Current status of Medical humanities education in Vietnamese medical schools: a comparative perspective from the USA and Republic of Korea

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This study helps to understand the current status of the Medical humanities education in medical schools in Vietnam and provides insights and references for promoting it. Methods We conducted a comparative study based on a literature review and survey of Medical humanitiescourses in medical schools in Vietnam, the USA and Republic of Korea. Data from the USA and Republic of Korea were referenced from the previous reports. To obtain the data from Vietnamese medical schools we examined the curriculum posted on the websites and, if insufficient, collected them by contacting the faculties in the schools. We explored the similarities and differences in Medical humanities courses educated in medical schools in Vietnam and those in the USA and Republic of Korea. Additionally, chi-square tests were used to examine the association between the types of medical schools and offerings of Medical humanities courses in Vietnamese medical schools. Results We analyzed information of 31 medical schools in Vietnam, 154 in the USA and 40 in Republic of Korea. Of these, 93.5% medical schools in Vietnam, 87.7% in the USA and all 40 in Republic of Korea provided at least one Medical humanities course. Medial humanities courses in Vietnam offered only 8 types of subjects, which was less diverse compared to more than 12 in the USA and Republic of Korea. In addition, the average number of Medical humanities courses in medical schools in Vietnam was less than those in the USA and Republic of Korea. The most common Medical humanities courses in Vietnam were Medical ethics (83.9%), Communication (71.0%) and Psychology (64.5%). Private schools showed a tendency to provide more class of Communication. Conclusions Medical humanities education in Vietnam is much lower than those in the USA and Republic of Korea. Considering the potential of Medical humanities to produce new medical doctors with excellent medical practice, efforts should be made to strengthen Medical humanities education when reforming the curriculum in the future in Vietnam. Medical humanities Medical humanities education current status Vietnam Figures Figure 1 Figure 2 I. BACKGROUND Although advances in science and technology have made great advances in medicine and health, it is still argued that medicine is as much an art as it is a science [ 1 – 3 ]. Osler famously stated: “Care more particularly for the individual patient than for the special features of the disease.” He also said: “The good physician treats the disease; the great physician treats the patient who has the disease” [ 4 ]. These perspectives highlight the importance of a humanistic approach to medical practice in which the ideal physician must not only grasp the scientific knowledge of disease but also understand the illness in relation to the patient’s personal experiences in a holistic view [ 5 , 6 ]. In this way, the ideal physician could integrate the art of healing into scientific treatment, practice patient-centered care and strive to ensure the patient’s well-being [ 5 ]. Therefore, medical education should adopt proper educational orientations and philosophies to cultivate excellent doctors who understand themselves, understand patient’s experience beyond their disease and appreciate the broader societal context [ 7 , 8 ]. This emphasizes the need to integrate art and humanities into training and experiences of physician from the first day of medical schools [ 9 , 10 ]. This integration is encapsulated in the term, “Medical humanities”, which includes a variety of artist disciplines such as theater, literature, poetry, visual arts and performing arts, as well as humanities disciplines such as ethics, history, philosophy, literature and art criticism and theory [ 11 – 13 ]. While the concept of Medical humanities (MH) is not new, there has been rigorous calls over the past several decades to comprehensively improve and integrates disciplines, experiences and instruction from the arts and humanities into medical education, particularly during undergraduate medical education (UME) [ 11 , 14 , 15 ]. These efforts have been reinforced by the Fundamental Role of the Arts and Humanities in Medical Education (FRAHME) initiative of the American Association of Medical Colleges (AAMC) [ 12 ]. In addition, emerging data supports the consensus that the integration of MH training into medical education will be a critical element in addressing evolving needs and challenges in healthcare practice and issues of public dissatisfaction and erosion of the public trust and respect for physicians [ 9 , 12 , 14 , 16 , 17 ]. MH education offers a number of benefits [ 18 , 19 ]: greater empathy [ 20 ], better moral and ethical reasoning, communication skills and professionalism [ 3 , 14 ], better academic performance [ 21 ], less burnout [ 22 , 23 ], improved clinical judgment [ 24 ], better critical appraisal skills [ 25 ], preparation for real-life scenarios in future career [ 26 ], deeper appreciation that patient’s problems go beyond their biology, and enhanced self-reflection [ 23 , 24 ]. MH education has now become part of the core curriculum in many medical schools worldwide. For instance, all of the medical schools in Italy and Spain included at least one required course with humanities content [ 27 ]. Most medical schools in the USA offer many optional and complementary opportunities to integrate humanities into medical knowledge through providing diverse courses such as history, literature, different forms of arts, sociology and social medicine, narrative medicine, theology and spirituality [ 28 ]. Chinese medical schools also promote MH education in medical training by integrating humanistic education into traditional biomedical courses, providing medical students early exposure to clinical practice and recognizing the potential of art and leisure activities in cultivating MH [ 29 ]. Medical education in Vietnam is currently undergoing major reform, with plans and preparations underway to achieve national and global accreditation, such as the World Federation for Medical Education (WFME) standards [ 30 , 31 ]. Consequently, there is an urgent need to develop other aspects of medical training such as medical humanities, besides the knowledge of basic sciences and clinical experiences [ 30 , 32 ]. Furthermore, the deterioration of medical ethics among some medical professionals and the decline in public trust in medical profession [ 33 ] have highlighted the necessity of integrating MH courses into current curricula for physicians. According to FRAHME guidelines, effective integration of MH into physician training requires a thorough investigation of the current status of MH education and the extent to which humanities are taught within medical schools [ 12 ]. Currently, there is no study that explores the status of MH education in Vietnam. To address this knowledge gap, we conducted this study to examine the current status of MH education in Vietnam and to compare it with the systems in the USA and Republic of Korea. II. METHODS We conducted this study with three research questions as follows: (1) What is the current status of MH education in Vietnamese medical schools regarding the subject presence, subject type, number of credits, academic considerations and academic year? (2) Are there any differences in MH offerings between public and private medical schools in Vietnam? Private medical schools in Vietnam are relatively new, with the first one established in 2015 (Tan Tao University School of Medicine). Considering the long history of public medical schools, this study aimed to compare whether there are any differences in the Medical humanities curricula between two types of institutions. (3) What are the commonalities and differences in MH education between Vietnamese medical schools and those in USA and Republic of Korea? In brief, this study explored the current status of MH education in Vietnamese medical schools, providing valuable insights for the future integration of MH into the curriculum for medical students. 1. Selection of references A comparative study was conducted to evaluate the presence of MH courses in medical schools in Vietnam and to compare these findings with the global context. The study used a combination of literature review and surveys of MH courses offered in medical schools in Vietnam, Republic of Korea, and the USA. Republic of Korea was selected as a representative Asian country because medical education reform was developed about 20 years ago. The USA represents a Western country, providing a contrasting perspective from a different cultural and educational context. 2. Data sources We examined the curricula of 31 medical schools in Vietnam. Information on the medical curricula of each medical school was obtained from their official institutional websites. In cases where the data available online was insufficient, we directly contacted faculty members at the respective schools to get the required information. Data from the USA were extracted from supporting information provided in previous reports on the extent of MH teaching in the USA, the United Kingdom (UK) and Canada in 2021 [28]. Data on the current status of MH education in 40 medical schools in Republic of Korea was obtained from a survey by the Korean Association of Medical Colleges (KAMC) in 2023 [34]. 3. Eligibility criteria In line with the purpose of this study and previous research, we broadly defined the Medical humanities as non-scientific subjects that can enhance the education of medical students, including medical ethics, anthropology, art, history, literature, and sociology [1-3, 27, 28]. Additionally, we included four subjects - Communication, Professionalism, Psychology, and Leadership, which are commonly educated in many medical schools in Republic of Korea and Vietnam, as part of the Medical humanities curriculum. We acknowledged that this inclusion extends the scope of medical humanities and differs from the definitions used in previous studies conducted in Spain and Italy and in the US, UK, and Canada [27, 28]. However, we decided to include these subjects for two reasons: first, they represent core components of medical education in Republic of Korea and Vietnam, reflecting regional educational priorities and curricular practices; and second, we have found that many traditional humanities topics are included in these subjects. To be eligible as encompassing medical humanities, curriculum websites had to indicate that there were actual courses (either required or elective). It was considered insufficient to claim that the humanities content was just the learning outcome of the course. We included subjects whether they were independent courses or part of integrative courses (broader courses). The integrative course “Medical psychology and Medical ethics”, for instance, was counted as the presence of two distinct subjects: Medical psychology and Medical ethics. Integrative courses that incorporated humanities topics but did not have specific titles were classified as "integrative courses” as the name suggests. 