Spirituality and Medicine Curriculum

Health is a state of well-being embracing not only a person's physical condition but also emotional, psychological and spiritual life. We know from polls and from clinical experience that spiritual concerns are often at the heart of patients' understanding and acceptance of illness, and of their attempts to make sense of suffering, endure the ordeals of illness and treatment, and to find healing. While medical practice in recent decades has emphasized the application of science and technology, with cure the goal, the spiritual dimension of health and health care can recall physicians to medicine's duty to respond compassionately to suffering and heal in a broader sense. Patients benefit from this expanded understanding and health care practices that follow from it. Engaging the spiritual dimension of health and health care can also help physicians and physicians-to-be maintain balance, better understand their calling and capabilities, and better appreciate their limits and life's work.

While spirituality has long been considered part of the art and morality of medicine, until very recently American medical education has addressed the subject only implicitly. In the last twenty years, however, medicine has renewed attention to the patient-physician relationship, to the life-context of the patient's illness, to the complicated choices facing patients and their families, and to more holistic ideas of health and healing. Medical education has broadened in response, so that we are now teaching young doctors that health is grounded in more than biology, that healing often entails spiritual as well as physical transformations, and that a good practice of medicine depends upon physicians' awareness of both their patients' and their own spirituality.

Since 1998, the University of Virginia School of Medicine has had a curriculum project in Spirituality and Medicine. Based in the Program of Humanities in Medicine and directed by Margaret E. Mohrmann, M.D., Ph.D., and Marcia Day Childress, Ph.D., this curriculum project is introducing into all four years of medical student education some formal teaching and opportunities for informal discussion of spirituality, broadly defined, as it applies to patients and to physicians. A broadly representative Spirituality and Medicine Advisory Board assists with the project. The project is funded by a four-year Templeton Curricular Development Award from the National Institute for Healthcare Research (1998-2002) and by a two-year grant from the Fannie E. Rippel Foundation (2000-2002).

The Spirituality and Medicine Curriculum components are listed below. In each instance, instruction in spirituality and medicine involves exploration of the role spirituality and religion play in the patient's understanding of illness and healing, and also examination of how the physician's own beliefs may influence his or her approaches to illness, healing, and his or her own professional life.
  • First-year medical students receive introductory instruction in spirituality and medicine and discuss the topic in small groups as part of the required course on the fundamentals of the patient-physician relationship, The Practice of Medicine.
  • Second-year medical students will continue to explore issues of spirituality, in the context of case studies used to teach principles of diagnosis and treatment, as part of the required course, The Practice of Medicine II, when this course begins in 2001-2002.
  • Third-year medical students on clinical clerkships participate in periodic, mentored conversations about spiritual and ethical issues arising in their clinical work. These Clinical Conversations take place on the Clinical Connections Days that bring all third-year students back to the medical school for special multidisciplinary programs organized around clinical themes.
  • Fourth-year medical students may choose an elective course , Spirituality and Medicine, that is a four-week, in-depth study of spirituality in medicine. The course is offered through the Program of Humanities in Medicine. Several other medical humanities electives - including Religion and Medicine, Complementary Therapies for Health, Suffering Seeking Meaning, and Death in America/Palliative Medicine - also explore spiritual dimensions of health and health care.
  • Twice each year, The Medical Center Hour explores issues or current controversies in spirituality, religion, and medicine. This multidisciplinary forum sponsored by the School of Medicine welcomes not only medical students, faculty, and staff but also the entire University community and the public. The Spirituality and Medicine Medical Center Hours feature speakers of national repute.