Does the History of Medicine have a role in the medical curriculum?

Among the many subjects which have fallen by the wayside in the study of medicine is the History of Medicine, at least in India. Henry Sigerist, Professor of History of Medicine at Johns Hopkins, wrote passionately for the inclusion of the history of medicine and for research into local traditions of medicine in the Bhore Committee Report.  For years, those recommendations have been observed in the breach. Nor does the “Vision 2015” document of the Medical Council of India provide for a new lease of life for the History of Medicine.  This despite the fact that a “Foundation Course” is conceived of when students join the medical course, the aim of which is to prepare the student to study medicine effectively. I would have thought the contemporary context of medicine in the light of past events would be important for this.

For medical students in India who join medical colleges at the age of 17, the lack of a liberal education background is only too evident, and has, in my opinion, important repercussions in terms of how students later develop into medical practitioners. In an attempt to embrace the new as sacrosanct, the wisdom of the past is discarded as archaic, no matter how relevant. While reading ancient Indian texts, I am struck at how much ‘rediscovery’ there is in contemporary reseearch of wisdom that has, in fact, been known for a very long time. Students are asked to practice evidence-based medicine and while this has been defined stringently for treatment modalities, the notion of such guidelines for ‘evidence’ is less relevant when we think of health or public health, for that matter, as opposed to medicine. Where in this context would ‘historical evidence’ fit in? Should we discard the ‘evidence’ that urban planning and its effective implementation resulted in the most dramatic falls in the prevalence of some diseases including tuberculosis? At a talk given at St. John’s Medical College in Bangalore, the noted medical historian, Mridula Ramanna, who has extensively researched Western Medicine and Public Health in Colonial Bombay presidency, talked about being contacted to discuss issues of plague control during the Surat outbreak. This is only one example of how a disregard for history could affect practical understanding of public health interventions.

Having run a small History of Medicine course for several years, I am no longer put off when there is a collective sigh at my first lecture. History, unfortunately, as it is currently taught in schools does not endear students to its embrace; history is seen as a litany of dates and facts, not as experience in continuum which defines who we are, what we think, what we do and how we see our future. Perhaps if we thought of ourselves and our current time as being very forgettable by future generations, we might think less of the preeminent role that we assign to the present, and pause to contemplate the past.

History as I relate to it is full of stories which inspire, disgust, intrigue – indeed evoke a whole range of emotions, and which, in the fullness of time, allow one in moments of quiet contemplation, to change.