4. Data items and analysis We collected the following information from curricula websites of Vietnamese medical schools: ● Type of university (public or private) ● Presence of subjects in humanities in the curriculum ● Type of subject (medical ethics, anthropology, art, medical history, literature, sociology, communication, professionalism, psychology, and leadership, unspecified medical humanities and integrative course and others) ● Academic consideration (compulsory or elective) ● Academic year of the curriculum in which the course is offered (first to sixth) ● Number of credits For an "integrative course" that includes two independent subjects, the credits are divided evenly between the two courses. For example, the integrative course "Medical psychology and Medical ethics" with two credits, one credit was assigned to Medical psychology and one credit was assigned to Medical ethics. We recorded if at least one medical humanity was taught, whether or not it was mandatory, and how many medical humanities were offered (required or elective). We compared the status of MH education with those in the USA and Republic of Korea. We examined whether there was a relationship between the type of medical school and the offering of each MH course. The analysis was performed using SPSS statistics 25. III. RESULTS 1. Participating medical schools We collected information from 31 medical colleges in Vietnam, including 22 public schools and 9 private schools. Data from previous surveys of 40 medical schools in Republic of Korea and 154 medical schools in the USA were also analyzed. 2. Medical humanities courses in Vietnam compared to those in the USA and Republic of Korea We found similarities and differences in medical humanities courses offered in medical schools in three countries. Twenty-nine (93.5%) medical schools in Vietnam provided at least one MH course, either mandatory or optional. In comparison, all 40 medical schools in Republic of Korea and 135 (87.7%) schools in the USA claimed to offer at least one such course. However, MH courses in Vietnam were less diverse than those in Republic of Korea and the USA. Only 8 types of subjects were present in Vietnamese schools, compared to 12 types offered in Republic of Korea, and 11 specific courses plus additional unspecified courses were offered in the USA (see Figure 1). The most frequently offered MH course across all three countries was Medical ethics which was included in 84.4%, 83.9% and 100% of medical schools in Vietnam, the USA, and Republic of Korea, respectively. Besides Medical ethics, the three most popular subjects varied across countries: Psychology, Communication, and Professionalism in Vietnam; History, Communication, Professionalism and Leadership in Republic of Korea; Art, Literature and History in the USA (see Table 1). Medical schools in Vietnam offered an average of 2.5 MH courses per institution while the USA and Republic of Korea offered 3.0 and 8.1 (2.9 in premedical programs and 5.3 in medical programs) courses, respectively. In medical schools in Vietnam, the majority of MH courses were introduced during the first and/or second year of the curriculum (see Figure 2) whereas medical students in Republic of Korea were exposed to these courses from the first year to the sixth year. 3. MH education and type of medical schools In Vietnam, public medical schools were more likely to offer courses in Medical ethics, Psychology, Professionalism, and Sociology, while private schools tend to provide more courses in Communication, Anthropology, Unspecified medical humanities, and Leadership (see Table 2). However, we found only a statistically significant correlation between the number of Communication courses offered and the type of school, with private school provided more Communication courses than public school (P<0.05). 4. Academic characteristics of the courses in medical schools in Vietnam We analyzed the content of the three most common subjects that were present in at least 20 medical schools in Vietnam (see Table 2). These were Medical ethics (n=26, 83.9%), Communication (n=22, 71.0%) and Psychology (n=20, 64.5%). All schools offered these contents in only one course in the curriculum and they are all mandatory (see Table 3). Medical ethics Most medical schools in Vietnam (86.4% public and 77.8% private) offered Medical ethics (see Table 2). This content was often included as part of broader courses, such as Medical psychology and Medical ethics, Communication education and Medical ethics, or Law and Medical ethics and typically consisted of 1 credit. In both public and private schools, most of the subjects were offered in the first year (69.2%), while some schools provided subjects in the second year. Notably, only two public schools offered Medical ethics in the fourth year of the curriculum. Communication Communication was a course in more than half of all private medical schools and public schools. Only one public institute offered the course as an independent course, while in others it was offered as part of a broader course, such as Demography – Communication and Health Education or Communication and Health Education. Most of these courses were assigned 1 credit or less. All public schools offered the course in the first (n=6) or second (n=7) year of the curriculum. In contrast, in private schools, this offering varied across schools, lasting from Year 1 to Year 5, with Year 1 being the most prevalent (n=3). Psychology Psychology content was included in 72.7% of public schools and 44.4% private schools. In most cases (85%), it was taught alongside other topics in general subjects, such as Medical psychology and Medical ethics, or Demography, Psychology and Medical ethics. Regarding the academic year, psychology content was primarily offered in the first year (n=14) and the second year (n=4). In both public medical schools, this subject was assigned 2 credits, while in other cases, it consisted of 1 or less than 1 credit. IV. DISCUSSION This study provides an analysis of Medical humanities education in medical school curricula across all medical schools in Vietnam, with a comparative perspective on the USA and Republic of Korea. Our results demonstrate the unique academic characteristics of MH education in Vietnam, along with notable similarities and differences with those of medical schools in the USA and Republic of Korea. Thus, this manuscript provides valuable contributions to the medical education literature by providing insights and practical proposals for improving the MH education in Vietnam, as well as lessons applicable to other countries that share similar challenges. The findings are discussed in two parts. First, we consider the current status of MH education in Vietnam in a global context, and then we analyze the status in public and private schools and the outcomes of key subjects in detail. We found similarities and disparities between Medical humanities courses offered by medical schools in Vietnam and those in the USA and Republic of Korea. Almost all Vietnamese medical schools (93.5%) offered at least one subject in MH, which was just slightly lower than in Republic of Korea (100%) but higher than in the USA (87.7%). While this is not a gap, the limited variety of subjects in Vietnam is a significant concern. MH courses provided in Vietnam were far less diverse than other courses, with just 8 types of subjects offered. While most schools positively offered courses such as Medical ethics, Communication and Psychology, subjects such as Professionalism, Anthropology, Sociology and Leadership were only provided in a few institutions. More surprisingly, subjects such as History of medicine, Literature, and Art, which were offered by many medical schools in the USA and Republic of Korea were completely absent in Vietnam. This situation appears inadequate to provide medical students with a comprehensive understanding of the humanistic aspects of disease and patient care. Experiences in subjects such as Literature, and various forms of Arts provide excellent educational opportunities for medical students to acquire the principles, values, and skills of the humanities [ 35 , 36 ]. It has been shown that arts-based education is effective in shaping desirable attitudes in physicians and improving observational skills necessary for diagnosis [ 35 ]. For example, exposure to “simulated experiences” such as reading novels or poetry or watching performing arts can help medical students gain humanistic interaction skills, wisdom, and critical insight into human experiences and emotions. This is something that would otherwise be unattainable [ 37 – 41 ]. Moreover, direct participation in the artistic process provides the students with the opportunities to experience novel emotions, explore their feelings, question them, and develop essential competencies for the development of solid doctor-patient relationships such as empathy and self-confidence [ 38 , 42 ]. Recently, the significance of literature has been increasingly emphasized as a source of moral education that can help medical education focus on a more profound understanding of patients’ experiences and on promoting compassionate and humane care [ 43 ]. In addition, the opportunity to learn about patient-reported illness stories and specific medical situations (age, disability, death) that use literary works as adjunctive treatments for some conditions has all contributed to the recent surge in the importance of literature [ 44 ]. The significance of Medical history education to produce excellence physician has also been argued for a long time due to its educational values [ 44 ]. Providing education in the History of medicine can help medical student to develop professional identity in various ways as it enable students: 1) to understand the humanistic aspect of medicine by explaining how medicine has addressed human health and disease issues throughout human history; 2) to promote the professionalism by acknowledging that the medical field has a rich history that stretches back to the Hippocratic period; 3) to recognize the limitations and uncertainties of medicine, which helps to improve current medical practice; 4) understand the emergence or disappearance of disease based on historical changes; 5) acquire general knowledge and critical intellectual competence; 6) to understand the history of their major or institution and integrate it with themselves [ 45 ]. Another significant gap was the number of MH courses offered. On average, each medical school in Vietnam provided only 2.5 MH subjects, which was significantly lower than in Republic of Korea (8.1) and in the USA (3.0). In Vietnam, MH education is primarily offered in the first and second years of medical school, whereas in Republic of Korea, students receive MH education throughout their entire curriculum, both in premedical and medical courses. A key feature of this education in Republic of Korea is the inclusion of integrative courses, which are offered in 87.5% of medical schools. They are present in the curriculum under different names such as Doctor-patient-society, Hospital life, Medicine and society or Medical humanities. This continuous exposure