A Response to “Doctors’ Challenges During Infectious Disease Outbreaks: Medical Education Insights from Realistic Fiction Movies” [Response to Letter]

Dear editor

First, I would like to thank Choi et al (2021)⁶ for their thorough reading and valuable comments on my published paper “Doctors’ Challenges During Infectious Disease Outbreaks: Medical Education Insights from Realistic Fiction Movies.”¹

I was very glad to see their comment saying “The selfless qualities of doctors portrayed in movies played important roles to inspire the decisions to pursue careers in medicine amongst many of our peers.” This reflects the humanistic aspect of being a medical student, and indicates that choosing medicine as a future career is motivated first by the ethical and human principles of many young students.

Ning Yan Choi et al (2021) actually perceived brilliantly my appreciation of movies as an educational tool in medical education. Indeed, I believe that every genre of art including cinema, literature, fine arts, and music, can be used as a medium in medical education to teach about social, psychological, and philosophical aspects of doctoring. Furthermore, using art works as a medium in medical studies has a contribution for professional skills. Past studies have suggested that art can be utilized to teach observational skills in medical students, a skill that is integral to patient examination.² It is important to mention here that while many studies recommend using art in medical education, the studies on its long-term impact on medical students are scarce.

The authors mentioned the issue of highlighting female doctors’ representations as powerful and leaders, while the reality reports on continuous gender disparities. They agreed that raising the issue invites medical students to discuss these disparities and reflect on them. I would add to this, that such reflections might lead them to think about their roles as future doctors and policymakers in changing this reality. Indeed, gender inequalities, added to other social disparities in medical settings, is a global “pandemic „, the impacts of which have been intensified during the COVID-19 pandemic. Workload, promotion, and visibility are some expressions of these inequalities. While epidemiology and medicine are female-dominated fields, men get quoted far more often than women about the pandemic (The World University Ranking, 2020).³ The same issue was reported in The Lancet when Gabster et al (2020)⁴ pointed out that women made up just 24% of COVID-19 experts quoted in the media and 24.3% of analyzed national task forces.

I appreciate the authors’ mentioning of the risks that may be engaged in movies of conspiracy theories such as the Toxic Skies movie, especially in times of pandemic such as COVID-19. While some observers may believe this conspiracy, many others, especially medical students, will find it an issue for discussion: the reasons behind searching conspiracies by some social groups; what did the governments do to strengthen these theories? Moreover, what is the sociology and psychology behind conspiracy theories during pandemics? Persons will not build their decision to get the vaccine based on a movie, but on many other factors such as age, economic status, low trust in the vaccine itself or the state, and the health service response during the pandemic and more.⁵

The authors mentioned that excluding non-English movies from the study was a major limitation, because they could “provide a more representative reflection of doctors’ experiences in countries with different socio-economic and cultural context.” I agree that this is a limitation of the study, but also want to explain this exclusion. Throughout the process of looking for movies in other languages that meet the inclusion criteria other than the language criterion, I found several movies in different languages that address the research topic. Unfortunately, many of them are not free online and need paid registration on different authenticated accounts that provide subtitles. In addition, some movies’ titles are not available in English but in other languages that prevent me reaching and including them. This may create inaccuracy in reporting on which movies addressed the issue. Also, there are so many languages in the world, the decision on including some and excluding others, will also create some kind of limitation and bias in the study.