History repeats itself: the relevance of the 1918 influenza pandemic to the medical school curriculum

Abstract

BACKGROUND The dramatic global impact of the coronavirus pandemic has increased consideration on epidemiological progressions of pandemics. Measures implemented to reduce viral transmission have been largely historical comparable in nature with the 1918 H1N1 influenza pandemic, demonstrating the importance of clinicians’ awareness on historical pandemics. Despite this, literature suggests medical students’ knowledge on previous pandemics is poor. This study aims to gather stakeholder information from UK medical students on the importance of including the history of Medicine in the medical school curriculum. METHODS: A cross-sectional cohort study conducted via a mixed question type online survey was distributed to all UK medical schools to explore stakeholder views on teaching on the history of Medicine in the curriculum. Grounded theory emergent coding was used to generate themes to free-text answers and SPSS and Excel were used to analyse quantitative data using pivot tables and Fishers exact tests. RESULTS: Two hundred and forty-one students consented to take part with a response rate of 98% (n = 237). 34% of students reported having teaching on pandemics with 78% of students stating it would be beneficial. Knowledge was poor with 5.7% of students achieving 100% on knowledge-based questions. 72% of students believed that learning about the history of medicine would be beneficial with 87% of these students referring to ‘benefiting (the) future’ in their answers. Additionally, 79% of students thought it would be beneficial to learn about the H1N1 Influenza 1918 pandemic with reference to the current COVID-19 pandemic. CONCLUSIONS: To date, this is the only UK based study assessing stakeholders’ views on including the history of Medicine in the medical school curriculum. Our findings demonstrate that medical students wish to have more historical content included in their degree to better prepare tomorrow’s doctors for situations that may occur when history repeats itself.

Essential Business: The Flu, the War, and the Economy

“…130 For workers in Winnipeg, writes Esyllt Jones, the epidemic affirmed a sense of solidarity based on the shared experience of illness, while the manifest failure to control the disease embarrassed the city's elite. 131 As its value declined, money ceased to function as an index of social distinction. "A colored woman in a cotton dress and shawl walked into a store in Georgia and asked for a pair of a certain type of shoe," reported the Saturday Evening Post in 1920.…”

“…Nilsson complained that the $14 she was allocated for rent was insufficient, and she received permission to move out of the city to reduce her cost of living. 113 This was a parsimonious budget. The resources of the Mothers' Allowance were all but exhausted by the pandemic.…”