provides students with comprehensive insights into the humanistic approach to medicine and cultivates the ability to understand different perspectives of human disease. The average number of courses were much higher in Republic of Korea than in the USA for the following reasons. First, since the late 1990s, the Korea Institute for Medical Education and Evaluation (KIMEE) has included MH education as an evaluation and accreditation item for medical education, requiring medical schools to offer humanities and social medicine as essential components of medical education [ 46 ]. Furthermore, since the Healthcare system reforms in 2000 [ 47 ], there has been a growing recognition of the importance of MH in medical education and practice in Republic of Korea. This shift aims to address the ethical, social, and cultural dimensions of healthcare, fostering a more holistic approach to patient care and gaining public trust [ 48 ]. In addition, the "Accreditation Standards of KIMEE 2019" (ASK 2019), developed based on the World Federation for Medical Education (WFME) Global Standards, continue to support the integration of MH in medical education. Second, subjects such as Communication, Professionalism, and Leadership are currently being offered independently at medical schools in Republic of Korea. Finally, the small number of subjects in the USA medical schools may be due to the limited scope of information used in this study. In the USA, medical school curriculum is a four-year program, and students are likely to have already received a liberal arts education before entering medical school, so the amount of humanities classes in medical school curriculum may be small. The results in this study reflect different trends in offering MH courses between public and private medical schools in Vietnam. Public medical schools were more likely to offer courses in Medical ethics, Psychology, Professionalism, and Sociology, whereas private schools offered more courses in Communication, Anthropology, Unspecified medical humanities, and Leadership. Despite these differences, we found no statistically significant correlation in all subjects with the type of schools, except Communication. Private schools offered more Communication courses than public schools and the difference was statistically significant (P < 0.05). This distinction may be understandable as private institutions may focus more on these aspects to differentiate themselves in a competitive market and aim to produce physicians who can provide excellent “service” in a healthcare setting. It has been noted that physician-patient communication is a strong and independent predictor of patient satisfaction and trust [ 49 ]. One of the previous studies of the current status of MH courses in the USA, UK and Canada also showed a statistically significant correlation between the number of MH courses offered and the average ranking, with higher-ranked schools being more likely to offere less MH topics. They explained that higher-ranked schools are less pressured to innovate courses and curricula that they deem unnecessary (for better or worse). Furthermore, higher-ranked medical schools may value the ‘harder’ aspects of the curricula, whereas lower-ranked schools, often newly established, may be more aware of the need to innovate or improve their curricula [ 28 ]. The three most popular courses in Vietnam, which were present in at least 20 medical schools, were Medical ethics, Communication, and Psychology. All three courses are required, ensuring that all medical students at those schools have access to these important topics. However, these courses were often embedded in broader courses and were only 1 credit, which may limit the time and depth of these courses. The academic nature of these courses did not differ significantly between public and private schools. Medical ethics is usually offered in the first year of the curriculum and is taught together with other subjects such as communication or law and health education. It is understandable that Medical ethics is the most common MH subject present in both public and private medical schools, as it has long been emphasized and valued as a “must-have” quality among medical professionals and is an essential component of traditional curricula. In addition, the decline of Medical ethics and the loss of public trust in the medical professionals have led to the implementation of a comprehensive system of solutions drawn from economics, management, law, and education [ 33 ]. Communication subjects have been offered in most medical schools, primarily under the title “Demographics – Communication and Health Education.”. While it is mostly covered in the first and second years of public schools, private institutions vary more across academic years, with some schools offering these courses later. Psychology is not on the list of most popular Medical ethics subjects in the USA and Republic of Korea, but is widely offered in Vietnamese medical schools, with 65.5% of schools offering it. However, in these countries, psychology is often integrated into broader subjects such as behavioral science or psychiatry rather than taught as a standalone subject. V. CONCLUSION In conclusion, MH are commonly offered in Vietnamese medical schools, and most medical schools have at least one required course. There is no significant difference between public and private schools in offering MH courses, but there is a correlation between private schools and offering Communication courses. However, the diversity and number of courses are much lower than in the USA and Republic of Korea. This suggests that there is a need to further integrate currently absent and essential courses, such as Medical history, Literature, and Art, into medical school curricula. Although it is difficult to find more time and space for MH education in existing overcrowded curricula, we believe that efforts to strengthen MH education are worthwhile when reforming curricula, given the potential of MH to produce new physicians with excellent medical practice. VI. LIMITATION Several limitations should be acknowledged in this study. First, we collected data primarily from school websites which may not fully represent what is actually taught at medical schools and did not provide depth into the subjects taught. However, we believe that examining curriculum websites is a fair approach given the importance of websites in disseminating information about the curriculum. Second, information on the state of MH education in USA medical schools was extracted from a previous survey that provided data only on medical courses and not on premedical courses. This gap may limit cross-national comparisons, especially given that premedical courses may play an important role in the broader scope of MH education. Medical students in the USA doesn’t need to study during 2-year premedical course which may provide some MH education because they have to finish their major for 4 years before entering a 4-year medical education program. Third, we considered MH in a broader definition in Vietnam and Republic of Korea, which included subjects not considered MH in previous studies in Western countries. We recognize that this inclusion broadens the scope of MH and makes comparisons with previous findings difficult. Nevertheless, given the importance of these courses in the curriculum, their cultural and regional characteristics, and the many traditional humanities topics they encompass, we decided to include them in our study. We believe that this is meaningful in providing insight and implications from the Asian country, reflecting the educational aspect of MH in the region. Finally, we did not examine other aspects of the medical humanities curriculum, such as institutional resources or access to learning opportunities, that might provide a more comprehensive understanding of the current state of MH education in Vietnam. These factors may be important to explore in future research that examines the relevant educational environments or infrastructures that enable or facilitate the provision of MH in medical schools. Despite these limitations, we believe that this study provides valuable insight into the current state of MH education in Vietnamese medical schools and provides useful implications from a comparative perspective with the USA and Republic of Korea. Declarations In the process of conducting a survey for this study, we complied with the contents of “WMA Declaration of Helsinki-ETHICAL Principles for Medical Research Involving Human Participants (https://www.wma.net/policies-post/wma-declaration-of-helsinki/)”. Ethics approval and consent to participate Not applicable for a literature review. Consent for publication Not applicable. Availability of data and materials The datasets used in this study are available from the corresponding author upon request. Competing interests All authors declare that they have no conflict of interest. Acknowledgements Not applicable Funding This study did not receive any specific grants from funding agencies in the public, commercial, or non-profit sectors. Author details 1 Department of Medical Education, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju, Gangwon-do, 26426, Republic of Korea 2 Clinical Skills Lab Center, Hue University of Medicine and Pharmacy, 06 Ngo Quyen Street, Hue City, Vietnam Author Contributions Byung-Il Yeh and Kim Chi: Developed intellectual framework and research design; Byung-Il Yeh and Kim Chi: Analyzed and interpreted data; Byung-Il Yeh and Kim Chi: Drafted the article; Byung-Il Yeh and Kim Chi: Revised the article critically; Byung-Il Yeh and Kim Chi: Approved the final version to be published; Byung-Il Yeh and Kim Chi: Agreed to be personally accountable for the author's own contributions. References Tooke J: The science (and art) of medicine. The Lancet 2016, 387:S6-S7. Wong JG: The Art and Science of Medical Education. The American Journal of the Medical Sciences 2015, 349(3):191. 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Duong DB, Nguyen TA, Goodell K, Osman NY, Nguyen TM, Pham VT, Vu LT, Vu HT, Cosimi LA, Pollack T et al: Undergraduate Medical Education Reform in Viet Nam for a Primary Health Care Workforce. Annals of global health 2022, 88(1):100. Đồng LV: Giáo dục Y đức cho cán bộ y tế ở Việt Nam hiện nay [Fostering Medical ethics for medical staff in Vietnam]. In: 2016. Jung H: Overall status of humanities and social sciences education curriculum in Republic of Korea. In: Survey data supported by KAMC; 2023 (This is an unpublished data. Attached Excel file contains data from a survey conducted by the "Korea Association of Medical Colleges(KAMC)" on the educational content being provided at 40 medical schools in Republic of Korea. For any missing information, we contacted the medical education officer at the school to obtain additional information and used it to prepare this manuscript.) Perry M, Maffulli N, Willson S, Morrissey D: The effectiveness of arts-based interventions in medical education: a literature review. Medical education 2011, 45(2):141-148. Ousager J, Johannessen H: Humanities in undergraduate medical education: a literature review. Academic medicine: journal of the Association of American Medical Colleges 2010, 85(6):988-998. Kirklin D, Meakin R, Singh S, Lloyd M: Living with and dying from cancer: a humanities special study module. Medical humanities 2000, 26(1):51-54. Downie RS, Hendry RA, Macnaughton RJ, Smith BH: Humanizing medicine: a special study module. Medical education 1997, 31(4):276-280. Macnaughton RJ: Special study modules: an opportunity not to be missed. Medical education 1997, 31(1):49-51. Bonebakker V: Literature & medicine: humanities at the heart of health care: a hospital-based reading and discussion program developed by the maine humanities council. 