do anything. I
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can do deep dives only with great difficulty. Maybe. And now I'm being
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snarky and intentionally snark I'm independently wealthy. I don't have to worry about all
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this kind of stuff. But if I'm coming from populations groups that fall under
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or have some relationship with the downsides of social factors and health and disease,
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so underrepresented groups, etc. You've just had multiple barriers go up. It's
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almost unimaginable. And I'm going to do this, this kind of thing where
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I'm going to develop some sociological framework. Anyway, ask me another question,
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So super helpun you've I don't know how helpful, but you're pushing my thinking.
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Why would anybody in their right mind want to be an MD sociologist?
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Well, let me phrase the phrase of the question, or sort of push
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the conversation in this direction. Please save me from myself from your points before,
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right, I mean, so COVID has been terrible and sort of pervasively
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terrible. All sorts of folks have been affected by it, and many since
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you mentioned marginalized communities, many folks from marginalized communities affected even worse. Right,
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so pre existing ills exacerbated in COVID. We've got this history in medical
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education of thinking about the social determinants of help in the sixties. It's now
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become more common, we'll say, for folks to talk about this. Suppose
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someone who's interesting going to the medicals because says medical school, says I want
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to fix what happened with COVID. I don't want this to happen again.
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And they think, well, we should get a vaccine. But then unfortunately
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they bump into Frend Hafferty and he points out all of these sociological or sorry,
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all these social challenges, right, So yeah, he's a bummer,
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he's got a negative orientation here. Oh I all right, here's a question
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for your group and a potential for a study. Early on, let's just
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say midpoint in the past three years, so year by year and a half
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ago, we were starting to hear about the Boucy effect in terms of medical
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education, and that is the increase in applications to medical school as individual supposedly
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for the increase in applications just there, and the speculation that that preas is
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being driven by the Fauci effect, now putting it air quotes surround it,
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because then the interpretation and that is the concern with the public health side of
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the COVID catastrophe, and that more understanding and more work needs to be done
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on that side of the equation. Okay, that's a hypothesis that whether it's
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it's Boucy as a symbol or as a person. People saying, and I'm
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being somewhat glib again, be like Mike, be like Fauci. Okay,
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is that the case we can go, we can do a prospective study and
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start looking at that bump and applications and perhaps first step any differences and emissions
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with respect to where that bump was coming from. Let's just say that the
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bump was coming from applicants who had more of a social determinants of health orientation.
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All right, did this lead? So that's first question, first answer,
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And then let's say the answer to that is yes, yes, more
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applicants with a social factors and health and disease orientation, and more acceptances extended
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to those people. So now we have a new cohort coming in a cohort
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bump into medical education. How does that play itself out within the context of
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medical education. Does that bump collectively somehow impact on what goes on in the
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medical education context. Does it challenge traditional educational practices? Does it? Do
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they serve as a disruptive force? Can you see measure account for changes within
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education their education or the education of subsequent cohorts? Second, or third or
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fourth, I've lost track of the number? Is well, how many more
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people going of those going to public health? I mean, we have had
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a traditional structure within this country of public health being a second class citizen within
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the overall healthcare community. And it's there tertiary care or more hospitals, there
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outpatient clinics, and then there's the kind of community health, and there's the
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public health. And so are more people going in you can count? You
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can? Are they more md MPH programs and more than just Masters of public
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health programs? How has masters and doctoral degrees in public health changed post COVID?
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Have they reoriented themselves in terms of what's seen as important and what it
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means to be a public health professional. We can look at all of those
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kinds of things, and as far as I'm concerned, those are all very
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sociological questions, all driven by this impart speculation, And I think it is
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speculation that, oh, we have a Fauci effect going on in the in
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the arena of medical education. Well, I would think that in about maybe
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this isn't exciting, but in about fifteen to twenty years we will have an
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answer to that question, or we will have answers plural since I don't believe
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in an answer to just about anything. But oh, we haven't even gotten
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around to the issue of does anybody think that this is important? To study.
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Maybe not. Maybe it just happens or doesn't happen, and nobody knows
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whether it happens or doesn't because it's not considered to be an important question.
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I think it is, but I'm not going to be here in twenty years,
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so it well, I agree with you. I think it is.
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And it's not just you. There's probably the three, four or five dissertations
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that could be written by folks who might hear this and say I really want
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to do that mg PhD in sociology, or just I want to think about
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these sociologically, but what about super helpful good background? And maybe we do
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get more folks interested in training and becoming physicians in light of the Fauci effects.
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Maybe they push for additional content or different kinds of content to better inform
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them wherever they want to go. And that's where I want to pull us
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back to it. So pressure on an already packed formal curriculum, not maybe
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by just the students who say, hey, I want to be about you.
