Should Organic Chemistry Be a Premed Requirement?

1-quack-4-malpractice writes "For the second time, the Wall Street Journal health blog has questioned whether premed students should be forced to suffer through organic chemistry. Dozens of doctors weighed in with comments, and many of them seem to think that the wry subject is an almost useless rite of passage. Wired Science points out that there are not enough doctors who do research in addition to seeing patients, and they are the ones who benefit most from a thorough grounding in basic sciences like organic chemistry."

Comments

Are you kidding??

[Anonymous Coward]

...it should be a highschool requirement.
What the hell is happening to our education?

costs

[Lord Ender]

Medical costs have been growing at a far far faster rate than inflation. Clearly, demand for doctors is outstripping supply by a lot. We really need to lower the artifical barriers to entry to practicing medicine, such as unnecessary classwork.

And before you jump up and down screaming "I want only the best of the best to be doctors!" I should remind you that many people don't have access to any doctors at all, and a B-student doctor is just as capable as an A-student doctor at determining whether your sore throat needs further medical care.

We just plain need more doctors.

It's a weed-out course...

[Anonymous Coward]

If it's not Orgo, it'll be something else. Gotta have something that separates the unwashed masses from those with some chance of making med-school. And, as chemistry courses go, it's more a memorization than a "physics/math" course and so more applicable to the kind(s) of things covered in med school (from what I can tell).

The fact that it can toast "real" chem majors caught in the crossfire can be dealt with (and was, in my case).

Insane that not all require it

[WindBourne]

Overall the average doc is not a bad critter. But as times change, the drugs change as do their interactions. Organic chem gives the ability to the doc to understand HOW these drugs interact. In particular, when looking at the PDR and seeing the struct, it is possible for a doc to think about what they are seeing in patients, possibly with other drugs.

In the end, an MD with organic is like the difference between CS vs. MIS. MIS teaches the current tech. It gives somebody a CURRENT job. CS teaches principles to allow that person to adopt and change and get future jobs. An MD with Organic Chem will adopt better to knew methods and new diseases (think prions which were unknown in the industry just 25 years ).

Re:Insane that not all require it

[drinkypoo]

This is precisely my argument in favor of forcing medical students to learn ochem. If you don't understand this stuff, you really shouldn't be prescribing drugs. We understand fairly little (or nothing) about the way many drugs work as it is. To not have some idea at least about how they will interact is simple incompetence through ignorance.

On the other hand, as the sibling AC comment points out, most doctors are just going to prescribe whatever their sales rep is pushing that month. It is a sad reality of patent-protected medicines that when a drug is no longer covered by patent, a new drug will be pushed to the patients both directly and through unscrupulous physicians even if the new drug is less effective than the old one - which is often the case.

As others have pointed out the future is most likely to include more medical practitioners, and fewer actual doctors. This is probably for the best - I think we've all received incompetent medical care in the USA; for most of us it is probably the norm. I know that is the case for me.

Incidentally, I am not a "computer scientist", yet I am able to learn new skills. I wouldn't hire me for any kind of substantial programming job or anything, but this is really more about a mindset than anything else. Then again, I know far more about the inner workings of the computer than the average "tech" (whatever the hell that means) and that does help quite a bit.

Re:Classic problem.

[coldandcalculating]

Nothing is funnier than the truth. During my undergraduate career I worked for the Chemistry department and it was my job to watch some of these hopeless pre-med students suffer through o-chem lab. Needless to say, I feel a lot better knowing that a good share of the more inept ones got filtered out so early on in the game. Now I work in a hospital doing biomedical research. I see a great deal of talented physicians, but it really surprises me how many of the old guard (and plenty of the young blood) are ignorant on important topics relevant to medicine today. While organic chemistry classes in and of themselves don't remedy this sort of problem, I think that those who succeed in them generally tend to be the kinds of people who can keep their minds open and who are able to learn into their old age.

O-Chem as primer

[Puff of Logic]

Speaking as a current medical student, I absolutely think that Organic Chemistry is an appropriate pre-med subject. While the material covered isn't particularly useful beyond establishing a solid basis for understanding the chemistry of biochemical pathways, the value of O-Chem is that it's usually the first time an undergrad student is hit by a tidal-wave of information. O-Chem, just like a lot of the stuff in med school, isn't necessarily difficult stuff; the challenge lies in assimilating information and understanding relationships at a high rate. O-Chem was an excellent primer for the drinking-from-a-firehose atmosphere of medicals school, as well as a good tool to test scientific critical thinking on the MCAT.

