Someone has been listening to me. Or rather, to me and a growing number of voices that are questioning the requirements for admission to medical school. I have argued in a past blog that you won’t get more good primary care doctors, who practice a lot of humanities in addition to the science, if the only people you admit to medical school are scientists. Two medical schools and the American Association of Medical Colleges are beginning to agree.
Pauline Chen gives a good overview of what’s happening in this area here. Essentially, Boston University and the medical school at Mt. Sinai have made pretty radical efforts to apply either more than the traditional evaluation points to their admissions process, or different ones altogether. Mt. Sinai, in particular, has an extraordinary an early-acceptance program for college sophomores and juniors in which they can get into medical school without the MCATs, and without a few of the standard pre-med science and math requirements. In return, the accepted students have to continue to major in an humanities-related field and maintain an adequate GPA. They also have to undergo intensive science enrichment courses prior to matriculation. BU hasn’t gone quite that far, but they have included many more “holistic” data points into their admissions decisions, a process that is extremely labor intensive for the schools’ admissions staff.
Both schools have great ideas that are showing some promising results. I see a couple potential problems:
1. Mt. Sinai seems to be sort of cramming in all the old science requirements in off-hours, allowing students to pursue wider studies in college. I would rather see a larger decrease in the science and math requirements. Basic chemistry and biology are probably necessary, but no one has ever explained to me why you need physics. Or calculus. You don’t need most of this stuff in medical school. All you need in medical school is the ability to put your head down and push through the memorization. You don’t need math, you just need patience. The thing is, the only way to get rid of the math and science is to get rid of the MCAT, because believe you me you can’t get through that behemoth with an english major. Then, even if you do that, you eventually run into Step 1, the first of the three-part exam you take in medical school to pass medical school. The Mt Sinai kids might need more “enrichment” courses to get through that. If those hoops are eliminated, you might find some great doctors underneath those mountainous requirements.
2. Asking sophomores to commit to medical school means you’re asking 19 and 20 year olds to decide what they want to be when they grow up. I couldn’t even decide what to wear on any given day when I was 19. The path of medical school and residency is so long and so arduous that it’s a tough commitment to make at any age, let alone 2 years out of high school. Kids should be having fun and learning a wide range of great new things in college, and even after. It’s the perfect time in their lives to do this. The best thing would be to at least consider the application of ANY college student who wants to apply, even if he doesn’t have the science and math. You’d be more likely to end up with an happy, well-rounded individual.
My proposals aren’t going to come true, of course. We hold onto the doctor-scientist identity very strongly. But these schools and the AAMC are making a start and I bet they’re making some great doctors too.
Shirie Leng, MD is a practicing anesthesiologist at Beth Israel Deaconess Medical Center in Boston. She blogs regularly at medicine for real, where this post originally appeared.
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Shirie Leng has made several posts claming that midlevels are delivering services equal in value to doctors.
Then, she turns around and makes all kinds of BS claims about how doctors dont have enough exposure to X, Y, and Z in their training and that healthcare suffers as a result.
Which is it Shirie?
When I took the MCAT in 1975, there were a surprising number of questions about the humanities and questions that tested for deductive reasoning. However, with the explosive growth of medical knowledge (my textbooks became door stops 25 years ago), the test became very focused on the biomedical sciences.
Now that the growth in medical knowledge has become exponential, the test is shifting to recognize the importance of the behavioral sciences and the role they play in effective care, which include how to find the right answer instead of just knowing the right answer.
In order to navigate this mass of available medical knowledge, physicians in training still need to have basic understanding of current and new sciences and the language the disciplines use.
Being a great doctor means to be compassionate, caring, understanding the social context of disease, and the ability to find the answers your patients need and deserve. So, yes—you still will need math.
I agree with this post, mostly. Physics and calculus are clearly not required to be a good physician. But another mathematical topic is woefully undercovered by most pre-med and medical school curricula, which is statistics. It should actually be a requirement in high school, but short of that, a strong foundation of statistics (and risk assessment and related areas) should be required for admission to or in medical school.
Strongly agree with you on this William. The title of the post is sort of supposed to be humorous. Stats is a must.
I think a broad understanding of a lot of different subjects is good even for us scientist and doctors. There is a lot of special training but that doesn’t mean that we can be well rounded too
I absolutely don’t suggest that scientists can’t be good doctors or well-rounded individuals. My argument is that the focus of pre-med is so heavily on performance in science and math classes that curiosity and wide-range interests can get subjugated to the “must get the A” mentality. This tends to result in med students are good test-takers but have forgotten how to interact with the wider world.