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That's how I want to fix it, but just who want to be
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or who are of the mindset to be more sociologically informed. So being sociologically
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informed means understanding just what you were saying, that the formal curriculum is a
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contestable and contested space. You have only so many hours. However, they
38:27
can be allocated and then configured within the allocation. We were talking earlier about,
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well, where within the curriculum do you appear up against whom you know,
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by the way, just to have fun. When don't you want to
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teach? What's some time slots during the day that at the No, I
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don't want to teach that. That's the kiss of that. That's the curriculum
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slot kiss of death. Every slot is a welcome slot. I mean,
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you know this. They're all great, but it's I'm having fun. I'm
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just teaching. No, this is good because I used to think it was
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right after lunch. I don't want to be teaching right every else, but
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I have got to learn it's actually in my limited experience relative to other classes
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and courses the students have and that content. So if there's an exam somewhere
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else the week before the week after, I don't want the big ethics lecture
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then, because that's just not when folks are so I think it's relative to
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what else is going on. I like that answer relative to what's going on.
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Back to the contested space, I mean faculty, as much as they
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might moan and groan about how many hours they have to teach and all of
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those kinds of things, they'll fight over curricular time in part because it's viewed
40:07
as a marker of either their personal importance or into the importance of their discipline
40:19
within the medical education space. So one thing that has been a constant in
40:27
medical education has from for me since the seventies, but I'm sure it goes
40:32
back further, has been fights over who gets what kinds of space within the
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curriculum. So back to Bob Strouds big victory. He got space within Kentucky's
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curriculum for his projects behavioral science where it didn't exist before, and he couldn't
40:54
point to any place else and say, well, have it's doing it,
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so you know we can do it. No, it wasn't doing it.
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But it doesn't make any difference what the topic is. When I came into
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medical education, hot topic and my dissertation was on it, so help me
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get hired. Death and dying. Everybody had to have a death and dying
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or you know, anacology whatever was going to be called had to have it.
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Find me a medical school. Maybe they exist, but not many.
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You know, sociologists like to rummage around abroad numbers. So I'm just gonna
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say, find me a medical school it has a death and dying course today,
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And if they do, it's under constant attack because now pick your subject,
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climate change, diversity, oh, social terminants of whatever it might be.
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You keep on nutrition. We have to be teaching our students about nutrition.
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And part of teaching about nutrition is what and this is something we have
42:15
been talking about earlier, meaning before today, Prian, How does students know
42:23
it's important? Yes, it's important for integrate a curriculum to integrate things,
42:32
which is in some cases another way of saying make relevant. But part of
42:38
the way that students know that the school is telling them it's important is that
42:45
there's a course with this name, so so factors in climate health and let's
42:52
kill two birds with one stone now, and that somehow they're examined on it.
42:59
You know, it's is another hidden curriculum factor. It's like, well,
43:02
it's not just at this subject, are you testing us on this?
43:07
And it's not just that the school's testing Well, there's this thing, step
43:12
one, step two is it on the boards, And all of these are
43:19
sources of messaging about importance. And so okay, fine, it's it's nice
43:30
because I don't want to use the word important again. It's nice that climate
43:34
change has a presence today that it didn't have twenty years ago. And whether
43:40
it makes it into the front lines or maybe the second line of curricular content,
43:50
the battles are going to continue. That is a constant for me of
43:54
medical education is fights over what should be in the curriculum and therefore what needs
44:02
to go. And I was hired to teach a death and dying course which
44:09
maybe lasted, perhaps because of my bad teaching, another three or four years,
44:15
and it got replaced by something more important. Noah, death isn't important
44:23
enough anymore. We have to find something else now. Of course, the
44:28
whole topic of death and dying keeps on being we visited home. We need
44:31
to figure out better ways to facilitate dying, and and there are waves in
44:42
the popularity or the visibility of certain topics. I'll stop. Yeah, no,
44:49
no, that's that's how we'll It's going to be a bit cheeky.
44:52
But you can't be that old because I actually taught a course called death and
44:58
Dying within the last few years. Yeah, yeah, that was good.
45:06
That was good. But it was under the auspices of a philosophy department as
45:10
a medical ethics course. It's not in a medical oh a cripple kiss of
45:15
death, the goosophy medical ethics, and then we come to the topic definitely.
45:21
Yeah, so that but not, to your point, not in a
45:23
medical school. And we're oh, geez I see, not in a medical
45:27
school. No, no, no, this isn't under the auspices of a
45:30
philosophy department in a separate of the related um institution. So this is UM.
45:37
It's interesting, and I'm I'm going to get you out on one question
45:40
because I just saw the time. I mean, it's too interesting to talk
45:43
to you where we're running out of time. But this has been thank you,
45:45
this has been so helpful. We've got historical framing of sociology externally thinking
45:51
about medical education than the importance of sociological thinking that might be too much.
45:55
Understanding social factors within um within medical education as a way to improve patient care.
46:04
Pendulum swings back and forth. What folks care about hidden curriculum, formal
46:07
curriculum, I mean this is in some ways, I think, the first
46:12
of a master class, right because we might have raised more questions than we've
46:15
answered. But Fred Thanking, this has been super Helvil. You're gonna have
46:20
to let me con you into coming back on so we can pick up some
46:23
of the hidden curriculum themes, themes about marginalized populations, the formal curriculum.
