Listen to this articleThe basics:
- Rutgers NJMS integrates art and music into first-year medical courses
- Dr. Andrew Berman uses humanities to foster empathy and observation skills
- Nationally, most U.S. medical schools are adopting similar approaches
- Initiative aligns with the school’s Center for Humanism and Medicine
Pop music and paintings are appearing in lectures at Rutgers New Jersey Medical School. Dr. Andrew Berman is weaving humanities into his first-year classes at the Newark-based institution as a way to help future doctors sharpen observation skills, heighten empathy and better understand the emotional dimensions of patient care.
The pulmonologist and professor of medicine is part of a growing movement in medical education that uses humanities to build skills that go beyond the exam room. Just a few of the medical schools that have blended art and music into the curricula include Mount Sinai, Yale, Penn State, Stanford, University of Pennsylvania and University of Michigan.
The majority of U.S. medical schools have incorporated art and music in some fashion, according to the Association of American Medical Colleges. The content, methods and outcomes vary widely, and the group urged more integration and better evaluation of how those experiences make better doctors.
Preliminary research has shown that analyzing songs and paintings encourages medical students to slow down, look more closely and listen more carefully – the same qualities that build trust between physicians and their patients.
According to a report from the University of Pennsylvania School of Medicine, students who participated in visual arts observation demonstrated improvement in clinical observation schools.
A study at Sidney Kimmel Medical College found that students who completed a music-based lesson on recognizing emotional cues in songs significantly out-performed controls in identifying emotions in human voice recording. Another report claimed that music can train “close listening” skills that are relevant for clinical listening, such as lung sounds and a patient’s tone of voice.
Breaking it down
At Rutgers New Jersey Medical School, the first-year courses cover foundational medical sciences in an integrated, organ system-based curriculum that includes modules on biochemistry, genetics, cell biology, hematology, immunology and infectious disease, as well as classes on the musculoskeletal and integumentary systems, the cardiovascular system, pulmonary system and renal system.
Berman, director of the school’s division of pulmonary and critical care medicine and allergy and rheumatology, said, “I do believe that the organ system-based approach is good for a number of reasons. One, there’s a lot to know, and when there’s a lot to know, the best way to go about it is breaking it down into smaller pieces. I think that applies to any complex critical problem, but it also allows the students to get a feel of different specialties. They all come into medical school trying to figure out what they’re going to be. It’s one of their hardest decisions. The first hard decision is getting into medical school, and then as soon as they get into medical school, they’re faced with another big decision – ‘What kind of doctor do I become and how do I start? Where do I begin?’ And so, I think this helps that somewhat.”
As part of the first-year curriculum, Berman teaches a five-week course that seeks to provide comprehensive knowledge of the respiratory system that can serve as a foundation for clinical years. Along with the fundamentals of pulmonary physiology and anatomy, the class covers how the lungs interact with other major organ systems in normal and disease states, along with diagnosis and treatment of common pulmonary disorders.
From Swift to Warhol
A self-described music and art lover, Berman gradually began sprinkling the two into his class over the past few years. He now starts classes by either playing recorded music or showing a work of art that he considers relevant to the discussion at hand. The songs cover a variety of genres, from Taylor Swift to Pink Floyd, while the art ranges from Andy Warhol to Sandro Botticelli.
I believe what makes a better instructor is when they give more of themselves.
– Dr. Andrew Berman, professor of medicine, Rutgers New Jersey Medical School
“I believe what makes a better instructor is when they give more of themselves. I thought that this was a way of bringing my joy into the classroom and also taking people outside the classroom,” he explained. “In medical school, for the first couple of years, you’re either in the classroom physically or remotely. When they’re in my class, they’re thinking about the lungs and how does oxygen get into the lungs and bloodstream and do all this stuff.
“Life as a physician is not like that. Life as a physician is multiple inputs, some of which have to do with medicine and many of which do not have to do with medicine. And this was sort of one way to make that concept into a construct,” he said, adding, “I wanted to help them start to approach some of the difficult concepts that can get a little tricky.”
Just breathe
He initially started out showing artwork, like Vincent Van Gogh’s “Starry Night” to kick off a lesson on the movement of air into the lungs.
