On Water Buffalo and Academic Medicine
Beginning with the Han Dynasty, around 100 BC, water buffalos played a pivotal role in Chinese civilization, when they began to be used in plowing rice fields. Heavier plows and increased food production led to significant population growth. The admiration of the water buffalo in Chinese societies is evident in abundant artistic portraits as well as in the prevalent aversion to eating beef.
What has a water buffalo to do with academic medicine? The revelation dawned on me about a year ago when I became involved in a project promoting humanism in medicine. For those readers unfamiliar with Taiwanese medical education, the Flexner model of medical education has had great influence. Although basic science knowledge and clinical skills are emphasized in Taiwanese medical schools, recently an insightful advisor to the Ministry of Education urged the ministry to devote resources to restoring the centrality of humanities in Taiwanese medical education. Consequently, a renowned senior faculty member in my department was given a grant, and junior faculty members were required to share the work. Since I was educated in liberal arts, medicine, and anthropology in the United States and the United Kingdom, the lion's share of the task of integrating the humanities and social sciences into medical education was bestowed upon me.
As a student of anthropology, I have observed the Taiwanese academic medicine culture in which junior faculty members obediently address each senior faculty member as "seinsei" (teacher) and carry out research projects commissioned to the seinsei. However, I was relatively new to the Taiwanese medical schools and was not sure whether I should "go native" and take on the heavy burden.
I started to investigate the scope of the project by conducting in-depth interviews with the leadership of the 11 Taiwanese medical schools, gathering their perspectives on medical humanities education. I sought advice from a trusted dean on what a junior faculty member with two small children should do when a superior assigns her a grand task while she is still struggling to establish a foothold in academic medicine. The dean smiled and pointed to a ceramic sculpture of a water buffalo pulling a cart full of crops on the coffee table. "See this water buffalo, my favorite animal? It keeps on pulling the cart no matter how heavy the load is. Of course, if you cannot bear any more weight, you should politely let the senior know. However, it is better to work in teams. In addition, you should feel honored to be invited to join a team."
The image of the ceramic water buffalo has stayed in my mind since I began to work on the project to restore humanism in medical education. After conducting needs assessments of faculty members and students across the country, I identified faculty development to be the critical first step. Over the past year, with the assistance of experienced medical educators from distinguished institutions such as Harvard, Johns Hopkins, UCSF, Brown, McGill, and McMaster, a series of workshops have engaged over 300 medical educators from the 11 Taiwanese schools to begin to plan the longitudinal integration of the humanities and social sciences. A dozen projects have been commissioned to Taiwanese medical educators to develop and implement relevant curriculum. More workshops and projects will be planned in the next three years.
My outlook is hopeful as I begin to recognize more water buffalos in academic medicine. Together, we diligently plow the fields, turning over the surface soil to bring nutrients and aerating the soil to allow it to hold more moisture. Perhaps, one of us will survive and evolve into a seinsei figure, recruiting more water buffalos, expanding the fields, or inventing the tractor.
Beginning with the Han Dynasty, around 100 BC, water buffalos played a pivotal role in Chinese civilization, when they began to be used in plowing rice fields. Heavier plows and increased food production led to significant population growth. The admiration of the water buffalo in Chinese societies is evident in abundant artistic portraits as well as in the prevalent aversion to eating beef.
What has a water buffalo to do with academic medicine? The revelation dawned on me about a year ago when I became involved in a project promoting humanism in medicine. For those readers unfamiliar with Taiwanese medical education, the Flexner model of medical education has had great influence. Although basic science knowledge and clinical skills are emphasized in Taiwanese medical schools, recently an insightful advisor to the Ministry of Education urged the ministry to devote resources to restoring the centrality of humanities in Taiwanese medical education. Consequently, a renowned senior faculty member in my department was given a grant, and junior faculty members were required to share the work. Since I was educated in liberal arts, medicine, and anthropology in the United States and the United Kingdom, the lion's share of the task of integrating the humanities and social sciences into medical education was bestowed upon me.
As a student of anthropology, I have observed the Taiwanese academic medicine culture in which junior faculty members obediently address each senior faculty member as "seinsei" (teacher) and carry out research projects commissioned to the seinsei. However, I was relatively new to the Taiwanese medical schools and was not sure whether I should "go native" and take on the heavy burden.
I started to investigate the scope of the project by conducting in-depth interviews with the leadership of the 11 Taiwanese medical schools, gathering their perspectives on medical humanities education. I sought advice from a trusted dean on what a junior faculty member with two small children should do when a superior assigns her a grand task while she is still struggling to establish a foothold in academic medicine. The dean smiled and pointed to a ceramic sculpture of a water buffalo pulling a cart full of crops on the coffee table. "See this water buffalo, my favorite animal? It keeps on pulling the cart no matter how heavy the load is. Of course, if you cannot bear any more weight, you should politely let the senior know. However, it is better to work in teams. In addition, you should feel honored to be invited to join a team."
The image of the ceramic water buffalo has stayed in my mind since I began to work on the project to restore humanism in medical education. After conducting needs assessments of faculty members and students across the country, I identified faculty development to be the critical first step. Over the past year, with the assistance of experienced medical educators from distinguished institutions such as Harvard, Johns Hopkins, UCSF, Brown, McGill, and McMaster, a series of workshops have engaged over 300 medical educators from the 11 Taiwanese schools to begin to plan the longitudinal integration of the humanities and social sciences. A dozen projects have been commissioned to Taiwanese medical educators to develop and implement relevant curriculum. More workshops and projects will be planned in the next three years.
My outlook is hopeful as I begin to recognize more water buffalos in academic medicine. Together, we diligently plow the fields, turning over the surface soil to bring nutrients and aerating the soil to allow it to hold more moisture. Perhaps, one of us will survive and evolve into a seinsei figure, recruiting more water buffalos, expanding the fields, or inventing the tractor.