Will Medical Schools Move Away from Science Requirements?

[Pangloss]

From the New York Times:

http://www.nytimes.com/2010/07/30/nyregion/30medschools.html

 

Apparently a small number of students are admitted to Mount Sinai each year without the usual requirement of organic chemistry, physics, and the MCAT. These students still have to take a crash summer course on organic chemistry, but instead study the humanities in their junior and senior years prior to entering medical school.

 

This quote was kinda jarring:

 

Ms. Adler said she was inspired by her freshman study abroad in Africa. “I didn’t want to waste a class on physics, or waste a class on orgo,” she said. “The social determinants of health are so much more pervasive than the immediate biology of it.”

 

Ouch. But they still have to take all the same courses once they get into medical school. If they don't learn the subjects, they fail just like anybody else. The feeling seems to be that they'll be more in touch with the human side of things (better bedside manner?).

[Mr Skeptic]

How much is it worth it to a patient to have a doctor that can understand all kinds of chemical reactions? How much is it worth it to a patient if the doctor can convince them to get off their lazy ass and stop shoving semi-toxic crap down their throats?

[DJBruce]

How much is it worth it to a patient to have a doctor that can understand all kinds of chemical reactions? How much is it worth it to a patient if the doctor can convince them to get off their lazy ass and stop shoving semi-toxic crap down their throats?

 

Personally, I would prefer that my doctor understand the chemical and biological reactions and pathways that are causing my particular condition, or that are being altered by the medication they are prescribing. I would think the ability to interact with patients would come through experience.

[Genecks]

I think the length of medical school should be extended. As such, the classes studied, such as organic, physics, etc.. should be put into the medical school curriculum rather than the undergraduate curriculum. Why should undergraduate universities bear the burden?

 

The AMA guild is what the problem is. It's forced universities to have ridiculous student competition. It should be medical schools that teach the organic chemistry, biology, and physics in relation to medicine. There needs to be a sharper division in order to allow scientists to become scientists and medical doctors to be medical doctors.

 

I think most modern doctors are tools, anyway.

Edited August 1, 2010 by Genecks

[Skye]

In Australia medicine was traditionally a ~6 year undergraduate degree that you entered straight out of high school. Some univerisities have started adding to, or replacing, these courses with four year postgrad degrees. There are no requirements for science subjects in the undergrad courses, they do need to pass the standard test that includes organic chem and physics though. The reasons are mostly commercial, it opens up a larger number of potential students and increases the number of years they'll be paying fees to 7 or 8.

[DJBruce]

The AMA guild is what the problem is. It's forced universities to have ridiculous student competition. It should be medical schools that teach the organic chemistry, biology, and physics in relation to medicine. There needs to be a sharper division in order to allow scientists to become scientists and medical doctors to be medical doctors.

 

So would you suggest shortening the length of med students undergraduate degree? Since I would venture to guess that most doctors would tell you their schooling last long enough, and is almost impossible to afford without going into massive quantities of debt so adding more schooling might not be practical.

 

The competition for medical school, and the tough pre-med requirements insures that the people who get into medical school are some of the best and brightest. So I really see nothing wrong with the competition and curriculum, actually I find it comforting knowing that my doctor is one of the brightest people around. Also if a person cannot handle the stress of the competition for getting into medical school do you think they will be able to handle the stress of holding the life of numerous people in their hands everyday?

[Genecks]

DJ Bruce, I think what you're stating is misguided.

 

First off, a lot of things that doctors do through the years is book work. There has been little, if any, application of their knowledge. It's only until residency that they begin to be actual medical doctors who treat people. They get to see pain, death, and the happiness of the people they can treat and cure. What good is all of that book work? People can't and don't remember the massive amount of information they've been fed. They remember it for a period of time and then forget it.

 

If you think that people remember all of that, DJ Bruce, that's very misguided. At best, the people have shown they've found a way to assimilate information. They've accomplished something if they know how to use it as a reference. They've mastered it if they can recall it.

 

Think of an electrician or mechanic who never picks up tools to build something but always reads books about fixing something. It's not until the application (and ability to recall and apply what has been learned) that the person is true to his/her trade.

 

I want a medical doctor who can actually figure out what's wrong with me. Does that mean his/her schooling that was about 11 years ago and about 6 years ago after residency helped? I doubt that person can remember exactly everything. Memorization and recall comes through repetition and application. I would want a medical doctor who had a nice residency filled with application of learned facts in relation to his/her trade. That's why people specialize: There is a large inefficiency when people attempt to be knowledgeable about everything. Sure, it would be great if God was working on you, but that's highly imaginative.