“You have the sky in all these swirls of these very broad, fast, frenetic brushstrokes, which are supposed to create this sense of energy. And that’s very similar to what’s going on in our main windpipe, the trachea,” he said. “It’s a form of turbulent air movement – which is different from a laminar flow – that is in the lower airways … and once you start talking about turbulence, laminar and all of this … it gets dry pretty quickly,” he said.
“It also becomes its own world, which you’re not really part of. You’re part of because you have to learn it and then you move on. And I want really to show that this is all part of every day and bringing the everyday world into it,” Berman said.
“With music in the beginning, I would always start with songs that have to do with air or breathing and have that in the title, like a Taylor Swift song called ‘Breathe’ and Phil Collins’ ‘In the Air Tonight.’ There’s a lot of different songs that have air and breathe in it. And that’s kind of fun because I play ‘name that tune’ and that’s how we start the class. They’re moving in, sitting down, the music is playing and they’re getting settled. And then I stop and whoever gets the song, gets a piece of candy, which is an Airhead taffy candy. So, it all stays in the air theme,” he said.
“Then I said, ‘Why am I restricting myself to songs about breathing in air?’” Berman recalled.
For example, he started the class with Post Malone’s “Hold My Breath” just before a complex lecture on ventilation.
“When I’m talking about ventilation, I am talking about what happens when we breathe and when we don’t breathe. And the carbon dioxide that builds up in the blood that goes through the brain that triggers us to breathe more,” he said.
Helps the class ‘chill’
While Berman hasn’t tracked any noticeable difference in academic performance among his students, he has noticed they “have become more responsive to the class in a positive way.”
“I usually get good feedback from the students that it helps them feel at ease in the beginning. And to be honest, that’s my goal,” Berman said.
And, given how challenging the material can be, he hopes to create an environment where students feel comfortable enough to admit if they need help and ask questions.
“It also does help the class kind of chill, and it does engage them more,” he said. “A subtle little thing I noticed is that you’ll find them moving from the back of the classroom toward the front of the classroom. Little pieces like that suggests to me that they’re more engaged.”
A subtle little thing I noticed is that you’ll find them moving from the back of the classroom toward the front of the classroom. Little pieces like that suggests to me that they’re more engaged.
– Dr. Andrew Berman
José Toribio, a second-year medical student, shared, “Learning the physiology of the human body, and how it responds to disease, is both a science and an art. Dr. Andrew Berman brings creativity and humanism into medicine, using art and music to breathe new life into our coursework.
“One memorable lecture on infectious diseases of the lungs began with Johnny Rivers’ ‘Rockin’ Pneumonia and the Boogie Woogie Flu.’ The moment captured Dr. Berman’s ability to blend humor, history and empathy, reminding us that medicine is ultimately about restoring the joy of living. His passion for his patients and his dedication to teaching the next generation of physicians shine through in every lesson,” he added.
‘This is what we do’
By interpreting emotion in a song or meaning in a painting, medical students can learn to read the subtler cues of illness and empathy, preparing them to connect with patients not just as cases, but as people, Berman believes.
“Doctoring is all about four different skills. You have to listen, you have to look, you have to interpret and you have to report — skills that take place when you listen to music or when you look at art. And those are applicable to not only being a doctor, but to being a person. This is what we do – regardless of who we are – but it just so happens that for a doctor, that’s their job.”
Doctoring is all about four different skills. You have to listen, you have to look, you have to interpret and you have to report — skills that take place when you listen to music or when you look at art.
– Dr. Andrew Berman
Besides improving key clinical and interpersonal skills, Berman feels humanities can encourage reflective practice. That means helping students think about what it will be like to encounter suffering, death and illness, and the importance of treating the whole person – not just disease.
“For a doctor, it’s essential to be aware that it’s not about you,” said Berman. “Doctors don’t simply treat a disease – they treat the person who is ill. And that involves trying to understand their patient, the condition and world around them.”
The human side of modern medicine
The concept of introducing humanistic elements also serves as a core principle of the Healthcare Foundation of New Jersey Center for Humanism and Medicine. Founded in 2004 at Rutgers NJMS, the center is dedicated to protecting the compassionate and human-centered aspects of modern medicine.
