July 20, 2008

Pre-Med content featured in this month's NEJM

Relevance and Rigor in Premedical Education
Jules L. Dienstag, M.D.

In recent decades, scientific knowledge has changed dramatically, once-settled scientific principles have been replaced by more sophisticated concepts and entirely new disciplines, and parallel changes have occurred in medical practice and health care delivery. In the face of these new realities, medical school curricula have had to adapt. Yet despite these sweeping changes, including the permeation of most areas of medicine by molecular and cellular biology and genetics, requirements for admission to medical school have remained virtually unchanged for many decades.
This article talks about the ever-expanding knowledge base required to become a physician... and Dienstag questions whether or not the old admission criteria for medical school are appropriate for the always-lifting expectations of our future doctors.
1 year of biology + 2 years of chemistry (1 yr gen chem, 1 yr o-chem) + 1 yr physics isn't enough. I agree.

However, I don't think that raising the bar on the admission criteria will somehow magically improve the crop of incoming medical students. Some of my best friends in medical school are History, English, even Real Estate majors and they are excelling. They have admitted to me from time to time that they struggle with some of the basic science subjects we are forced to learn rapidly on our own (i.e. microbiology, embryology) but really... would requiring people to take these courses as an undergrad really be beneficial? A lot of what I learned as a biology major WASN'T applicable to the study of Human Medicine.

Regardless, Dienstag makes a good point that the best pre-med courses would be INTEGRATIVE... encouraging students to make connections across basic science subject lines. I wonder if medical schools could ever require this, since it would be a pre-med subject that would vary greatly based on the lecturer (as no textbooks exist for such a course.)

From All Walks of Life — Nontraditional Medical Students and the Future of Medicine
Sandeep Jauhar, M.D., Ph.D.

When I was growing up, my parents wanted me to become a doctor, but I had other ideas. I wanted to be a television journalist, or perhaps a trial lawyer or private investigator — something with panache. In college, intoxicated by the mysteries of the universe, I ended up studying condensed-matter physics, in which I eventually earned a Ph.D. But after a close friend contracted an incurable illness, I began to have doubts about my career path. Seeking a profession of tangible purpose — like many older students — I was drawn to medicine.

Jauhar talks about the benefit of having "non-traditional" students in a class of students straight from college. While they possess different qualities of maturity and dedication, knowing full well the luxury of a student's lifestyle (as opposed to working paycheck to paycheck with little other reward)... they also have fewer years of output towards society before they end up retiring. They also have more outside life to attend to, with husbands/wives and kids. Can the U.S. medical system afford this in the long run?

I think this is the major sacrifice we have to make to have more well-rounded physicians. More female doctors, more older students, more foreign graduates will help to break down the stereotypes of the medical profession. In the ideal world, I think everyone would be a physician -- basically, the knower of their own body -- in the philosopher-king, artist-scientist Renaissance sort of way where we can all be equally enlightened in our equal access to the information we need (Yay, internet!)

No comments:

Post a Comment