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KIMEE: ASK2019 Medical Education Evaluation and Accreditation Criteria. In.; 2024. (Please go to “https://kimee.or.kr/en/standards/standards-for-accredication/ ” and download “Standards for Accreditation(Post 2 nd cycle, 2012-2018.). OECD: OECD Reviews of Health Care Systems: Korea 2003, OECD Reviews of Health Systems. In. Paris; 2023. Kim MJ: Unintended consequences of healthcare reform in Republic of Korea: evidence from a regression discontinuity in time design. Health Research Policy and Systems 2023, 21(1):60. McKinley C, Limbu Y, Pham L: An Investigation of Processes Linking Patient-Centered Communication Approaches to Favorable Impressions of Vietnamese Physicians and Hospital Services J International Journal of Society, Culture & Language. 2020, 8(1):44-59. Tables Table 1 The most popular Medical humanities subjects in three countries The USA (N=154) South Korea (N=40) Vietnam (N=31) Subject Number of schools (%) Subject Number of schools (%) Subject Number of schools (%) Medical ethics 130 (84.4%) Medical ethics 40 (100%) Medical ethics 26 (83.9%) Art 60 (39.0%) History 25 (62.5%) Communication 22 (71.0%) Literature 50 (32.5%) Communication 16 (40.0%) Psychology 20 (64.5%) History 36 (23.4%) Professionalism 10 (25.0%) Professionalism 4 (12.9%) Theology and spirituality 24 (15.6%) Leadership 10 (25.0%) Anthropology 3 (9.7%) Sociology and Social medicine 23 (14.9%) Art 4 (10.0%) Sociology 2 (6.5%) Table 2 Association between type of school and Medical humanities offering in Vietnam Subject Public school Private school P Present Absent Present Absent n % n % n % n % Medical Ethics 19 86.4 3 13.6 7 77.8 2 22.2 P>0.05 Communication 13 59.1 9 40.9 9 100.0 0 0.0 P0.05 Professionalism 3 13.6 19 86.4 1 11.1 8 88.9 P>0.05 Anthropology 2 9.1 20 90.9 1 11.1 8 88.9 P>0.05 Sociology 2 9.1 20 90.9 0 0.0 9 100.0 P>0.05 Medical humanities 0 0.0 22 100.0 1 11.1 8 88.9 P>0.05 Leadership 0 0.0 22 100.0 1 11.1 8 88.9 P>0.05 Table 3 Academic characteristics of three most common Medical humanities subjects in Vietnam Subject Medical ethics Communication Psychology Public school (n=22) Private school (n=9) Public school (n=22) Private school (n=9) Public school (n=22) Private school (n=9) Presence Yes 19 7 13 9 16 4 No 3 2 9 0 6 5 Presence in the curriculum Independent subject 3 1 1 0 3 0 Part of other subject 16 6 12 9 13 4 Academic consideration Compulsory 19 7 13 9 16 4 Elective 0 0 0 0 0 0 Credit number 1 15 6 11 8 13 4 2 3 1 1 0 2 0 >2 0 0 0 0 0 0 N/A 1 0 1 1 1 0 Academic year 1 13 5 7 3 12 2 2 3 1 6 2 2 2 3 0 0 0 1 0 0 4 2 0 0 1 0 0 5 0 0 0 1 0 0 6 0 0 0 0 0 0 N/A 1 1 0 1 2 0 Additional Declarations No competing interests reported. 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BACKGROUND","content":"\u003cp\u003eAlthough advances in science and technology have made great advances in medicine and health, it is still argued that medicine is as much an art as it is a science [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Osler famously stated: \u0026ldquo;Care more particularly for the individual patient than for the special features of the disease.\u0026rdquo; He also said: \u0026ldquo;The good physician treats the disease; the great physician treats the patient who has the disease\u0026rdquo; [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. These perspectives highlight the importance of a humanistic approach to medical practice in which the ideal physician must not only grasp the scientific knowledge of disease but also understand the illness in relation to the patient\u0026rsquo;s personal experiences in a holistic view [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In this way, the ideal physician could integrate the art of healing into scientific treatment, practice patient-centered care and strive to ensure the patient\u0026rsquo;s well-being [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Therefore, medical education should adopt proper educational orientations and philosophies to cultivate excellent doctors who understand themselves, understand patient\u0026rsquo;s experience beyond their disease and appreciate the broader societal context [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. This emphasizes the need to integrate art and humanities into training and experiences of physician from the first day of medical schools [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. This integration is encapsulated in the term, \u0026ldquo;Medical humanities\u0026rdquo;, which includes a variety of artist disciplines such as theater, literature, poetry, visual arts and performing arts, as well as humanities disciplines such as ethics, history, philosophy, literature and art criticism and theory [\u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhile the concept of Medical humanities (MH) is not new, there has been rigorous calls over the past several decades to comprehensively improve and integrates disciplines, experiences and instruction from the arts and humanities into medical education, particularly during undergraduate medical education (UME) [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. These efforts have been reinforced by the Fundamental Role of the Arts and Humanities in Medical Education (FRAHME) initiative of the American Association of Medical Colleges (AAMC) [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. In addition, emerging data supports the consensus that the integration of MH training into medical education will be a critical element in addressing evolving needs and challenges in healthcare practice and issues of public dissatisfaction and erosion of the public trust and respect for physicians [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMH education offers a number of benefits [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]: greater empathy [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], better moral and ethical reasoning, communication skills and professionalism [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], better academic performance [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], less burnout [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], improved clinical judgment [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], better critical appraisal skills [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], preparation for real-life scenarios in future career [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], deeper appreciation that patient\u0026rsquo;s problems go beyond their biology, and enhanced self-reflection [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. MH education has now become part of the core curriculum in many medical schools worldwide. For instance, all of the medical schools in Italy and Spain included at least one required course with humanities content [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Most medical schools in the USA offer many optional and complementary opportunities to integrate humanities into medical knowledge through providing diverse courses such as history, literature, different forms of arts, sociology and social medicine, narrative medicine, theology and spirituality [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Chinese medical schools also promote MH education in medical training by integrating humanistic education into traditional biomedical courses, providing medical students early exposure to clinical practice and recognizing the potential of art and leisure activities in cultivating MH [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMedical education in Vietnam is currently undergoing major reform, with plans and preparations underway to achieve national and global accreditation, such as the World Federation for Medical Education (WFME) standards [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Consequently, there is an urgent need to develop other aspects of medical training such as medical humanities, besides the knowledge of basic sciences and clinical experiences [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Furthermore, the deterioration of medical ethics among some medical professionals and the decline in public trust in medical profession [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] have highlighted the necessity of integrating MH courses into current curricula for physicians. According to FRAHME guidelines, effective integration of MH into physician training requires a thorough investigation of the current status of MH education and the extent to which humanities are taught within medical schools [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Currently, there is no study that explores the status of MH education in Vietnam. To address this knowledge gap, we conducted this study to examine the current status of MH education in Vietnam and to compare it with the systems in the USA and Republic of Korea.\u003c/p\u003e"},{"header":"II. METHODS","content":"\u003cp\u003eWe conducted this study with three research questions as follows:\u003c/p\u003e\n\u003cp\u003e(1) What is the current status of MH education in Vietnamese medical schools regarding the subject presence, subject type, number of credits, academic considerations and academic year?\u003c/p\u003e\n\u003cp\u003e(2) Are there any differences in MH offerings between public and private medical schools in Vietnam?\u003c/p\u003e\n\u003cp\u003ePrivate medical schools in Vietnam are relatively new, with the first one established in 2015 (Tan Tao University School of Medicine). Considering the long history of public medical schools, this study aimed to compare whether there are any differences in the Medical humanities curricula between two types of institutions.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e(3) What are the commonalities and differences in MH education between Vietnamese medical schools and those in USA and Republic of Korea?\u003c/p\u003e\n\u003cp\u003eIn brief, this study explored the current status of MH education in Vietnamese medical schools, providing valuable insights for the future integration of MH into the curriculum for medical students.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1. Selection of references\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA comparative study was conducted to evaluate the presence of MH courses in medical schools in Vietnam and to compare these findings with the global context. The study used a combination of literature review and surveys of MH courses offered in medical schools in Vietnam, Republic of Korea, and the USA. Republic of Korea was selected as a representative Asian country because medical education reform was developed about 20 years ago. The USA represents a Western country, providing a contrasting perspective from a different cultural and educational context.