Re:Classic problem.

[Anachragnome]

The "idiots" just cheat or do whatever they have to, to get that degree.

It stops nothing. Seriously, how many times have you gone to a Doctor and said to yourself, "This guy is an idiot."?

I've had a doctor diagnose a broken rib as pancreatitis, spent over $10k paying for doctors to diagnose a problem that I eventually figured out MYSELF with just some research on the Web(verified by 2 other doctors afterwards) and had a doctor misdiagnose a problem, then make it worse by prescribing something that exacerbated the problem.

If an idiot REALLY wants to be a doctor, he will become a doctor.

A more stringent oversight system would be more useful.

It ISN'T a requirement.

[lancejjj]

I have a doctor who couldn't pass organic chemistry. We call them "nurse practitioners". Sure, they aren't formal doctors, but they'll see me.

Here are some great follow-up examples:

Why on earth should engineering majors study optics, when so few will work with optics?

Why should a computer science major study operating systems, when scant few of them will actually work on an operating system?

Why should English majors study poetry, when so few will become poets?

Why should Business majors study economics, when so few will actually become economists?

Why should a home owner buy fire detectors, when so few will have their house burn down?

Why should people buy the Journal, when it publishes such stupid crap?

Exactly: weed out is definitely GOOD

[martinw89]

I go to the University of Florida right now. We're decent for a public school, and our medical program is actually pretty good. Some prereqs apply to Premed and all of the Engineering majors, so when I started here I had some classes with premeds.

For example, Calc 1 was extremely difficult. Plus, the rude teacher (one of the course coordinator's bitches) was bad at his job. With outside tutoring, I managed to scrape by. I think Calc is important for most majors, even premed, so this might not be the best example. However, the class shrunk as the year went on. Doing Calculus was difficult, but I can only assume less difficult than being a full time, life saving doctor. It's a good thing that these people got weeded out. Plus, it taught people like me to work harder to actually make it.

What am I trying to get to with all this rambling? I think difficult weed outs are good for the earlier part of your college career. Most premeds won't use Organic. But, they need to prove they can work hard towards a difficult subject early on. Otherwise, the resources go to waste. And as an added benefit, the people who do make it by these weed outs usually gain work ethic from the experience.

Re:Exactly: weed out is definitely GOOD

[reverseengineer]

As an chemist (pharmaceutical development, so mostly analytical on small organic molecules) who sat through many an o-chem class with pre-meds, I am of course biased towards the subject, one of the most useful things I have ever learned. That being said, while I will argue for the importance of organic chemistry to medical professionals, it seems clear to me, from what I heard in my education and from what I see from the comments here, that the lessons o-chem can impart are not being absorbed.

Organic chemistry is the basis of pharmacology. Organic chemistry is the basis of molecular biology. From the future doctor's point of view, that should make it required reading. Do you want to know what makes some drugs orally active and others parenteral only? Do you want to know why one drug has a thousand times the activity, or a thousand times the metabolic clearance, of another drug in the same class? Do you wish to know the mechanisms underlying lipid storage disorders, protein misfolding, or genetic mutation? Is it conceivable you might ever want to develop pharmaceuticals alongside your old /. pal reverseengineer? Organic chemistry lays the groundwork for all of these things. I don't think it's asking too much for doctors who plan on treating diseases based on proteins, DNA, and sugars to know the basic chemistry of amino acids, nucleotides, and carbohydrates, as well as a basic notion of the reaction mechanisms. There's a sweet spot of knowledge here: I don't care if my physician can tell me the products of the Hell-Volhard-Zelinsky reaction, but knowing the difference between an aldose and a ketose would be helpful.

Here's the rub: the mechanisms are really the key to knowing o-chem. Unfortunately, it wasn't until my third semester of orgo, when it was up to orgo for the people who genuinely enjoyed it, that I really saw this. If you know what the electrons will do, and why they will do it, you understand organic reactions, and you don't need to memorize everything. This is where I think organic chemistry education is really falling short. At my alma mater, in particular, there are two levels that most chemistry courses are taught at. Being a chemistry nerd, I took the accelerated track all the way (adv. p-chem was like chewing glass). Only the most ambitious and self-confident pre-meds followed this track; the rest followed the regular sequence.

