Creating the Ideal Physician—One Note at a Time
- Research has indicated that activities involving the humanities—literature, visual arts and music—play an important role in building better physicians.
- Several programs at SKMC, including the Dean’s Concert Series and the Jefferson Chamber Orchestra, have become vital parts of co-curricular life and enrich the experiences of both students and members of the broader Jefferson community.
- Participation in music programming might become part of a distinction track at SKMC that would lead to a certificate in the humanities in conjunction with one’s medical degree.
In the crazy, stressful life of a medical student, there are many ways to cope—healthy eating, exercise, meditation, yoga, counseling. Michelle Sheng’s prescription for stress-relief weighs 400 pounds, has 88 keys, and the instructions are to “play p.r.n.”—or pro re nata, a Latin phrase meaning “as needed.”
It’s a good bet that Sheng’s the only third-year Sidney Kimmel Medical College student with a piano in her apartment. “I missed having a piano that I could play as needed,” she explains. “I found several free instruments on Craigslist, but you had to move them yourself. Then I saw someone who was offering a beautiful 100-year-old piano, with moving included. I had it tuned, and now I can play whenever I want.”
Sheng grew up playing both piano and violin and is a member of the Jefferson Chamber Orchestra, an informal ensemble that performs at special university functions such as the White Coat Ceremony—and occasionally as part of the 6-year-old Dean’s Concert Series. Launched in 2010 by Dean Mark Tykocinski, MD, the series quickly became a vital part of co-curricular life at SKMC. It promotes music appreciation and a certain esprit de corps for the university community, engaging audiences not only with music, but often with the performers themselves.
In an environment that’s laser focused on scientific knowledge and clinical practice, the popular weekday-afternoon series is a non-academic effort to encourage development of “the ideal physician,” according to Charles Pohl, MD ’87, associate provost for student affairs.
Nurturing the Skills for Success
SKMC already has a required humanities credit for first-year students that can be satisfied both within and outside the established curriculum. And Pohl is working to create a distinction track in the humanities—“a sort of college within a college,” he says—that would lead to a certificate in the humanities. “To successfully prepare students for the future healthcare workforce,” he says, “we need to develop emotional intelligence, empathy and compassion, tolerance for ambiguity, comfort with complexity and resilience.”
Wellness programs that teach work-life balance and reduce stress, anxiety and burnout are not just good for medical students, Pohl believes. They are lifelong skills for a successful career in the profession. “A lot of medicine is just being mindful—in the moment,” he says. The arts and humanities are “natural activities that help people achieve these qualities.”
Michelle Sheng agrees: “You don’t want to come out of medical school as a robot. I feel like we get tunnel vision and feel guilty about taking a break. All of us want to be good doctors—to learn
so we can do our jobs well. Still, there’s a part of all of us that’s still human.” For her, “music is universal—and through it I can always connect with others.”
The Dean’s Concert Series helps make these connections six times each academic year with a diverse set of programs curated by Gilya Hodos, DMA, a classical pianist and music educator who teaches at Penn State Abington.
“I’m not a medical educator,” Hodos says, “but I am completely passionate about bringing music into this setting. These concerts provide a musical respite for very busy students, faculty members and administrators.” In designing the concerts, she tries to create the intimate experience of the old-fashioned “salon,” where concerts were given in people’s homes—creating an intimate relationship between audience and musicians, many of whom are also composers.
“That’s what makes this series different,” she says.
In addition to showcasing musicians from Jefferson, Hodos books dynamic and stimulating outside groups, drawing on her contacts throughout the rich Philadelphia music scene. She works with these performers to create programs that will help connect the performer with the SKMC audiences—often including opportunities for audience members to participate in the music-making.
Hodos says the medical school audience is highly educated and sophisticated but that “much of what we bring to the series is fresh and new to them.” The Dean’s Concerts “go a long way toward creating a more holistic, multidimensional listener—well rounded, sensitive, empathetic.” To Hodos, “there’s no question that music plays an important role in nurturing these kinds of physicians.”
