The Armstrong Scholars curriculum starts in the first year of medical school with the interprofessional elective, Moral Movements in Medicine, which develops foundational skills in radical listening and interprofessional engagement. Each subsequent year of the Program builds on these skills, providing transformative opportunities for Scholars within a supportive environment of faculty and peers.
Moral Movements in Medicine is an interprofessional elective focusing on the development of empathy and narrative competence—the skills of active listening and interpretation of patients’ stories. All students in the elective choose one of several themed small-group modules led by a team of two faculty (one MD faculty from the Trent Center, one from a different professional program), and meet monthly for discussion of specific narrative readings. Module topics range from narrative medicine to plague literature to photography/visual art. Participants must also earn a set number of credits from several elective offerings: book clubs, movie nights, and a series of Saturday “walks through Durham’s social history,” which are lead in conjunction with a community partner to center multiple (and non-academic) perspectives on the Duke/Durham relationship.
Scholars will participate in a series of monthly arts and humanities workshops, held after hours to minimize disruption to clerkship schedules. For instance, after discussion of a creative work (e.g. poem, prose excerpt, art work) related to medicine, students free-write for 5 minutes in response to a prompt. This allows students a chance to self-reflect and debrief their emotional responses to challenging clinical scenarios; the focus is on helping students to preserve their own integrity amidst the pressures of the wards. Students are also encouraged to participate in La Pluma, Duke’s medical writing critique group. Students must participate in at least 9 arts and humanities workshops or La Pluma sessions to remain in the program.
The focus of the third year is on ethics, in the sense of moral leadership rather than solving dilemmas or research compliance. The program will sponsor quarterly Community Conversations with faculty chosen as an exemplar of socially-responsible or imaginative health practice. Additionally, an annual “Ethics night” late in the year will be open to the entire class with Humanities Scholars given priority registration. Lastly, Scholars will be expected to take at least 2 of the 4 humanities electives offered by the Trent Center (history, ethics, narrative medicine, arts) during either their MS3 or MS4 years.
A February humanities senior seminar integrates the themes of the entire four years, with the aim of developing a socially-conscious professional identity, and a strategy to sustain that commitment through residency. The course will center around a health advocacy seminar, with a focus on community engagement and outreach The goal would be to emphasize both the challenges and rewards of socially conscious doctoring, as well as ways to ensure one’s message is heard by the other party. Other components of the senior synthesis will include a sustained common read on doctoring (examples: Abraham Verghese’s Cutting for Stone or Rabih Alameddine’s The Wrong End of the Telescope) and a weekly continuity clinic in the student’s intended specialty. Scholars will also develop and submit a publishable product through independent study with a faculty mentor (e.g. either a creative work or an essay in medical humanities or ethics). Scholars are encouraged to develop their project idea early in the year to allow time for submission of the manuscript prior to graduation.