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2. Data sources\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe examined the curricula of 31 medical schools in Vietnam. Information on the medical curricula of each medical school was obtained from their official institutional websites. In cases where the data available online was insufficient, we directly contacted faculty members at the respective schools to get the required information. Data from the USA were extracted from supporting information provided in previous reports on the extent of MH teaching in the USA, the United Kingdom (UK) and Canada in 2021 [28]. Data on the current status of MH education in 40 medical schools in Republic of Korea was obtained from a survey by the Korean Association of Medical Colleges (KAMC) in 2023 [34].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3. Eligibility criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn line with the purpose of this study and previous research, we broadly defined the Medical humanities as non-scientific subjects that can enhance the education of medical students, including medical ethics, anthropology, art, history, literature, and sociology [1-3, 27, 28]. Additionally, we included four subjects - Communication, Professionalism, Psychology, and Leadership, which are commonly educated in many medical schools in Republic of Korea and Vietnam, as part of the Medical humanities curriculum.\u003c/p\u003e\n\u003cp\u003eWe acknowledged that this inclusion extends the scope of medical humanities and differs from the definitions used in previous studies conducted in Spain and Italy and in the US, UK, and Canada [27, 28]. However, we decided to include these subjects for two reasons: first, they represent core components of medical education in Republic of Korea and Vietnam, reflecting regional educational priorities and curricular practices; and second,\u0026nbsp;we have found that many traditional humanities topics are included in these subjects.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTo be eligible as encompassing medical humanities, curriculum websites had to indicate that there were actual courses (either required or elective). It was considered insufficient to claim that the humanities content was just the learning outcome of the course. We included subjects whether they were independent courses or part of integrative courses (broader courses). The integrative course \u0026ldquo;Medical psychology and Medical ethics\u0026rdquo;, for instance, was counted as the presence of two distinct subjects: Medical psychology and Medical ethics. Integrative courses that incorporated humanities topics but did not have specific titles were classified as \u0026quot;integrative courses\u0026rdquo; as the name suggests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4. Data items and analysis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe collected the following information from curricula websites of Vietnamese medical schools:\u003c/p\u003e\n\u003cp\u003e● Type of university (public or private)\u003c/p\u003e\n\u003cp\u003e●\u0026nbsp;Presence of subjects in humanities in the curriculum\u003c/p\u003e\n\u003cp\u003e●\u0026nbsp;Type of subject (medical ethics, anthropology, art, medical history, literature, sociology, communication, professionalism, psychology, and leadership, unspecified medical humanities and integrative course and others)\u003c/p\u003e\n\u003cp\u003e●\u0026nbsp;Academic consideration (compulsory or elective)\u003c/p\u003e\n\u003cp\u003e●\u0026nbsp;Academic year of the curriculum in which the course is offered (first to sixth)\u003c/p\u003e\n\u003cp\u003e●\u0026nbsp;Number of credits\u003c/p\u003e\n\u003cp\u003eFor an \u0026quot;integrative course\u0026quot; that includes two independent subjects, the credits are divided evenly between the two courses. For example, the integrative course \u0026quot;Medical psychology and Medical ethics\u0026quot; with two credits, one credit was assigned to Medical psychology and one credit was assigned to Medical ethics.\u003c/p\u003e\n\u003cp\u003eWe recorded if at least one medical humanity was taught, whether or not it was mandatory, and how many medical humanities were offered (required or elective). We compared the status of MH education with those in the USA and Republic of Korea. We examined whether there was a relationship between the type of medical school and the offering of each MH course. The analysis was performed using SPSS statistics 25.\u003c/p\u003e"},{"header":"III. RESULTS","content":"\u003cp\u003e\u003cstrong\u003e1. Participating medical schools\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe collected information from 31 medical colleges in Vietnam, including 22 public schools and 9 private schools. Data from previous surveys of 40 medical schools in Republic of Korea and 154 medical schools in the USA were also analyzed. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2. Medical humanities courses in Vietnam compared to those in the USA and Republic of Korea\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe found similarities and differences in medical humanities courses offered in medical schools in three countries. Twenty-nine (93.5%) medical schools in Vietnam provided at least one MH course, either mandatory or optional. In comparison, all 40 medical schools in Republic of Korea and 135 (87.7%) schools in the USA claimed to offer at least one such course. However, MH courses in Vietnam were less diverse than those in Republic of Korea and the USA. Only 8 types of subjects were present in Vietnamese schools, compared to 12 types offered in Republic of Korea, and 11 specific courses plus additional unspecified courses were offered in the USA (see Figure 1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe most frequently offered MH course across all three countries was Medical ethics which was included in 84.4%, 83.9% and 100% of medical schools in Vietnam, the USA, and Republic of Korea, respectively. Besides Medical ethics, the three most popular subjects varied across countries: Psychology, Communication, and Professionalism in Vietnam; History, Communication, Professionalism and Leadership in Republic of Korea; Art, Literature and History in the USA (see Table 1). Medical schools in Vietnam offered an average of 2.5 MH courses per institution while the USA and Republic of Korea offered 3.0 and 8.1 (2.9 in premedical programs and 5.3 in medical programs) courses, respectively. In medical schools in Vietnam, the majority of MH courses were introduced during the first and/or second year of the curriculum (see Figure 2) whereas medical students in Republic of Korea were exposed to these courses from the first year to the sixth year.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3. MH education and type of medical schools\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn Vietnam, public medical schools were more likely to offer courses in Medical ethics, Psychology, Professionalism, and Sociology, while private schools tend to provide more courses in Communication, Anthropology, Unspecified medical humanities, and Leadership (see Table 2). However, we found only a statistically significant correlation between the number of Communication courses offered and the type of school, with private school provided more Communication courses than public school (P\u0026lt;0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4. Academic characteristics of the courses in medical schools in Vietnam\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe analyzed the content of the three most common subjects that were present in at least 20 medical schools in Vietnam (see Table 2). These were Medical ethics (n=26, 83.9%), Communication (n=22, 71.0%) and Psychology (n=20, 64.5%). All schools offered these contents in only one course in the curriculum and they are all mandatory (see Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMedical ethics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMost medical schools in Vietnam (86.4% public and 77.8% private) offered Medical ethics (see Table 2). This content was often included as part of broader courses, such as Medical psychology and Medical ethics, Communication education and Medical ethics, or Law and Medical ethics and typically consisted of 1 credit. In both public and private schools, most of the subjects were offered in the first year (69.2%), while some schools provided subjects in the second year. Notably, only two public schools offered Medical ethics in the fourth year of the curriculum.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCommunication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCommunication was a course in more than half of all private medical schools and public schools. Only one public institute offered the course as an independent course, while in others it was offered as part of a broader course, such as Demography \u0026ndash; Communication and Health Education or Communication and Health Education. Most of these courses were assigned 1 credit or less. All public schools offered the course in the first (n=6) or second (n=7) year of the curriculum. In contrast, in private schools, this offering varied across schools, lasting from Year 1 to Year 5, with Year 1 being the most prevalent (n=3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePsychology\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePsychology content was included in 72.7% of public schools and 44.4% private schools. In most cases (85%), it was taught alongside other topics in general subjects, such as Medical psychology and Medical ethics, or Demography, Psychology and Medical ethics. Regarding the academic year, psychology content was primarily offered in the first year (n=14) and the second year (n=4). In both public medical schools, this subject was assigned 2 credits, while in other cases, it consisted of 1 or less than 1 credit.\u0026nbsp;\u003c/p\u003e"},{"header":"IV. DISCUSSION","content":"\u003cp\u003eThis study provides an analysis of Medical humanities education in medical school curricula across all medical schools in Vietnam, with a comparative perspective on the USA and Republic of Korea. Our results demonstrate the unique academic characteristics of MH education in Vietnam, along with notable similarities and differences with those of medical schools in the USA and Republic of Korea. Thus, this manuscript provides valuable contributions to the medical education literature by providing insights and practical proposals for improving the MH education in Vietnam, as well as lessons applicable to other countries that share similar challenges. The findings are discussed in two parts. First, we consider the current status of MH education in Vietnam in a global context, and then we analyze the status in public and private schools and the outcomes of key subjects in detail.