Psychiatrist Helps Medical Students Navigate Modern Healthcare Through Self-Reflection, Candid Discussion

Philosophers and scientists have long maintained that mastery of any subject is best achieved through teaching. In what has been coined the “protégé effect,” teaching has proved to be a powerful sounding board that deepens our understanding by forcing us to think critically and more abstractly about the topic at hand.

This maxim holds particular meaning for Cleveland Clinic psychiatrist Minnie Bowers, MD, a preceptor in the institution’s renowned Program in Medical Humanities. Much to her surprise, not only has the teaching experience given her a glimpse into the future of modern medicine, but it also has provided invaluable new insights into her own 40-year medical career as a Black physician.

“I’m continuing to learn right along with my students, which is incredibly gratifying,” says Dr. Bowers, the first psychiatrist to serve as a preceptor in the Art and Practice of Medicine course. “You might assume that physicians spend a lot of time reading about and discussing big-picture medical issues, but that’s not necessarily true. Most of us are conditioned to practice in a specific field – and because we’re so focused on our own patients and lives, we may look past other, more challenging dimensions of healthcare. This course is revelatory in its ability to bridge those knowledge gaps.”

Broadening horizons

The Program in Medical Humanities is designed to foster the skills necessary to provide humane medical care, including observation, analysis, empathy and self-reflection. The course materials are grounded in literature, bioethics and health systems, Dr. Bowers explains, and special presenters are frequently recruited to lecture about their areas of expertise.

The 32 students in Dr. Bowers’ class meet weekly in a large classroom for the first hour of instruction and then break into smaller eight-person groups for discussions led by a preceptor. Although Dr. Bowers says her role is to help facilitate “healthy conversations,” she has been pleasantly surprised by how little guidance her students require.

“These are extremely bright, well-read young people who are eager to contribute, which makes my job easy,” she says. “The most helpful thing I can do is to share my perspective as a clinician who has been practicing in this country for more than 40 years. In the classroom, my most valuable asset is longevity.”

A Cleveland native, Dr. Bowers was educated in local public schools before eventually earning an undergraduate degree from Fisk University and a medical degree from Meharry Medical College, both historically Black institutions in Nashville, Tennessee. Despite feeling connected to her peers, she says that the link between race and medicine was seldom discussed.

Decades later, Black Man in a White Coat would become required reading for Dr. Bowers’ Cleveland Clinic students, and the text soon paved the way for another “eye-opening experience.” She says the 2015 memoir, which explores the unique challenges and racial disparities confronting Black doctors and patients, helped her prepare for some of the frank classroom discussions that lay ahead.

“This class has been a revelation for me because – in the 40 years I've been practicing medicine – I’ve rarely discussed racially charged issues with my colleagues,” says Dr. Bowers, who has served on the faculty of Cleveland Clinic’s Center for Adult Behavioral Health since 2010. “In the ‘70s and ’80s, when I was starting my career, we simply didn’t go there. We’re now teaching a younger generation of doctors and researchers to approach these subjects with empathy and candor, and we’re arming them with the information they need to do so. From time to time, I’ll need to take a deep breath because I’m overwhelmed by the opportunity I’ve been given – the opportunity to talk openly about my life as a Black physician. I’m deeply grateful for the experience.”

Gaining ground

Although many of the themes covered in the course are complex, controversial and even politically sensitive, Dr. Bowers says the conversations always remain civil. She credits her students, who originate from virtually every corner of the globe, for approaching even the most difficult discussions with curiosity and openness.

“We dive into subjects that you wouldn’t necessarily talk to your colleagues about on a daily basis, so I think everyone is grateful for a neutral environment that allows tough questions and the exploration of new ideas,” she explains. “Our international students, in particular – many of whom arrive in the U.S. with only a basic understanding of our healthcare system – receive an American history lesson almost every week.”

Popular classroom topics include the legalization of marijuana, health equity and the care of underserved communities, patient privacy, health policy, research ethics, and the structure and cost of U.S. healthcare. Dr. Bowers cites a recent Supreme Court ruling that allows cities to criminalize sleeping and camping in public places, which led to an animated discussion about homelessness and food scarcity.

Several weeks earlier, a child psychiatrist was invited to speak about the management of transgender patients, which proved to be a “wakeup call” not only for some students, but also for Dr. Bowers herself.

“I've been in psychiatry for decades and am no stranger to new ideas, but I’m consistently surprised by how much I still have to learn,” she says. “I’m so impressed by the willingness of these students – most of whom are in their 20s or 30s – to consider alternative viewpoints. They enter discussions without fear or angst and with a genuine desire to fully understand these issues from virtually every angle.”

To ensure fruitful classroom conversations, Dr. Bowers also encourages her students to remain self-aware and attuned to any bias they may harbor. “It’s very easy to make assumptions about the views and motives of other people, particularly those we consider different from ourselves,” she notes. “When I speak to my students, I try to emphasize the importance of listening with an open mind and heart – and, in turn, I’m reminded to do the same.”

Dr. Bowers says she is particularly impressed by the breadth and quality of information the curriculum provides.

“We don't have to agree on every point, but it’s essential that we all have the information we need to make informed decisions,” she says. “The things we talk about extend far beyond the bureaucracy of healthcare; we’re really exploring who we are as people and caregivers. It’s the kind of critical, humanistic inquiry that produces exceptional physicians and medical scientists.”