Although ethics is increasingly integrated in the curriculum of U.S. medical schools, it remains not well integrated with system issues, and social and structural contexts of illness. Moreover, ethical analysis is not often taught as a clinical skill. To address these issues, an outcomes driven course in Social Sciences, Humanities, Ethics and Professionalism (SHEP) was created. Within the course, a web-based concept mapping device, SHEP Case Analysis Tool (SCAT), was created which schematizes the structure and flow of clinical cases from diagnosis to treatment options, to shared decision making to outcome, and includes key stakeholders, influences, and structural features of the health system. In the course, each student analyzes a case in which they were directly involved using SCAT and presents their analysis to faculty and peers. This exercise 1) reinforces knowledge-based portions of the course pedagogy, 2) supports meta-cognition and critical thinking through concept mapping, 3) applies multidimensional analysis to identify ethical, social, and system issues that impact patient-care. 4) develops problem solving skills, 5) counters the hidden curriculum/support professional identity formation, and 6) develops skills in reflective discourse. This paper outlines the development and use of this concept mapping case analysis tool in an undergraduate medical education curriculum.

Medical ethics education is crucial for medical students and trainees, helping to shape attitudes, beliefs, values, and professional identities. Exploration of ethical dilemmas and approaches to resolving them provides a broader understanding of the social and cultural contexts in which medicine is practiced, as well as the ethical implications of medical decisions, fostering critical thinking and self-reflection skills imperative to providing patient-centered care. However, exposure to medical ethics topics and their clinical applications can be limited by curricular constraints and the availability of institutional resources and expertise. Podcasts, among other Free Open Access Medical Education (FOAMed) resources, are a novel educational tool that offers particular advantages for self-directed learning, a process by which learners engage in asynchronous educational opportunities outside of traditional academic or clinical settings. Podcasts can be readily distributed to wide audiences and played at any time, reducing barriers to access and offering a level of flexibility that is not possible with traditional forms of education and is well-suited to busy schedules. Podcasts can also use real voices and storytelling to make the content memorable and eminently human. This paper describes the development, production process, and impact of Core IM’s “At the Bedside,” a podcast focusing on issues in medical ethics and the medical humanities, intending to supplement standard bioethics curricula in an accessible, relevant, and engaging way. The authors advocate for broad incorporation of podcasts into medical ethics education.

There are increasing calls for coverage of medicine during the Holocaust in medical school curricula. This article describes outcomes from a Holocaust and medicine educational program featuring a study trip to Poland, which focused on physician complicity during the Holocaust, as well as moral courage in health professionals who demonstrated various forms of resistance in the ghettos and concentration camps. The trip included tours of key sites in Krakow, Oswiecim, and the Auschwitz-Birkenau concentration camps, as well as meeting with survivors, lectures, reflective writings, and discussions. In-depth interviews and reflective writings were qualitatively analyzed. Resulting themes centered on greater understanding of the relationship between bioethics and the Holocaust, recognizing the need for moral courage and social awareness, deeper appreciation for the historical roles played by dehumanization and medical power and their contemporary manifestations, and the power of presence and experiential learning for bioethics education and professional identity formation. These findings evidence the significant impact of the experience and suggest broader adoption of pedagogies that include place-based and experiential learning coupled with critical reflection can amplify the impact of bioethics and humanism education as well as the process of professional identity formation of medical students.

Professor William Ivory (Ivor) Browne, consultant psychiatrist, who died on 24 January 2024, was a remarkable figure in the history of medicine in Ireland and had substantial influence on psychiatric practice and Irish society. Born in Dublin in 1929, Browne trained in England, Ireland, and the US. He was chief psychiatrist at St Brendan’s Hospital, Grangegorman, Dublin from 1965 to 1994 and professor of psychiatry at University College Dublin from 1967 to 1994. Browne pioneered novel and, at times, unorthodox treatments at St Brendan’s. Along with Dr Dermot Walsh, he led the dismantling of the old institution and the development of community mental health services during the 1970s and 1980s. He established the Irish Foundation for Human Development (1968–1979) and, in 1983, was appointed chairman of the group of European experts set up by the European Economic Community for reform of Greek psychiatry. After retirement in 1994, Browne practiced psychotherapy and pursued interests in stress management, living system theory, and how the brain processes trauma. For a doctor with senior positions in healthcare and academia, Browne was remarkably iconoclastic, unorthodox, and unafraid. Browne leaves many legacies. Most of all, Browne is strongly associated with the end of the era of the large ‘mental hospital’ at Grangegorman, a gargantuan task which he and others worked hard to achieve. This is his most profound legacy and, perhaps, the least tangible: the additional liberty enjoyed by thousands of people who avoided institutionalisation as a result of reforms which Browne came to represent.

