Spirituality Courses Become Part of Medical School Curriculum

BUFFALO, N.Y. -- Along with memorizing body parts and learning to diagnose and treat diseases, medical students in the University of Buffalo School of Medicine and Biomedical Sciences are being introduced this fall to a new set of courses incorporating spirituality into their training to become physicians.

Restoring the heart and humanity of medicine is the goal of the new four-year curriculum -- Spirituality in Medicine Interdisciplinary Training Program -- developed by David M. Holmes, M.D., clinical assistant professor and associate vice chair for medical student education. He also directs UB's family medicine clerkship and electives.

Development of the new curriculum is being funded by a $50,000 Templeton Grant from the George Washington Institute for Spirituality and Health at George Washington University.

"Many patients have spiritual beliefs that affect their health and well-being," said Holmes. "According to a 2004 Gallup poll, 90 percent of American adults believe in God, and 84 percent say that religion is very important or fairly important in their own life."

Spiritual practices have also been shown to be associated with fewer hospital days, less depression, less substance abuse, lower blood pressure, greater sense of well-being and more, he added.

"Spirituality in medicine research took off in the 1990s and is still going strong," Holmes said, "with the majority of studies demonstrating a positive association between spiritual beliefs and practices and health."

He noted that both the American Association of Medical Colleges and the Joint Commission of Accreditation of Healthcare Organizations have issued policy statements saying that physicians need to understand a person's spirituality and culture, how they perceive health and illness, and particularly their desires regarding end-of-life care in order to communicate effectively with patients.

Karen Devlin, who will manage the new program, added that understanding the impact of spirituality and culture on their patients also guides the physician regarding compliance with treatment recommendations.

The importance of such understanding is presented starkly in "The Spirit Catches You and You Fall Down," a book that chronicles the trials of American doctors attempting to treat a Hmong child with epilepsy who comes from a culture that considers her seizures as a sign of a special connection to the spirit world.

The Clinical Practice of Medicine course during the first year, when students work in out-patient settings, will include studying the doctor/patient relationship in the context of spirituality, and learning how to use spirituality as a tool in treating patients and in guiding the student's own experiences.

During the second year, in which students work in in-patients settings, the course will incorporate the role spirituality plays in the compassionate care of patients, and will focus on how to "care for the caregiver," which involves dealing with stress management and the suffering of patients. Students will learn how to ask patients about their spiritual beliefs and sources of support during a workshop on delivering bad news to patients, and will consider how their own sense of calling to the medical profession is expressed in their actions and values toward patient care.

Concepts of spirituality and faith also will be added to some of the third-year clerkships. Students will spend time learning the hospital chaplain's role in health care and when to refer patients to them, learning about the role of spirituality in end-of-life care working in Hospice and meeting with leaders of different religions who will discuss their beliefs about end-of-life and after-life.

The fourth-year curriculum already offers a popular elective, "Faith, Medicine and End-of-Life Care," which includes journal writing and clinical experiences with physicians, Hospice chaplains and chaplains who care for HIV patients.

The role of spirituality and health care in underserved populations will be added to the elective "Interprofessional Care of Medically Underserved Populations," an evening elective open to students in UB's five health-sciences schools. Interested students also may have the opportunity to do research in spirituality and health care in areas such as addictions.

The Spirituality in Medicine Interdisciplinary Training Program will remain a permanent part of the medical school curriculum.

The University at Buffalo is a premier research-intensive public university, the largest and most comprehensive campus in the State University of New York. The School of Medicine and Biomedical Sciences is one of five schools that constitute UB's Academic Health Center. UB's more than 27,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities.