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Re: [Phys-l] Premed Requirements Commentary

Here is the relevant excerpt from this editorial:

Changing Premed Requirements and the Medical Curriculum
Ezekiel J. Emanuel, MD, PhD
JAMA. 2006;296:1128-1131.

Changing Premed Requirements

By issuing admission requirements, medical schools have a profound impact on what thousands of college students learn and do not learn each year.3 Many premed requirements are irrelevant to future medical education and practice.3, 16 Does knowing how to integrate sin have anything to do with caring for a patient or elucidating the role of TERC in aplastic anemia? Do any physicians, even researchers, have to know about Diels-Alder adducts? Is calculating the angular momentum of a spinning top relevant to any medical practice? Most of what is contained in 1 year of college calculus, organic chemistry, and physics is irrelevant to medical practitioners, researchers, and administrators. Researchers who need such information do not rely on their college courses.
Why are calculus, organic chemistry, and physics still premed requirements? Mainly to "weed out" students. Surely, it would be better to require challenging courses on topics germane to medical practice, research, or administration to assess the quality of prospective medical students, rather than irrelevant material.3
At least 6 relevant topics are not premed requirements. First, the mathematics most medical students need are statistics. Statistics are essential to reading the medical literature, designing research studies, and implementing quality improvement initiatives. Moreover, knowledge of statistics is more valuable for life and for being a thoughtful, informed citizen.
Genetics, molecular biology, and biochemistry are much more essential to medicine than organic chemistry and physics. True, some knowledge of nomenclature and organic structures and reactions is important for biochemistry, but the necessary material could be taught in a few weeks, rather than requiring an entire year of irrelevant synthetic pathways. Two courses encompassing genetics and molecular biology would be much more educationally valuable for medical students than one in physics.
As the mere existence of the Hippocratic oath attests, ethical challenges are inherent in medical practice and research.17 Yet there is no premed ethics requirement. Students need the ability to distinguish ethical issues from communications, economic issues, or aesthetic issues, to make ethical arguments, and to give ethical reasons that justify their decisions. Requiring a general ethics course is preferable to a focused bioethics course, which should wait until students have experience with actual patients and clinical dilemmas.
Moreover, much of the practice of medicine, as well as dealing with a research team and administering organizations, entails dealing with people and, therefore, human psychology. Requiring that students take a psychology course that provides education about established notions of human behavior, such as the fundamental attribution error, hindsight bias, transference, and moral distancing, could enhance physicians' interactions with patients, colleagues, and employees, not to mention their own families.
Discontinuing the requirements for calculus, organic chemistry, and physics would open up 6 semesters for more relevant courses. Adding 1 semester each of statistics, ethics, psychology, genetics, and molecular biology and 1 year of biochemistry, would require 1 semester less of course work if genetics and molecular biology satisfied the biology requirement. With this extra time, students could pursue other interests in this formative period, ensuring they received a true liberal education.

Dennis E. Krause
Assoc. Prof. of Physics, Dept. Chair
Department of Physics
Crawfordsville, IN 47933
Office: Goodrich 313
Phone: (765) 361-6181
Fax: (765) 361-6340