This article provides an overview of the historiography of medical education and calls for greater attention to the connections between medical schools. It begins by reviewing research on medical education in imperial metropoles. Researchers have compared medical schools in different national contexts, traced travellers between them or examined the hierarchies that medical education created within the medical profession. The article then shows how historians have emphasised the ways in which medicine in colonial empires was shaped by negotiation, exchange, hybridisation and competition. The final part of the article introduces the special issue ‘Medical Education in Empires’. Drawing on a variety of sources in English, French, Dutch and Chinese, the special issue builds on these historiographies by juxtaposing cases of medical schools in imperial contexts since the eighteenth century. It considers who funded these medical schools and why, what models of medicine underpinned their creation, what social changes they contributed to, what life was like in these schools, who the students and teachers were and what graduates did with their medical careers. This special issue thus contributes to clarifying the role of medical education in empires and the long-term impact of empires on the medical world.

While larger British colonies in Africa and Asia generally had their own medical services, the British took a different approach in the South Pacific by working with other colonial administrations. Together, colonial administrations of the South Pacific operated a centralised medical service based on the existing system of Native Medical Practitioners in Fiji. The cornerstone of this system was the Central Medical School, established in 1928. Various actors converged on the school despite its apparent isolation from global centres of power. It was run by the colonial government of Fiji, staffed by British-trained tutors, attended by students from twelve colonies, funded and supervised by the Rockefeller Foundation, and jointly managed by the colonial administrations of Britain, Australia, New Zealand, France and the United States. At the time of its establishment, it was seen as an experiment in international cooperation, to the point that the High Commissioner for the Western Pacific called it a ‘microcosm of the Pacific’. Why did the British establish an intercolonial medical school in Oceania, so far from the imperial metropole? How did the medical curriculum at the Central Medical School standardise to meet the imperial norm? And in what ways did colonial encounters occur at the Central Medical School? This article provides answers to these questions by comparing archival documents acquired from five countries. In doing so, this article will pay special attention to the ways in which this medical training institution enabled enduring intercolonial encounters in the Pacific Islands.

Current escalation of natural disasters, pandemics, and humanitarian crises underscores the pressing need for inclusion of disaster medicine in medical education frameworks. Conventional medical training often lacks adequate focus on the complexities and unique challenges inherent in such emergencies. This discourse advocates for the integration of disaster medicine into medical curricula, highlighting the imperative to prepare health-care professionals for an effective response in challenging environments. These competencies encompass understanding mass casualty management, ethical decision-making amidst resource constraints, and adapting health-care practices to varied emergency contexts. Therefore, we posit that equipping medical students with these specialized skills and knowledge is vital for health-care delivery in the face of global health emergencies.

In 1851, the colonial administration of the Dutch East Indies established a two-year program to educate young Javanese men to become vaccinators in Batavia (today’s Jakarta). During the following sixty years, the medical curriculum was expanded several times; in 1913, it consisted of a ten-year program. In 1927, the Batavia Medical School, granting degrees equivalent to those of Dutch university-affiliated medical schools, commenced operations. Consequently, a steadily increasing number of Indonesian physicians with various credentials were employed by the colonial health service, plantations, sugar factories and mines, or established private practices. They became a social group that occupied an ambiguous and even paradoxical position somewhere between Europeans and the indigenous population. During the 1910s, this inspired these physicians to obtain credentials and professional recognition equal to those of their European colleagues. Several of them became active in journalism, politics and social movements. During the 1920s, several became radicalised and criticised the nature of colonial society. In the 1930s, following the increasingly repressive nature of colonial society, most of them remained active in the public sphere while a small group dedicated itself to improving medical research and health care. After the transfer of sovereignty from the Netherlands to Indonesia on 27 December 1949, this small cadre reestablished medical education and health care, and built the Indonesian medical profession.

This article examines some of the racist features of nineteenth-century medical school curricula in the United States and the imperial networks necessary to acquire the data and specimens that underpinned this part of medical education, which established hierarchies between human races and their relationship to the natural environment. It shows how, in a world increasingly linked by trade and colonialism, medical schools were founded in the United States and grew as the country developed its own imperial ambitions. Taking advantage of the global reach of empires, a number of medical professors in different states, such as Daniel Drake, Josiah Nott and John Collins Warren, who donated his anatomical collection to Harvard Medical School on his retirement in 1847, began to develop racial theories that naturalised slavery and emerging imperialism as part of their medical teaching.

This paper describes the implementation of curricula for Liberia's first-ever psychiatry training programme in 2019 and the actions of the only two Liberian psychiatrists in the country at the time in developing and executing a first-year postgraduate psychiatry training programme (i.e. residency) with support from international collaborators. It explores cultural differences in training models among collaborators and strategies to synergise them best. It highlights the assessment of trainees’ (residents’) basic knowledge on entry into the programme and how it guided immediate and short-term priority teaching objectives, including integrated training in neuroscience and neurology. The paper describes the strengths and challenges of this approach as well as opportunities for continued growth.

Medical trainees (applicants, students, and house officers) often engage in global health initiatives to enhance their own education through research and patient care. These endeavors may concomitantly prove of value to host nations in filling unmet clinical needs. At present, healthcare institutions generally focus on the safety of the trainee and the welfare of potential patients and research subjects when sanctioning such programs. The American medical community has historically afforded less consideration to the ethics of engagement by trainees from the United States in nations known for serious human rights transgressions. This essay examines the ethics of such endeavors and argues for increased consideration of these broader considerations when trainees engage in global health work abroad.