The biomedical model is a long-standing approach to medicine supported by Hippocrates in the approach to the physical etiologies behind diseases but criticism lies in its failure to distinguish the difference between disease and illness. Often students, especially in pre-clinical years, reduce a problem observed in a patient to its disease’s pathomechanism and biomolecular background and are ineffective in understanding the experience of the illness.(Sadigh, 2008) I believe the quote by Cassell effectively explains this as ‘One cannot expect doctors to attend to sick persons as persons if they cannot describe them’. An illness is not just the physical change that occurs within an individual but it is the multitude of feelings, behaviors, and perceptions that make it so subjective.(ÁRNASON and HJÖRLEIFSSON, 2016)
But how can we mitigate the reductionist approach used in medical schools worldwide, one of the biggest things I believe that can be explored is developing case based learning in all parts of preclinical studies, the well known phrase of ‘putting a face to a name’ is a great example of how medicine is best taught through the lens of the individual who burdens the disease. This is not just viable in classroom settings but in the textbooks and medical literature which are used as sources of learning, each topic should be presented in relation to the clinical setting that it could be seen in. My own personal example of how effective this was during my first year of medicine, I was tasked to create a presentation on the biochemical process of Lesch Nyhan Syndrome. Having no previous knowledge of this disease, I reviewed the mechanism of the disease through medical textbooks and internet articles but it was only through a documentary that explained how this syndrome affected a 7 month year old baby and the effects that it had on his family where I was able to fully contextualize this syndrome. To date, this has been one of the most fascinating aspects of medicine which I have learnt about, because I am able to relate this individual’s experience to a complex biochemical pathway.
Person centered approaches to clinical curriculum are seen in today’s modern medicine with the development of osteopathic curricula which emphasizes the role of holism in medicine. Although principles are similar to the Hippocratic Oath, the Osteopathic oath’s main principle entails that the ‘body is a unit, the person is a unit of body, mind and spirit’, they have the intention to include all aspects of the patient, not just the symptoms. This approach will be useful to integrate into many more medical curricula worldwide rather than the select few, they produce students who are able to approach clinical scenarios more easily and regard cases as integrated pathways to reach a successful decision. (Advocatetanmoy, 2022)