\u003c/p\u003e \u003cp\u003eWe found similarities and disparities between Medical humanities courses offered by medical schools in Vietnam and those in the USA and Republic of Korea. Almost all Vietnamese medical schools (93.5%) offered at least one subject in MH, which was just slightly lower than in Republic of Korea (100%) but higher than in the USA (87.7%). While this is not a gap, the limited variety of subjects in Vietnam is a significant concern. MH courses provided in Vietnam were far less diverse than other courses, with just 8 types of subjects offered. While most schools positively offered courses such as Medical ethics, Communication and Psychology, subjects such as Professionalism, Anthropology, Sociology and Leadership were only provided in a few institutions. More surprisingly, subjects such as History of medicine, Literature, and Art, which were offered by many medical schools in the USA and Republic of Korea were completely absent in Vietnam. This situation appears inadequate to provide medical students with a comprehensive understanding of the humanistic aspects of disease and patient care. Experiences in subjects such as Literature, and various forms of Arts provide excellent educational opportunities for medical students to acquire the principles, values, and skills of the humanities [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. It has been shown that arts-based education is effective in shaping desirable attitudes in physicians and improving observational skills necessary for diagnosis [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. For example, exposure to \u0026ldquo;simulated experiences\u0026rdquo; such as reading novels or poetry or watching performing arts can help medical students gain humanistic interaction skills, wisdom, and critical insight into human experiences and emotions. This is something that would otherwise be unattainable [\u003cspan additionalcitationids=\"CR38 CR39 CR40\" citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Moreover, direct participation in the artistic process provides the students with the opportunities to experience novel emotions, explore their feelings, question them, and develop essential competencies for the development of solid doctor-patient relationships such as empathy and self-confidence [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. Recently, the significance of literature has been increasingly emphasized as a source of moral education that can help medical education focus on a more profound understanding of patients\u0026rsquo; experiences and on promoting compassionate and humane care [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. In addition, the opportunity to learn about patient-reported illness stories and specific medical situations (age, disability, death) that use literary works as adjunctive treatments for some conditions has all contributed to the recent surge in the importance of literature [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. The significance of Medical history education to produce excellence physician has also been argued for a long time due to its educational values [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. Providing education in the History of medicine can help medical student to develop professional identity in various ways as it enable students: 1) to understand the humanistic aspect of medicine by explaining how medicine has addressed human health and disease issues throughout human history; 2) to promote the professionalism by acknowledging that the medical field has a rich history that stretches back to the Hippocratic period; 3) to recognize the limitations and uncertainties of medicine, which helps to improve current medical practice; 4) understand the emergence or disappearance of disease based on historical changes; 5) acquire general knowledge and critical intellectual competence; 6) to understand the history of their major or institution and integrate it with themselves [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAnother significant gap was the number of MH courses offered. On average, each medical school in Vietnam provided only 2.5 MH subjects, which was significantly lower than in Republic of Korea (8.1) and in the USA (3.0). In Vietnam, MH education is primarily offered in the first and second years of medical school, whereas in Republic of Korea, students receive MH education throughout their entire curriculum, both in premedical and medical courses. A key feature of this education in Republic of Korea is the inclusion of integrative courses, which are offered in 87.5% of medical schools. They are present in the curriculum under different names such as Doctor-patient-society, Hospital life, Medicine and society or Medical humanities. This continuous exposure provides students with comprehensive insights into the humanistic approach to medicine and cultivates the ability to understand different perspectives of human disease. The average number of courses were much higher in Republic of Korea than in the USA for the following reasons.\u003c/p\u003e \u003cp\u003eFirst, since the late 1990s, the Korea Institute for Medical Education and Evaluation (KIMEE) has included MH education as an evaluation and accreditation item for medical education, requiring medical schools to offer humanities and social medicine as essential components of medical education [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. Furthermore, since the Healthcare system reforms in 2000 [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e], there has been a growing recognition of the importance of MH in medical education and practice in Republic of Korea. This shift aims to address the ethical, social, and cultural dimensions of healthcare, fostering a more holistic approach to patient care and gaining public trust [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. In addition, the \"Accreditation Standards of KIMEE 2019\" (ASK 2019), developed based on the World Federation for Medical Education (WFME) Global Standards, continue to support the integration of MH in medical education. Second, subjects such as Communication, Professionalism, and Leadership are currently being offered independently at medical schools in Republic of Korea. Finally, the small number of subjects in the USA medical schools may be due to the limited scope of information used in this study. In the USA, medical school curriculum is a four-year program, and students are likely to have already received a liberal arts education before entering medical school, so the amount of humanities classes in medical school curriculum may be small.\u003c/p\u003e \u003cp\u003eThe results in this study reflect different trends in offering MH courses between public and private medical schools in Vietnam. Public medical schools were more likely to offer courses in Medical ethics, Psychology, Professionalism, and Sociology, whereas private schools offered more courses in Communication, Anthropology, Unspecified medical humanities, and Leadership. Despite these differences, we found no statistically significant correlation in all subjects with the type of schools, except Communication. Private schools offered more Communication courses than public schools and the difference was statistically significant (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). This distinction may be understandable as private institutions may focus more on these aspects to differentiate themselves in a competitive market and aim to produce physicians who can provide excellent \u0026ldquo;service\u0026rdquo; in a healthcare setting. It has been noted that physician-patient communication is a strong and independent predictor of patient satisfaction and trust [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOne of the previous studies of the current status of MH courses in the USA, UK and Canada also showed a statistically significant correlation between the number of MH courses offered and the average ranking, with higher-ranked schools being more likely to offere less MH topics. They explained that higher-ranked schools are less pressured to innovate courses and curricula that they deem unnecessary (for better or worse). Furthermore, higher-ranked medical schools may value the \u0026lsquo;harder\u0026rsquo; aspects of the curricula, whereas lower-ranked schools, often newly established, may be more aware of the need to innovate or improve their curricula [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe three most popular courses in Vietnam, which were present in at least 20 medical schools, were Medical ethics, Communication, and Psychology. All three courses are required, ensuring that all medical students at those schools have access to these important topics. However, these courses were often embedded in broader courses and were only 1 credit, which may limit the time and depth of these courses. The academic nature of these courses did not differ significantly between public and private schools. Medical ethics is usually offered in the first year of the curriculum and is taught together with other subjects such as communication or law and health education. It is understandable that Medical ethics is the most common MH subject present in both public and private medical schools, as it has long been emphasized and valued as a \u0026ldquo;must-have\u0026rdquo; quality among medical professionals and is an essential component of traditional curricula. In addition, the decline of Medical ethics and the loss of public trust in the medical professionals have led to the implementation of a comprehensive system of solutions drawn from economics, management, law, and education [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCommunication subjects have been offered in most medical schools, primarily under the title \u0026ldquo;Demographics \u0026ndash; Communication and Health Education.\u0026rdquo;. While it is mostly covered in the first and second years of public schools, private institutions vary more across academic years, with some schools offering these courses later. Psychology is not on the list of most popular Medical ethics subjects in the USA and Republic of Korea, but is widely offered in Vietnamese medical schools, with 65.5% of schools offering it. However, in these countries, psychology is often integrated into broader subjects such as behavioral science or psychiatry rather than taught as a standalone subject.\u003c/p\u003e"},{"header":"V. CONCLUSION","content":"\u003cp\u003eIn conclusion, MH are commonly offered in Vietnamese medical schools, and most medical schools have at least one required course. There is no significant difference between public and private schools in offering MH courses, but there is a correlation between private schools and offering Communication courses. However, the diversity and number of courses are much lower than in the USA and Republic of Korea. This suggests that there is a need to further integrate currently absent and essential courses, such as Medical history, Literature, and Art, into medical school curricula. Although it is difficult to find more time and space for MH education in existing overcrowded curricula, we believe that efforts to strengthen MH education are worthwhile when reforming curricula, given the potential of MH to produce new physicians with excellent medical practice.