 

Also, toughest and brightest? Such a free-will argument.

 

There are a lot of people who are "in the know." You could call these people primed and spoon-fed to be future doctors. Such people may come from parents whom are doctors or even biologists. There are also the people who find good opportunities and resources to learn. And then there are people who do things to the best of their ability without much guidance at all. Truth be, those people are blind as bats and don't succeed too well.

 

That's my serious guess as to what's going on. I relate to the SED reports, which show how graduate students often have parents that have graduate degrees. It's just passing down the torch from one member of a community to the other.

 

Basically, people are being determined through external factors to succeed. The educational system is doing something highly unethical and unjust by causing people to compete as it does.

 

I'm not saying it's impossible to study hard and succeed. But your ability to study depends on how you were taught to study. And sometimes people learn a few tricks on their own, but I've considered that most people are unconscious of how they've learned to be so effective, thus they claim to have done the majority of work themselves. I have a decent memory of the various people in my life who've taught me how to study, work harder, and so forth. Some people forget that stuff.

 

I would say people are tough and bright if they can prevent themselves from going "ew" once they see a dead body or a person puking. You'll be amazed by how many pre-meds are easily disgusted and act childish upon such sights. I say throw them immediately into the real world to make them question their career choice. Then again, by the time people get so far, they rationalize their personhood and self, and they go on ahead anyway. Somehow they form into this "social role" and play their part as a "doctor."

 

Think about medicine before we even got to decent modern biological mechanisms in the 1950s. Seriously? You're going to ask me if a modern knowledge of biology means they can handle having people's lives in their hands? That wasn't the case for people over 100 years ago. They had pathetic knowledge of their craft (of course which hadn't developed) yet attempted to take care of people. And we still have pathetic knowledge of biology, as I'm sure more knowledge is sure to come. YES. People can handle having lives in their hands while not having the best knowledge. People can be caring and empathetic while attempting to heal people to the best of their ability. That doesn't mean they'll always have the best knowledge, and they surely will not ever.

 

I doubt there are enough savant-like doctors who can look at a problem and calculate the probable issues of your health from the most detailed physical details involving physics, organic reactions, rates and limits, etc.. into an answer about health. It's all about diagnosis.

 

What do I think?

 

I think the medical trade should be a specialized trade where people go to school just for that trade.

If people want to be medical doctors, then let them be medical doctors.

Let all of their training be toward becoming a medical doctor.

Have separate schools for that.

 

I'm a firm believer in specialized education, which the American educational system seems to not acknowledge due to guilds, such as the AMA, existing. It's about money. It's that simple. People are trying to act ignorant, b.s. others about how people really go about succeeding, and create a system of unethical competition and success. Many foreign doctors even consider the American medical institution to be corrupt. I've talked to them, too. If it was about people caring, knowing their stuff, and actually living out the role of a care-taker, the training system would be much different.

Edited August 1, 2010 by Genecks

[Marat]

The German medical school system answers many of the problems discussed above. German students enter medical school directly from 'high school' (Abitur) at age 19, and then take a six-year course which includes the American pre-med as well as the American medical school program. They are also required to work in hospitals starting the first summer after their first year in medical school, so that they become familiar with the whole experience of treating patients from the lowest levels of care on up. The most startling difference between Germany and the United States is that German students in high school had already had very advanced lab courses so they found all the lab work in medical school to be quite familiar. In contrast, their knowledge of mathematics was rather poor compared to that of American students planning on a science career, since many did not know any calculus, and the professors had to try to explain concepts from calculus via graphic representations to make them clear to those without the required background.

 

The most stressful difference was that the screening process continued throughout medical school, with both difficult course exams and competitive state exams to pass. It is still difficult to get into medical school in Germany (you need about a 1.3 on the German grade scale, which corresponds to an American A average in the first two years of university, which is how much study an American needs for application to a German school), but it is more difficult to get through to the end.

[CharonY]

One should note that up until recently the German system is completely different from the American one, not only medical school. In Germany you choose a subject (e.g. biology, physics, chemistry etc.) and the whole curriculum is created around these topics. I.e. biologists get a different chemistry training than chemists. Thus the medical school equivalent basically does the same as any other discipline.

I disagree that highschools in Germany have advanced labwork, though. I do recall that calculus is part of the basic highschool curriculum, though.

[Sisyphus]

If the requirements for passing medical school aren't any different, then what's the problem? It's not like there are going to be "humanities doctors" now. Medical schools are just betting that some students will make it despite unconventional undergraduate preparation. If they're right, they're right. If not, those students will fail out.