The study of literature encourages the development of otherwise hard-t
o-teach clinical competencies. It provides access to the values and ex
periences of physicians, patients, and families; it calls for the exer
cise of skill in observation and interpretation, develops clinical ima
gination, and, especially through writing, preserves fluency in ordina
ry language and promotes clarity of observation, expression, and self-
knowledge. Faculty in one-third of U.S. medical schools teach literatu
re in courses that, although concentrated in the preclinical years, ra
nge from the first day of school through residency programs. Once focu
sed on the work of physician - authors and realist fiction about illne
ss that encouraged moral reflection about the practice of medicine, li
terary study in medicine now encompasses a wide range of literature an
d narrative types, including the patient history and the clinical case
. Literary study is intended not only to enrich students' moral educat
ion but also to increase their narrative competence, to foster a toler
ance for the uncertainties of clinical practice, and to provide a grou
nding for empathic attention to patients. Literature may be included i
n medical humanities courses, and it may provide rich cases for ethics
courses or introductions to the patients - physician relationship; it
also may be the focus of small, elective, or selective courses, frequ
ently on particular social issues or on the experience of illness. Rea
ding, discussion, writing, and role-play rather than lectures are the
methods employed; faculty include those the PhDs in literature and MDs
who have strong interests in the contributions of literature to pract
ice. Pedagogical and scholarly resources include Literature and Medici
ne, the Center for Literature and the Health Care Professions, and an
online database and discussion group.