\u003c/p\u003e"},{"header":"VI. LIMITATION","content":"\u003cp\u003eSeveral limitations should be acknowledged in this study.\u003c/p\u003e \u003cp\u003eFirst, we collected data primarily from school websites which may not fully represent what is actually taught at medical schools and did not provide depth into the subjects taught. However, we believe that examining curriculum websites is a fair approach given the importance of websites in disseminating information about the curriculum.\u003c/p\u003e \u003cp\u003eSecond, information on the state of MH education in USA medical schools was extracted from a previous survey that provided data only on medical courses and not on premedical courses. This gap may limit cross-national comparisons, especially given that premedical courses may play an important role in the broader scope of MH education. Medical students in the USA doesn\u0026rsquo;t need to study during 2-year premedical course which may provide some MH education because they have to finish their major for 4 years before entering a 4-year medical education program.\u003c/p\u003e \u003cp\u003eThird, we considered MH in a broader definition in Vietnam and Republic of Korea, which included subjects not considered MH in previous studies in Western countries. We recognize that this inclusion broadens the scope of MH and makes comparisons with previous findings difficult. Nevertheless, given the importance of these courses in the curriculum, their cultural and regional characteristics, and the many traditional humanities topics they encompass, we decided to include them in our study. We believe that this is meaningful in providing insight and implications from the Asian country, reflecting the educational aspect of MH in the region.\u003c/p\u003e \u003cp\u003eFinally, we did not examine other aspects of the medical humanities curriculum, such as institutional resources or access to learning opportunities, that might provide a more comprehensive understanding of the current state of MH education in Vietnam. These factors may be important to explore in future research that examines the relevant educational environments or infrastructures that enable or facilitate the provision of MH in medical schools. Despite these limitations, we believe that this study provides valuable insight into the current state of MH education in Vietnamese medical schools and provides useful implications from a comparative perspective with the USA and Republic of Korea.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eIn the process of conducting a survey for this study, we complied with the contents of \u0026ldquo;WMA Declaration of Helsinki-ETHICAL Principles for Medical Research Involving Human Participants (https://www.wma.net/policies-post/wma-declaration-of-helsinki/)\u0026rdquo;.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable for a literature review.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used in this study are available from the corresponding author upon request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors declare that they have no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study did not receive any specific grants from funding agencies in the public, commercial, or non-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eDepartment of Medical Education, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju, Gangwon-do, 26426, Republic of Korea\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eClinical Skills Lab Center, Hue University of Medicine and Pharmacy, 06 Ngo Quyen Street, Hue City, Vietnam\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eByung-Il Yeh and Kim Chi: Developed intellectual framework and research design; Byung-Il Yeh and Kim Chi: Analyzed and interpreted data; Byung-Il Yeh and Kim Chi: Drafted the article; Byung-Il Yeh and Kim Chi: Revised the article critically; Byung-Il Yeh and Kim Chi: Approved the final version to be published; Byung-Il Yeh and Kim Chi: Agreed to be personally accountable for the author\u0026apos;s own contributions.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eTooke J: The science (and art) of medicine. 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Medical humanities 2000, 26(1):23-30.\u003c/li\u003e\n\u003cli\u003eLaplane L, Mantovani P, Adolphs R, Chang H, Mantovani A, McFall-Ngai M, Rovelli C, Sober E, Pradeu T: Why science needs philosophy. 2019, 116(10):3948-3952.\u003c/li\u003e\n\u003cli\u003eQuintero GA: Medical education and the healthcare system - why does the curriculum need to be reformed? BMC Medicine 2014, 12(1):213.\u003c/li\u003e\n\u003cli\u003eOrefice C, P\u0026eacute;rez J, Banos J-E: The presence of humanities in the curricula of medical students in Italy and Spain. Educacion Medica 2019, 20:79-86.\u003c/li\u003e\n\u003cli\u003eHowick J, Zhao L, McKaig B, Rosa A, Campaner R, Oke J, Ho D: Do medical schools teach medical humanities? Review of curricula in the United States, Canada and the United Kingdom. Journal of evaluation in clinical practice 2022, 28(1):86-92.\u003c/li\u003e\n\u003cli\u003eQian Y, Han Q, Yuan W, Fan CJTJoIMR: Insights into medical humanities education in China and the West. 2018, 46:3507 - 3517.\u003c/li\u003e\n\u003cli\u003eDuong DB, Phan T, Trung NQ, Le BN, Do HM, Nguyen HM, Tang SH, Pham V-A, Le BK, Le LC et al: Innovations in medical education in Vietnam. 2021, 7(Suppl 1):s23-s29.\u003c/li\u003e\n\u003cli\u003eLi\u0026ecirc;n N: C\u0026aacute;c trường đại học Y khoa Việt Nam hướng tới mục ti\u0026ecirc;u kiểm định y khoa quốc tế [Medical schools in Vietnam aim for global accreditation]. In: B\u0026aacute;o Điện tử đại biểu nh\u0026acirc;n d\u0026acirc;n. 2024.\u003c/li\u003e\n\u003cli\u003eDuong DB, Nguyen TA, Goodell K, Osman NY, Nguyen TM, Pham VT, Vu LT, Vu HT, Cosimi LA, Pollack T et al: Undergraduate Medical Education Reform in Viet Nam for a Primary Health Care Workforce. Annals of global health 2022, 88(1):100.\u003c/li\u003e\n\u003cli\u003eĐồng LV: Gi\u0026aacute;o dục Y đức cho c\u0026aacute;n bộ y tế ở Việt Nam hiện nay [Fostering Medical ethics for medical staff in Vietnam]. In: 2016.\u003c/li\u003e\n\u003cli\u003eJung H: Overall status of humanities and social sciences education curriculum in Republic of Korea. In: Survey data supported by KAMC; 2023 (This is an unpublished data. Attached Excel file contains data from a survey conducted by the \u0026quot;Korea Association of Medical Colleges(KAMC)\u0026quot; on the educational content being provided at 40 medical schools in Republic of Korea. For any missing information, we contacted the medical education officer at the school to obtain additional information and used it to prepare this manuscript.)\u003c/li\u003e\n\u003cli\u003ePerry M, Maffulli N, Willson S, Morrissey D: The effectiveness of arts-based interventions in medical education: a literature review. Medical education 2011, 45(2):141-148.\u003c/li\u003e\n\u003cli\u003eOusager J, Johannessen H: Humanities in undergraduate medical education: a literature review. Academic medicine: journal of the Association of American Medical Colleges 2010, 85(6):988-998.\u003c/li\u003e\n\u003cli\u003eKirklin D, Meakin R, Singh S, Lloyd M: Living with and dying from cancer: a humanities special study module. Medical humanities 2000, 26(1):51-54.\u003c/li\u003e\n\u003cli\u003eDownie RS, Hendry RA, Macnaughton RJ, Smith BH: Humanizing medicine: a special study module. Medical education 1997, 31(4):276-280.\u003c/li\u003e\n\u003cli\u003eMacnaughton RJ: Special study modules: an opportunity not to be missed. Medical education 1997, 31(1):49-51.\u003c/li\u003e\n\u003cli\u003eBonebakker V: Literature \u0026amp; medicine: humanities at the heart of health care: a hospital-based reading and discussion program developed by the maine humanities council. Academic medicine: journal of the Association of American Medical Colleges 2003, 78(10):963-967.\u003c/li\u003e\n\u003cli\u003eMatharu K: Using Indigenous Australian drama to break cultural barriers in healthcare relationships. Medical humanities 2009, 35(1):47-53.\u003c/li\u003e\n\u003cli\u003eShapiro J, Rucker L: Can poetry make better doctors? Teaching the humanities and arts to medical students and residents at the University of California, Irvine, College of Medicine. Academic medicine: journal of the Association of American Medical Colleges 2003, 78(10):953-957.\u003c/li\u003e\n\u003cli\u003eHunter KM, Charon R, Coulehan JL: The study of literature in medical education. Academic medicine: journal of the Association of American Medical Colleges 1995, 70(9): 787-794.\u003c/li\u003e\n\u003cli\u003eShapiro J: Illness narratives: reliability, authenticity and the empathic witness. Medical humanities 2011, 37(2):68-72.\u003c/li\u003e\n\u003cli\u003eKwon I: The Value of Medical Humanities in Medical Education: Focusing on the History of Medicine. Ui sahak 2022, 31(3):495-517.\u003c/li\u003e\n\u003cli\u003eKIMEE: ASK2019 Medical Education Evaluation and Accreditation Criteria. In.; 2024. (Please go to \u0026ldquo;https://kimee.or.kr/en/standards/standards-for-accredication/ \u0026rdquo; and download \u0026ldquo;Standards for Accreditation(Post 2\u003csup\u003end\u003c/sup\u003e cycle, 2012-2018.).\u003c/li\u003e\n\u003cli\u003eOECD: OECD Reviews of Health Care Systems: Korea 2003, OECD Reviews of Health Systems. In. Paris; 2023.\u003c/li\u003e\n\u003cli\u003eKim MJ: Unintended consequences of healthcare reform in Republic of Korea: evidence from a regression discontinuity in time design. Health Research Policy and Systems 2023, 21(1):60.\u003c/li\u003e\n\u003cli\u003eMcKinley C, Limbu Y, Pham L: An Investigation of Processes Linking Patient-Centered Communication Approaches to Favorable Impressions of Vietnamese Physicians and Hospital Services J International Journal of Society, Culture \u0026amp; Language. 2020, 8(1):44-59.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e The most popular Medical humanities subjects in three countries\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"677\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 238px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThe USA (N=154)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 238px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSouth Korea (N=40)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 200px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVietnam (N=31)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubject\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of schools (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubject\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of schools (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubject\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of schools (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eMedical ethics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e130 (84.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eMedical ethics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e40 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eMedical ethics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e26 (83.