The problem with the way "normal" organic chemistry is taught to pre-meds is that in order to "make it easier," it tends to get abstracted into meaninglessness. Pre-meds in orgo are often like Searle's Chinese room: they can give you the right answers, but they don't understand them. The whole thing's backwards: advanced organic students are taught the basics, the essence, the very point of organic chem while basic students suffer with their fat deck of flashcards and wonder if a C is going to keep them out of Hopkins.

If I were to fix this, I would keep o-chem a requirement for pre-meds, but it would be a quarter-length course at most, or folded into the start of a decent biochemistry course. It would focus hard on functional groups found in biological molecules- amines and carbonyl compounds especially- and discussion of the physiological consequences of reactions. More time drawing arrows showing electron flow. More time learning about equilibrium and kinetics. No time spent memorizing different ways to do electrophilic aromatic substitution reactions. What I want physicians to really know about benzene is that it is poisonous.

Regarding basic science Ed

[Daishiman]

Knowing the basic science behind professions should be a basic requirement of all university curricula. It is one of the things that separate trade schools from universities.

Some might say that it gives an additional burden because it might not be applicable directly to the actual job. But it serves two increasingly important purposes: it teaches you to think, and it gives you the ontological foundations for incorporating more knowledge.

I can only speak from my CS knowledge, but having studied Calculus and Algebra on my first year have truly opened up my mind and helped me become a better programmer, not just a computer scientist.
Calculus is essential because it's something that most people in related fields need to apply, and the CS curriculum should be designed so that one can interoperate with physicist, chemists, and engineers who have a need to apply their equations with computers.
Algebra completely changed the way I think about every logical construct, helped defined concepts that abstract away numbers, types, and classes, and presented me with some extremely difficult problems for which there was no other recourse than to brighten up and study and practice until one gets it. Forcing one to think and study beyond what one was used to in High School is a necessity.

In later years I was able to understand functional programming, abstract data types and numerical methods much more easily than if I hadn't; your mind clicks and relates all these concepts to each other and your learning accelerates exponentially.

So sure, if you're just a Java drone you don't need this. But Java drones are not true software engineers or computer scientists, and what's worse, they don't really know because they never managed to get into the depth of knowledge the subjects can get.

Take Type Theory and functional programming, for example. Very few people get to learn this in detail, and while you may never apply it fully professionally, the knowledge it brings helps you to define mental frameworks where proof of properties for objects, abstraction away from implementation, and modelling become significantly easier. Or numerical methods; chances are if you haven't taken a class on numerical methods - where you get pounded with rigorous proofs, arduous excercises, and loads of theory on computation, linear algebra, matrixes and such - you'll never really be capable of pulling off complex math problems without introducing slight calculation errors.

In the same vein, if you have the basics of organic chemistry, understanding how cetain medicines and biological processes work become significantly easier as you can get a feel of how that works on a fundamental level. I don't think that's exactly what keeps people from becoming doctors(something tells me it's got to do with being tens of thousands of dollars in debt by the time you graduate). I mean, if you suffer so much from just one course that it prevents you from continuing another 6 years of education, you never really had it in you to keep going, right?

Re:Classic problem.

[electrictroy]

I think the real question should be: "Is this Organic Chem RELEVANT to the job of being a ______? (insert career)" I'm an electrical engineer, and I had to take Organic Chem. Why?!?!? My job consists of wires, resistors, and gate arrays... not a single protein or amino in sight.

I can understand taking basic Chem 101 or Physics 101 or History 101 to gain an understanding of these subjects, but I don't see any value in taking any higher-level courses unless those courses have actual use for that person's future job as an Engineer or Doctor. I consider my time spent in Organic Chemistry a complete waste of money (approximately $3000 of tuition).

(Of course that may be the point - a college is a business after all - any chance to gain more money out of the customers' wallets, even if that means requiring not-needed classes.)

Re:Higher Math not needed for CS

[unlametheweak]

Your missing the point. Even though you may go through your life not using all the math you have learned the point is Math helps you sharpen your problem solving skills which is 99% of what a CS student will use.

I've heard this before. It seems to be an urban legend because I have never seen any evidence that Math improves problem solving skills (outside of the field of Mathematics of course) but I've heard many people make that claim. Calculus, for example, may be good for understanding how to maintain a certain speed behind a car while driving in the fog on a curved road, but most people can develop this skill better by actually taking driving lessons. As with a lot of posts here you make your point but don't back it up with any evidence. I wish people who were studying the sciences would be more scientific and logical in their arguments.