Master of Science in Narrative Medicine
In 2009, Columbia University inaugurated the first and only Master of Science in Narrative Medicine.
The care of the sick unfolds in stories. The effective practice of health care requires the ability to recognize, absorb, interpret, and act on the stories and plights of others. Medicine practiced with narrative competence is a model for humane and effective medical practice. It addresses the need of patients and caregivers to voice their experience, to be heard and to be valued, and it acknowledges the power of narrative to change the way care is given and received.
The core curriculum of this pioneering MS in Narrative Medicine combines intensive exposure to narrative writing and close reading skills, literary and philosophical analysis, and experiential work, with the opportunity to apply this learning in clinical and educational settings. Core courses provide the conceptual grounding for work in narrative medicine, and introduce the direct practice of teaching narrative competence to others.
The Narrative Medicine Master’s Program seeks to strengthen the overarching goals of medicine, public health, and social justice, as well as the intimate, interpersonal experiences of the clinical encounter. The Program fulfills these objectives by educating a leadership corps of health professionals and scholars from the humanities and social sciences who will imbue patient care and professional education with the skills and values of narrative understanding.
Health care and the illness experience are marked by uneasy and costly divides: between those in need who can access care and those who cannot, between health care professionals and patients, and between and among health care professionals themselves. The study of narrative medicine is profoundly multidisciplinary field that seeks to bridge those divides. The curriculum for the Master’s Program in Narrative Medicine includes core courses in narrative understanding, the illness experience, the tools of close reading and writing; focused courses on narrative in fields like genetics, social justice advocacy, and palliative care; electives in a discipline of the student’s choosing; and field work.
Those interested in the intersection of literature, medicine, and stories of illness are invited to apply. Upon completion, graduates will be prepared to start Narrative Medicine programs at other institutions, continue on to or return to a clinical career, or forge their own career integrating narrative into their unique interests.
During their first semester, all students take the Giving and Receiving Accounts of Self class. In this class, they are introduced to the fundamental tenants of Narrative Medicine and begin to explore the multitude of ways a speaker may tell a story and a listener receives it. During this class, students complete a witnessing assignment, where they astutely observe a clinician in practice. The student’s role as a witness is to observe and capture elements of the clinical interaction that may otherwise be missed: body language, interpersonal dynamics, manner of speaking on the part of both clinician and patient, as well as reflections on your presence and role as an observer. The goal is not to specify medications or blood pressure readings, but instead focus on such observations as the changing tones in the patient’s voice, the stories, the glances, and moods that are rarely noted in a patient’s medical record.
The students attend clinic hours as arranged, sit in a corner of the exam room, take notes on each clinical encounter and then write them up in a Witness Account. Many of the clinical encounters take place in Spanish. Yet, language is not a barrier, but rather a facilitator to communication; the observations of tone and body language may be even more nuanced. The students may reflect and write about the role of language and translation in the clinical encounter. The Witnessing Account should reflect your engagement with and reflections on the entire experience. Sometimes observations may read like a play or a script, sometimes like a short story. Students are encouraged to experiment with a voice and tone that works best for them. The act of writing out these notes can be a richly creative experience.
In Spring of their final semester, students participate in a six week clinical placement in tandem with the Methods of Narrative Medicine course where they design and implement a six-session Narrative Medicine curriculum. As many students will be returning to medical institutions as narrative medicine administrators or facilitators, this course focuses on developing methods for teaching and facilitating discussion and on developing and responding to writing exercises with health care professionals. Literary theory offers the foundation for understanding and knowing what to do with stories, while literary texts offer a broad range of genres, voices, narrative strategies, and techniques from which to teach. Students in this course will be introduced to a large bank of texts for learning and teaching, including short stories, prose poems, memoirs, novels, and a few films. At the same time that this course demonstrates the theories and methods in seminar, students will be putting these skills into practice in teaching practicums arranged in tandem with the seminar learning. Thoughts and methods will flow among the seminar, full-day intensive sessions, and the practicum. Some seminar classes will focus on practical questions, such as what makes a good writing prompt, what is the proper length story to assign to clinical trainees, and does the teacher respond orally or in writing to the writing of a learner. The aim of the course and practicum is to equip students with the knowledge to approach and inhabit stories and the skills to impart this knowledge to others.
Upon matriculation, graduates are invited to apply for a Post-Graduate Narrative Medicine Fellowship. The purpose of the Narrative Medicine Fellowship is to support projects that fortify the new field of Narrative Medicine both nationally and internationally. Candidates for the fellowship must be recent graduates of Columbia University’s Master’s of Science in Narrative Medicine who are interested in promoting narrative understanding in patient care, professional education, and curriculum development, or in forging new pathways in research important to the growth of the field of Narrative Medicine.