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eArt\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e60 (39.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eHistory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e25 (62.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eCommunication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e22 (71.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eLiterature\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e50 (32.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eCommunication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e16 (40.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003ePsychology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e20 (64.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eHistory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e36 (23.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eProfessionalism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e10 (25.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eProfessionalism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e4 (12.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eTheology and spirituality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e24 (15.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eLeadership\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e10 (25.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eAnthropology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e3 (9.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eSociology and Social medicine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e23 (14.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eArt\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e4 (10.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eSociology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e2 (6.5%)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u003c/strong\u003e Association between type of school and Medical humanities offering in Vietnam\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubject\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 212px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePublic school\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 212px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrivate school\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 61px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbsent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbsent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eMedical Ethics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e86.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e13.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e77.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e22.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eP\u0026gt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eCommunication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e59.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e40.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eP\u0026lt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003ePsychology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e72.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e27.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e44.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e55.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eP\u0026gt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eProfessionalism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e13.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e86.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e88.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eP\u0026gt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eAnthropology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e90.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e88.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eP\u0026gt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eSociology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e90.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eP\u0026gt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eMedical humanities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e88.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eP\u0026gt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eLeadership\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e88.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eP\u0026gt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e Academic characteristics of three most common Medical humanities subjects in Vietnam\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"665\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubject\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedical ethics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCommunication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePsychology\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePublic school\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=22)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrivate school\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=9)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePublic school\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=22)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrivate school\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=9)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePublic school\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=22)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrivate school\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=9)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003ePresence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003ePresence in the curriculum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003eIndependent subject\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n 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style=\"width: 79px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003eAcademic year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n 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\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Medical humanities, Medical humanities education, current status, Vietnam","lastPublishedDoi":"10.21203/rs.3.rs-6095105/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6095105/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground \u003c/strong\u003eThe importance of integrating Medical humanities education into medical curricula has been recognized worldwide. This study helps to understand the current status of the Medical humanities education in medical schools in Vietnam and provides insights and references for promoting it.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods \u003c/strong\u003eWe conducted a comparative study based on a literature review and survey of Medical humanitiescourses in medical schools in Vietnam, the USA and Republic of Korea. Data from the USA and Republic of Korea were referenced from the previous reports. To obtain the data from Vietnamese medical schools we examined the curriculum posted on the websites and, if insufficient, collected them by contacting the faculties in the schools. We explored the similarities and differences in Medical humanities courses educated in medical schools in Vietnam and those in the USA and Republic of Korea. Additionally, chi-square tests were used to examine the association between the types of medical schools and offerings of Medical humanities courses in Vietnamese medical schools.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults \u003c/strong\u003eWe analyzed information of 31 medical schools in Vietnam, 154 in the USA and 40 in Republic of Korea. Of these, 93.5% medical schools in Vietnam, 87.7% in the USA and all 40 in Republic of Korea provided at least one Medical humanities course. Medial humanities courses in Vietnam offered only 8 types of subjects, which was less diverse compared to more than 12 in the USA and Republic of Korea. In addition, the average number of Medical humanities courses in medical schools in Vietnam was less than those in the USA and Republic of Korea. The most common Medical humanities courses in Vietnam were Medical ethics (83.9%), Communication (71.0%) and Psychology (64.5%). Private schools showed a tendency to provide more class of Communication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions \u003c/strong\u003eMedical humanities education in Vietnam is much lower than those in the USA and Republic of Korea. Considering the potential of Medical humanities to produce new medical doctors with excellent medical practice, efforts should be made to strengthen Medical humanities education when reforming the curriculum in the future in Vietnam.\u003c/p\u003e","manuscriptTitle":"Current status of Medical humanities education in Vietnamese medical schools: a comparative perspective from the USA and Republic of Korea","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-18 11:19:33","doi":"10.21203/rs.3.rs-6095105/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-04-14T08:10:48+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-14T04:47:48+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-08T09:18:25+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-06T04:44:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"65512856958177096730343286572054671853","date":"2025-04-02T23:27:31+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-02T05:16:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"289534627589982757376889375358138771359","date":"2025-04-02T02:02:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"186505953647531210584301644123508317245","date":"2025-04-01T10:25:31+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"267336259248777636724042924993185510261","date":"2025-04-01T01:55:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"164590780649079486553878084118664606531","date":"2025-03-31T02:27:14+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-03-29T22:42:41+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-03-24T10:12:29+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-24T01:44:08+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-03-24T01:43:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5fbe32bc-66b8-47f9-8a20-06bc4250dc9d","owner":[],"postedDate":"April 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-07-07T16:02:07+00:00","versionOfRecord":{"articleIdentity":"rs-6095105","link":"https://doi.org/10.1186/s12909-025-07380-8","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2025-07-01 15:57:33","publishedOnDateReadable":"July 1st, 2025"},"versionCreatedAt":"2025-04-18 11:19:33","video":"","vorDoi":"10.1186/s12909-025-07380-8","vorDoiUrl":"https://doi.org/10.1186/s12909-025-07380-8","workflowStages":[]},"version":"v1","identity":"rs-6095105","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6095105","identity":"rs-6095105","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}