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April 11, 2013 1:16 PM Should Pre-Med Requirements be Reformed?

By Aaron Carroll

As I mentioned earlier, I’m at Amherst College for a few days talking to economics and premed students. At dinner tonight, one of the things we discussed was how premed requirements seem antiquated and sometimes useless. How many times do physicians really need to call on their two semesters of organic chemistry. This is coming from two chemistry majors (myself and the chair of the economics dept). How timely, then, that the NEJM has a piece directly on poing. “Reforming Premedical Education — Out with the Old, in with the New“:

The most consistent and strident calls for medical education reform over the past century have focused on premedical preparation. The first attempt at standardizing requirements for medical school admission came in 1904 from the American Medical Association’s Council on Medical Education. In 1910, Abraham Flexner recommended requiring biology, chemistry, botany, and physics, and by 1930, today’s premedical science preparation — biology, chemistry, organic chemistry, and physics — was firmly established. But criticism began as early as 1929, and in 1939 the Association of American Medical Colleges weighed in.
Recent years have seen many calls for enhancing, overhauling, or abolishing the traditional premed requirements. Critics argue that the pace of scientific discovery and its clinical application have outstripped the requirements; that information technology has made memorizing vast amounts of content unnecessary; that the requirements lack clinical, scientific, and social relevance; that they’re used to cull the herd of talented aspiring physicians; that they disadvantage minority and female students; that they crowd out studies of bioethics, social justice, and health policy; and that rigidly structured premedical and medical school curricula hinder students from becoming self-directed lifelong learners.Furthermore, the current model has perpetuated “premed syndrome,” a culture of aggressive competition for grades that conflicts with the precepts of medical professionalism: academic and intellectual rigor, creative thinking, collaboration, and social conscience.

I could not agree with this more. Tonight, we discussed how some classes in psychology, philosophy, decision making, and others might be far more useful than physics and chemistry. David Muller has his own ideas:

academic rigor with less grades-driven competition; independent mentored scholarship; flexibility to pursue widely varied majors; self-directed educational plans that foster lifelong learning; more scientifically and clinically relevant coursework; and more courses instilling an appreciation for medicine’s social, political, and economic contexts.

Sounds good to me. Can we get this going?

@aaronecarroll

[Originally posted at The Incidental Economist]

Aaron Carroll ,MD, is an associate professor of Pediatrics and the associate director of Children’s Health Services Research at Indiana University School of Medicine.

Comments

  • Ryan Gray on April 12, 2013 9:00 PM:

    I love the FlexMed theory and I'm very interested in seeing what the outcomes are like. I was lucky enough to interview Dr. Muller and from what we discussed, I don't see many negatives.

    I have heard from others that have interviewed there for HuMed, that some of the students said they wouldn't go into medicine if it wasn't for programs like this. That person was very turned off by it. I don't know if I think that is necessarily a bad thing. I think if we can expand our diversity, we can have more people working to cure diseases and connect with patients in a new and different way.