Fall 2009

Training the Mind

By Shelley Adler, PhD, Education Program Director

Adler For medical students, the brain is an important topic of academic discourse. They spend a significant amount of time learning about its structure, the many ways in which its function is affected by neurological and psychiatric disease, and the more subtle negative effects of stress, lack of sleep, and exposure to medicinal or illicit drugs. The need for diagnosis and treatment of brain-related diseases provides a clear rationale for this emphasis on the brain’s structure, function, and dysfunction, but there are compelling reasons for also devoting time to learning ways that we can optimize the performance of the healthy human mind.

Why is a Healthy Mind Important in Healthcare?
First, many patients, whether healthy or ill, seek advice from their physicians on how to improve their cognitive and mental capacities, including thinking, focus, and emotional well-being. Second, mind-body techniques can be particularly helpful during times of illness. For example, meditation and focusing have long been used by healthcare providers to help patients dealing with debilitating stress, chronic pain, or other types of suffering.

Finally, physicians rely on the optimal function of their own brains and minds–the very nature of a physician’s work stretches these capabilities to the maximum. Problem-solving, multi-tasking, encoding and retrieval of information, adaptive responses to stress, social cognition, compassion, compartmentalizing–all of these abilities are part of a physician’s job requirements. Physicians and patients alike benefit from developing and honing these abilities to the fullest extent possible.

Experiencing the Mind-Body Connection in Medical School
There is a lot of potential in teaching medical students integrative practices that have been shown to enhance the abilities of the mind. To facilitate this, we developed an elective course called “Training the Mind” in collaboration with the Department of Neurology that integrates mind-body medicine content into a curriculum block on Brain, Mind and Behavior. In this course, first-year medical students attend lectures and participate in a group meditation three times per week throughout the quarter. Some of the specific objectives include:

1. Review historical and scientific literature related to attention, observation, memory, learning, problem-solving and altruism.

2. Introduce and practice techniques for mind enhancement, such as meditation, art appreciation, memory games and stress management.

3. Understand how our perspective on mortality influences mind functions such as attention, focus and relationships with others.

The course’s benefits are seen by both the students and instructors alike; not only are students learning “healthy mind exercises” that will help their future patients, they are experiencing the benefits themselves. At the end of the quarter, several students shared their reflections on the course:

This really sparked my interest in the idea of empathy, altruism and the interconnection of us all.

I will be more mindful of using techniques to enhance my ability to be present with my patients.

Meditation and mindfulness are already an important part of taking care of myself and living well; it's a very good thing to have this perspective integrated with the curriculum and encouraged.

These exercises accomplished something especially important to me. They coupled efforts to improve concentration with value. When we worked to develop our concentration, our focus centered on self-conception, the beauty of artwork and the expression of emotion. The class aligned our motivations to improve concentration with pre-existing incentives in order to make it easier for us.

Instructor’s Perspectives:

Given the focus we have in the medical school's formal neuroscience curriculum on "normal" function and disease, I am so pleased that we have created an opportunity for students to learn more about how to make their already well-tuned minds even more capable. As they understand more about the nature of the mind and techniques for improving focus, attention, and attaining a state of inner peace, I am quite sure they will be better equipped to cope with the rigors of medical training and, as an extension of this, find more joy in their work and become even better physicians.

-Dan Lowenstein, MD
Professor and Vice Chair, UCSF Department of Neurology
Lead faculty

This material gets to the core of medical practice and it will never show up in an official medical “curriculum.” Wisdom and compassion, however, are the basis for superior medical care. We have seen over and over again that medical care declines when techniques or economics become the over-riding concern of the practitioner.

-Howard Fields, MD, PhD
Professor, UCSF Department of Neurology
Guest presenter

UCSF medical students are an amazing group of people to work with. They are extremely intelligent and have had diverse, extraordinary life experiences. In medical school, of course they must very intensively apply their great cognitive abilities. In Training the Mind, however, we have the precious opportunity to explore together some of the other capacities of the mind.

-Kevin Barrows, MD
Associate Clinical Professor, UCSF Family and Community Medicine
Interim Director, Clinical Programs, Osher Center for Integrative Medicine
Guest presenter and member of planning committee

Providing medical students with insights into, and first-hand experiences of, the mind-body connection is an important role for integrative medicine education. It provides students with tools for improving their abilities to navigate the challenges of medical school, makes them better physicians, and equips them with tools to enhance the patient care experience.