Just a few of its activities include visiting patients to practice humanistic interactions; a student-led music group (the Vocal Chords a cappella ensemble) that performs at medical school events, hospital events and community gatherings; and a book group that focuses on books around medicine and humanism. It also offers scholarships and fellowships to students engaged in humanism-in-medicine projects, and helps coordinate service-learning initiatives addressing health literacy, screenings and empowerment.
“A physician’s responsibility extends beyond facts and analysis,” said Tanya Norment, program administrator for the organization. “It requires the integration of compassion with intellect ensuring that both the heart and soul are engaged in the care of patients.”
Beyond that, humanities can help promote well-being and resilience by giving students avenues for creative expression, stress relief, identity formation and connection with others beyond clinical tasks, Berman said.
Since the school established an annual literary journal, Ars Literarium, in 2016, Berman has served as one of two faculty advisors.
Backed by the Healthcare Foundation of New Jersey Center for Humanism and Medicine, the student-led journal has “turned into a really beautiful literary work and continued to flourish over the years and takes on the theme of the students,” Berman said. He went on to describe it as a “tremendous outlet” filled with poetry, art and other creative work.
“The journal allows for self-expression, while also being an outlet for decreasing pressure,” Berman said. “The ability to express yourself and the inclination to observe, both of which are fostered by Ars Literarium, will enable students to become better at patient interactions.”
For Berman, the overarching goal is to have patients, doctors, laboratory technicians, office staff, and everyone else in the health care spectrum all viewing each other as individuals.
“One of the criticisms that physicians have gotten over the years is they sort of block out who they are while they’re being a doctor,” he said, emphasizing that bringing more of oneself to an interaction with patients or colleagues can make it a “more honest experience.”
How times have changed
Rutgers NJMS’ curriculum also emphasizes expert communication skills, clinical acumen, empathy, and a commitment to enhancing opportunities for health and wellness among patients and communities. That includes sustainable service projects that address the needs of Newark and surrounding areas and entrustable professional activities during residency as a way to demonstrate competency in communication, history taking, physical examinations, clinical reasoning and medical knowledge.
When Berman attended medical school at Stony Brook University in New York 30 years ago, he recalled that the overall curriculum was “more disease focused.” Nowadays, it is “very much a patient-focused type of learning.”
“The social drivers of health – all the elements within the patient’s world and outside of the patient’s world that determined how they got there and how the system either helped or failed them – that was not part of my education when I was in these students’ shoes,” he said.
He’s also noticed a change in the types of students enrolling.
“Students in general are coming in with perhaps more life experience and … there’s less students who come in directly from their undergraduate work. Many have done things which are just so impressive, and they’ve also lived through COVID. So, they’ve seen how something can really come in and knock the system off its feet,” he said.
“And I think, as a physician, you get the feeling that you were part of what righted the system back up on its feet. And to be part of that, to just be a small piece with all my tremendously talented colleagues, we’re able to keep things afloat. I think that takes a system where there’s great understanding of people and thoughtfulness about others. I certainly saw that in the people that I work with and many of which I hope to model myself after,” he said.
Merged medical schools
In 2023, Rutgers University announced a controversial plan to merge its two existing medical schools (NJMS in Newark and Robert Wood Johnson Medical School in New Brunswick) into a single entity.
After the board of governors secures a single accreditation, the combined school will be known as the Rutgers School of Medicine. According to Rutgers officials, the integrated school will consist of two comparable campuses in Newark and New Brunswick rather than one campus absorbing the other.
A self-study is underway with accreditation anticipated by June 2027. The first charter class of the new Rutgers School of Medicine is expected to matriculate in Summer 2028, Rutgers has said.
University officials believe the merger will form a single, stronger public medical school that unites their strengths in education, research and clinical care. They also aim to improve efficiency, foster collaboration, raise national standing and better serve New Jersey’s communities.
Opposition to the move stems from concerns that Newark’s campus and its community may be shortchanged, risks to faculty and accreditation, and fears that the “co-equal” status may not be honored in practice.
