Pre-med requirements could be revised

Prerequisite courses for pre-meds could soon become a thing of the past.

The American Association of Medical Colleges, which represents the nation’s 131 accredited medical schools, will meet in Boston Sunday to discuss whether medical school applicants can fulfill a checklist of skills instead of completing a set of courses. The new requirements, medical school administrators said, will rely heavily on the Medical College Admission Test (MCAT) to evaluate applicants’ “competency.”

The checklist calls for students to acquire basic knowledge in eight areas, such as math, chemistry and biological evolution. Yale School of Medicine Dean Robert Alpern, who co-chaired the committee that wrote the checklist, said eliminating prerequisite courses would give undergraduates more freedom to choose courses that interest them.

“Changing requirements so that they are more relevant to modern medicine will allow students more time for creative engagement in a broad, expansive liberal arts education,” Alpern said.

Educators began calling for competency-based requirements for medical school applicants in the 1970s, but a detailed checklist has not been published until now, Alpern said. The checklist will put less emphasis on organic chemistry and more emphasis on statistics and biochemistry, which are more relevant to modern research, he said. Medical school students currently spend their first years reviewing these subjects, Alpern said, adding that with the new requirements, medical students could spend more time on recent scientific advances.

At the earliest, the School of Medicine would start to change pre-medical requirements in January or February 2010, Alpern said.

Even if the American Association of Medical Colleges moves forward with the checklist, Alpern said, the MCAT will need to be re-written to reflect the changes. A panel from the American Association of Medical Colleges will review the MCAT over the next four years.

Alpern said he has met with William Segraves, the associate dean for science education for Yale College, to develop courses tailored to the proposed changes.

In an e-mail Wednesday, Segraves said discussions about developing new courses are underway in many science departments, though no decisions have been made.

Undergraduate Career Services Director Philip Jones said he expects pre-medical courses in Yale College to remain the same until the majority of medical schools change their requirements. Jones said he doubted whether the new requirements would not affect the number of Yale undergraduates who apply to medical school every year, which is currently about 200.

The University is not the only school considering changes to its undergraduate curriculum in response to the proposed requirements. Next year, undergraduates at Duke University will be able to take a two-semester introductory course combining biochemistry, microbiology and ecology. The course will address many of the areas on the checklist, said Brenda Armstrong, the dean of admissions at the Duke University School of Medicine.

Interdisciplinary courses, Armstrong said, will alleviate the pressure on pre-medical students to major in biology and will allow them to explore other fields.

Six pre-med and medical students interviewed said they supported the proposed requirements. Karissa Britten ’12 said current prerequisite courses had no relation to real-life medical skills.

“I don’t see how I do in my pre-med classes as a very good indicator of my success as a doctor, only of my acceptance into medical school,” Britten said.

Alex Hirsch ’12 said the proposed checklist would better reflect the courses he is taking.

“I wish the switch to competencies would happen soon enough to affect me,” Hirsch said. “I’m already taking statistics because I know it’s integral to understanding medical journals and research abstracts.”

Josh Leinwand MED ’12 said he supported the proposed changes, though he added he was not confident there would be changes to entry requirements in the near future.

According to the American Association of Medical Colleges, more 42,000 people applied to medical school this year.

Comments

  • md

    Karissa Britten ’12 said current prerequisite courses had no relation to real-life medical skills.

    “I don’t see how I do in my pre-med classes as a very good indicator of my success as a doctor, only of my acceptance into medical school,” Britten said.

    Pre-med students actually aren’t experts on “real-life” medical skills. Poo-pooing the hard sciences as being peripheral to what it “really” takes to be a good doctor is kind of a premature sentiment and doesn’t bode well–a change in mindset is probably a good plan. Doctors aren’t just high paid social workers you know.

  • CTmd

    Hard sciences are crucial to being a competent doctor, and I think that is obvious to any pre-medical student. The point, however, is that the hard sciences in the current curriculum do not serve as good preparation. A pre-med will not be an expert in real-life medical skills, but they currently lack the critical thinking and application required to be a good physician.

    I don’t think anyone is proposing eliminating “hard science” courses but rather redirecting them in a more useful manner.

  • YC ’08, Med ’13

    Have to agree with md. I was a late-comer to pre-med, and also thought the basic sci courses were fairly obsolete. They’ll teach you what you actually need to know in med school, right? Turns out, you absolutely do need a good grasp of orgo, physics, chem, bio and biochem. Details matter, too… and med school won’t wait for you to catch up.

    You’re right, Karissa, to think other factors play into being a good doctor. But compassion by itself will do you no good. You’ll be happy you know the basic science stuff come third year, when attendings are grilling you on differential diagnoses.

  • YC ’02 P&S ’07

    Looking back, I would say a more thorough college background in biochemistry and statistics may have served me well in medical school, residency and a 2 year laboratory elective, so I would support a move to put greater emphasis on such topics. I think they are more pertinent than orgo for instance, although there’s something to be said for the foundation that physics and chemistry provide. As for requiring fewer courses, and placing additional emphasis on the MCAT, that may or may not be good idea; but I would say that the current curriculum does not prevent one from “creative engagement in a broad, expansive liberal arts education,” speaking as a pre-med English major who rowed for 4 years at Yale.

  • med 11

    obviously med ’13 hasn’t been on the wards yet. knowing orgo to help you with differential diagnosis? do you even know what a differential diagnosis is?

    it’s always better to know more than less in any subject, but one’s knowledge of orgo/physics/chem is of minimal to no use in the hospital. biochem/physiology/genetics/statistics are relevant in small doses, but that’s where it ends.

  • YC / JHUSOM

    People who haven’t been to med school yet are not qualified to specify what is and is not relevant to doctoring. Certainly, they may speculate freely, but they should recognize that they actually don’t have any basis for comparison.

  • cjd

    The article and so many of these comments miss the point of preparation. Pre-med isn’t just about facts and techniques, it’s about thinking and rounding out your mind, developing lateral, analytic and sensitive thinking habits. We know that statistics, experimental error and scientific method matter because there is research showing how widespread misinterpretation of test results and prescription is among doctors due to misunderstanding.

    Merely attending medical school does not qualify anyone as an expert judge on these matters.

  • Yale Engineer

    Although I am a strong proponent of the hard sciences, I’m rather shocked at the lack of a ‘communication’ ie. English competency area on the proposal.

    As for knowing biochemistry and genetics; 2/3s of patients on herceptin aren’t tested for HER2 overexpression. I would argue that the doctors putting their patients on that drug aren’t responsibly doing their job simply because they don’t know their hard science.

  • biochem junkie

    I agree that biochem, stats, physiology and genetics are more directly relevant to doctoring than are chemistry, orgo, physics. Nonetheless, the glaringly obvious point that is being missed here is that organic chemistry, chemistry, and physics are crucial to understanding biochemistry. If the “competencies” truly demand mastery of biochemistry, then students will need to focus MORE on organic chemistry, not less. Don’t we all want our doctors to understand the biochemistry behind the drugs they prescribe for us? Without such understanding, medicine becomes akin to following a recipe in a cookbook.

  • kb is silly

    Britten is stupid!

    Just kidding… all she said was that her grades were not indicative of how she will be as a doctor… she didn’t say that the classes were not important.

    FOOLS! Anyway, she’s hot… and right.