Some programs tell stories, like a 2016 concert that examined the life of Moritz Moszkowski, a Polish composer and pianist widely known during the late 1800s whose music is all but forgotten today. Another offering last spring featured Richard Kogan, MD, Juilliard-trained concert pianist and Harvard-educated psychiatrist, who explored the notable relationship between creative genius and insanity. Playing excerpts from the work of composers including Schumann, Tchaikovsky and Beethoven, Kogan examined their minds and masterpieces in a riveting fusion of medical and musical knowledge.
Tykocinski recently co-authored a paper examining the personal qualities that correlate with perceived leadership among medical students. The study found that peer-nominated top influencers “scored significantly higher on empathy, sociability and activity” and implied that, with the “increasing shift toward team-based, inter-professional and collaborative health-care delivery models,” physicians with these attributes “have the potential to serve as leading agents of cultural change … facilitating teamwork, solidarity and collective efficiency among the healthcare workforce.”
The role of the so-called “medical humanities” in building a better doctor has long been the subject of journal articles and conference presentations. The term traditionally referred to subjects such as the philosophy of medicine, ethical decision-making and medical anthropology and history. In recent years, however, leading medical educators have expanded that definition to embrace literature, visual arts and music—adding new dimensions to the medical school experience.
The 2015–2016 Dean’s Concert Series ended with a rollicking performance by the student-faculty Irish jig band, Bruce & The FenderBenders. Founded in 2010 by Avi Nguyen, MD ’14, the band features fiddles, flutes, cellos and guitars. “Bruce” is none other than Bruce Fenderson, PhD, professor of pathology at SKMC.
Fenderson seems to be at the center of campus-based music-making at Jefferson. An accomplished classical violinist—and toe-tapping Irish fiddler—he plays in two local community orchestras. In addition to the Jefferson Chamber Orchestra, which he organizes, SKMC also has two a capella groups—the all-male “Testostertones” and the female “Arrhythmias.”
“A lot of med students have talents in the arts and humanities—especially in music—that they developed as young people or as undergraduates. Ideally, students who aspire to medicine will continue to nurture that side of themselves, but it’s really difficult given the intensity of the curriculum,” Fenderson says, offering his own experience as an example.
As a dedicated musician from fifth grade through high school, he had a private violin teacher who “instilled a love of music and a commitment to excellence.” While playing violin in the Youth Symphonies of Greater Minneapolis, he also learned the saxophone to participate in school bands. But when Fenderson went to the University of Michigan and later to Johns Hopkins as a serious science student, he dropped the lessons and put away his instruments.
Reflecting on his life at age 40, he decided to return to playing the violin. “I realized that this is part of who I am, and I needed to get back to it,” he says. “And I knew there were others at the medical school who were following the same path.” Creating opportunities for students like Michelle Sheng to continue playing music became part of his educational mission at SKMC—and led to his founding the Jefferson Chamber Orchestra in 2005.
According to Fenderson, the unique structure of the orchestra—it has no conductor—forces musicians to listen carefully to each other as they play, to work together to solve musical problems on the fly. “You’re constantly analyzing the music in real time, second to second, as you pull it together,” he says, omitting the obvious correlation to solving urgent medical problems.
Music is Universal
Fenderson is a strong supporter of the Dean’s Concert Series—and not just as an occasional performer. “It shows the SKMC community that music is not just highbrow but universal,” he says. “The programs that Gilya puts together celebrate diversity. Some are sad and soulful; others make you want to get up and dance. It’s a really eclectic mix.”
SKMC also collaborates with the Curtis Institute of Music to provide a venue for students from each institution to socialize and enjoy two or three evenings of classical music annually.
Fenderson credits Tykocinski with the insight and initiative behind the emphasis on music-related activities at Jefferson, saying that “music creates a shared community and makes what we do more three-dimensional.” Hodos sees “Mark’s vision” as “part of his effort to broaden the humanities—to create a holistic, sensitive, empathetic person. There’s no question that music plays an important role in nurturing those kinds of people—those kinds of physicians.”
For Sheng, who recently dived into two years of clinical work and is considering a future in surgery, there’s just one 400-pound problem: “I want to have my piano with me wherever I go. So I need to make friends with someone who has a great big truck.”