46:29
I mean, there's there's so much here, and it's so interesting to think
46:31
about how all of this gets I need a better you know, metah,
46:37
but sort of thrown into the blender and coming out in a way that patient
46:42
care is improved, right, because that's what folks really want. And then
46:45
there's all these fights to sort of get it going. But leave us,
46:49
leave us in the audience with a final epic thought, what I know,
46:53
I know what? Or give us an epic thought, what are they going
46:58
to be thinking about until the next time they hear you ask him a question,
47:00
tell him to read something. UM, what's leave us with with a
47:05
homework assignment? A homework assignment? UM that is a copy I I'm I'm
47:24
not inclined to say anything about ah, anything that I've written. UM,
47:37
I'm trying to come up with and I'm just blocking on the exact ah ah
47:57
um, I'm coming up with. Oh, I want to come up with
48:12
the title of a article that I would like to suggest to everybody, and
48:23
bear with me since I wasn't at all prepared for this one due to the
48:30
failures of the host who invited you on. Um bretty, you can just
48:36
say anything Brian's written. That's fine, there's no all right, well,
48:45
oh I happened, since I know all of this can be all us dead
48:52
space. Well, ye take your time a week. We thank Allison for
48:59
around thing. I mean you, well, I just wanted to an ending
49:05
thought or question and we can edit out the homework assignment bit too. Or
49:09
I mean you mentioned Renee Fox before you tell folks to go read. We've
49:14
got um. I've always liked Pulse Stars social Determinants, not such Social Transformation
49:22
of American Medicine. You're hidding. Curriculum paper is great, um, but
49:25
I can plug all those um after two. I mean the ah the Social
49:37
Transformation of America Medicine has a wonderful subtitle that sometimes gets forgotten, and now
49:45
I'm blocking on that as well, The Rise of the Solemn Profession. I
49:50
believe sovereign sovereign thank you, yes, yes, the Rise of the sovereign
49:54
profession and h they it has what for me is one of the great opening
50:07
sentences of any book, that something like the dream of reason forgot to take
50:14
power into effect. And I, um, I think that is wonderful.
50:23
I'm I'm going to get to you. Uh whether Uh wait a second,
50:37
here we go, Um I'm looking for yes, here it is uh so.
50:49
The author's name is Kuma Guy Ar no A r n O k U
50:54
m A g Ai and it's a paper an academic medicine called something like making
51:07
Things Strange. Oh yes, making And here I'm plugging something other than sociology.
51:14
It's called Making Strange a Role for the humanities and medical education. Two
51:22
of my favorite writers are no Koma Guy and then the Least Were. But
51:30
the title is very sociological in that it asks you to take accepted wisdom and
51:44
make it strange, just question it and asking in what ways is it accepted
51:52
and should it be? And in some cases it should be, but in
51:55
other cases it does represent vested into and power and having that mindset of being
52:06
willing to question and reflect on what is gives you the potential for both dreaming
52:20
and then operationalizing what should be brother worth the weight. It's super helpful suggestion,
52:30
and unfortunately we run out of time or I mean, that's just an
52:35
issue close to my heart and all all of what we've talked about previously on
52:38
the need for medical education to have more philosophy in it. But that'll be
52:45
for another time. Yes, yes, another time. Can I interview you
52:47
on bringing philosophy to medical education? Well maybe you could. Students are telling
52:54
me about this. You can have podcast takeovers, so you can take over
52:59
this podcast weekend, flip the script. I think that would be wonderful because
53:06
you've certainly opened up my mind. See the sociology part would say, looking
53:14
at medical education, not what is there, but what isn't there? And
53:20
that, in some sense is the null curriculum issue. And then why and
53:29
as our conversations have been before, it seems like the constant notion of philosophy
53:35
and medical education has more traction within UK medical education than it does US medical
53:43
education. And so where has philosophy been and and how come it's operationalized under
53:52
the label of ethics yea, And whether it's operationalized well or not as yet
53:59
another question. So yes, I want to interview you about the role in
54:05
place of philosophy in medical education. Well yeah, no, that'll be fun.
54:12
Well we'll figure it out, but Fred, thank you so much for
54:15
the time. Everyone you're listening to the covid Ethics podcast. I am Brian
54:20
Pilkington and it has been my great pleasure to have Frederick Haafferty on Father of
54:23
the Hidden Curriculum and I'm not rereading the amazing bio, but please do check
54:29
out the article that he suggested making Strange a role for the humanities medical education,
54:35
as well as his paper on the HIDD curriculum I think from ninety four,
54:38
but we'll make sure all of the links are posted on the website.
54:43
So thanks for tuning in and Fred, thanks for the time, my pleasure.
54:46
See you later. Thank you for listening to this episode of the covid
54:51
Ethics series podcast. Be sure to check out video versions of our episodes online
54:55
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