The renaissance scholar in academic medicine: The road less traveled

Each of us makes formative decisions leading toward a professional career, and then, once in such career, we will make further decisions as to how narrow or broad our scope shall be. Many of these decisions are impacted by educational, cultural, and socioeconomic factors, but in more recent times, ‘success-driven metrics’ and implied consequences often result in a narrowed scope. In an era of journal impact factors, author h-index with its variant g-index, article citations/online views/downloads/altmetrics, shrinking competitive grant funding, and imperiled tenure status, can and should the Renaissance scholar exist in modern medical academia (Carpenter et al., 2014; Saraykar et al., 2017)? If the cornerstone of education is learning and key concepts of research include seeking knowledge, enjoying the process of discovery, understanding objectivity, and appreciating the need to teach others of your methods/findings, then without the Renaissance scholar, the soul of academic medicine may be lost.

Why did we first go to university? Some went as a natural progression for it seemed the necessary next step toward a career yet undefined; but hopefully, many of us also went simply for ‘the love of knowledge’. It is this love of knowledge that we must cherish throughout a lifetime. Reflect on those university days and consider the intellectual and even emotional excitement that unfolded when faced with unexpected required readings that piqued one’s imagination: the future scientist immersed in Baldassare Castiglione’s ‘Book of the Courtier’ or Aristotle’s ‘Nicomachean Ethics’; the dance-chemistry major realizing as an epiphany that the Diels-Alder reaction and aromaticity are fundamentally ‘a dance of the π electrons’. Consider each book, each inquisitive thought, and each revelation as building blocks leading to one’s own personal architectural masterpiece.

In different countries, there may be different paths toward becoming a physician. In the United Kingdom, most universities offer a 5-year program after secondary school; in the United States, there is a two-step process involving a 4-year university degree followed by a 4-year medical school; in Australia, there is a hybrid 4- to 6- year program depending on entry point (after secondary school or after university). We often argue that a critical failing in modern medicine is the lack of cultural competence, and even ethics, yet neither are substantively represented or required subjects in university curricula and the mandate to effectively address these in medical school and training programs remain unfulfilled (Lang et al., 2009; Lehmann et al., 2004; Loue et al., 2015). Our humanism and scientific literacy would be well served with W. Somerset Maugham, Ernest Hemingway, Anne Frank, Bryce Courtenay, CP Snow, Renee Fox, and Oliver Sacks, among a myriad of other authors, on our bookshelves.

This author was fortunate for his university, Columbia University, had a mandatory Core Curriculum with primary source readings in formative courses—Contemporary Civilization in the West and Humanities (literature, music, art). Now, half a century later, this author realizes how meaningful those courses were. The broad knowledge garnered defined the complexities of human interactions in the context of our complex societies as impacted by cultural, religious, ethnic, socioeconomic and educational themes. Furthermore, these courses led to an appreciation of the need to be a modern Renaissance individual and in the process ultimately led to a Renaissance career in medicine mixing clinical care with academia. ¹

The key in academic medicine is to appreciate that one can always narrow one’s focus after a broad-based foundation; but that the reverse is difficult—to balance a broadened self from a narrow foundation. Consider the architectural strength of the pyramids, yet the lack of stability when inverted. Alternatively, consider the beauty and strength of pointed arches and vaults in gothic cathedrals with their keystones. Each of us starting from strong foundations will attain capstones to our careers, and it is best to regard ‘learning medicine’ as a lifetime adventure wherein often our patients are our instructors who lead us to better understand both medical mysteries and the mystery of life itself.

Current success-driven academic models focus on ‘big data’—but it is imperative that we do not lose focus for both qualitative and quantitative research are essential, especially in psychiatry. Furthermore, all clinicians should appreciate the significance of the well-designed, descriptive case study and where that might lead us in our future clinical care and research endeavors. By not focusing on a sole topic, promotion and tenure may be a slower process; but hopefully as we progress through our careers, each of us will reflect on a medical life well spent, learning broadly with multiple fields of expertise, and always with a willingness to venture into unexplored areas—while periodically reinventing oneself; a true Renaissance scholar on the road less traveled.