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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."
Reminds me of the classic joke:
A college physics professor was explaining a concept to his class when a pre-med student interrupted him.
"Why do we have to learn this stuff?" he blurted out.
"To save lives," the professor responded before continuing the lecture.
A few minutes later the student spoke up again. "Wait-- how does physics save lives?"
The professor responded. "By keeping idiots out of medical school."
For working in that army of Java and .NET developers that drives the industry, do you really need to understand anything beyond basic algebra? Why burden CS students with silly classes when they won't even need to know what an integral is? I think it's a scam perpetrated by the academic industry to force us to pay for more credits and more books.
“Common sense is not so common.” — Voltaire
...it should be a highschool requirement.
What the hell is happening to our education?
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.
A slashdotter who didn't build his own computer is like a Jedi who didn't build his own lightsaber.
Is organic chemistry grimly humerus? Or twisted out of shape - perhaps into a boat or a chair? Is the skew E- or Z-? D- or L-? That's the important thing.
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).
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 ).
I prefer the "u" in honour as it seems to be missing these days.
I don't see why. In fact, I don't see why we require premedical students to take chemistry at all, or even biology, for that matter. Come to think of it, what is the point of requiring a bachelor's degree in order to pursue an MD- the two are only tangentially related. Why not make the MD degree a trade certificate, something perhaps akin to a license to drive a truck? That way we could confine the premedical curricula to only those topics students really need to know on a daily basis as mature, practicing, guts 'n' glory clinicians.
Just like CS students should have to have Cal II and III and Diffy-Q and assembler.
Too many things are dumbed-down too much already. I'm sorry if you're too dumb to learn organic chem or assembler or higher maths... Too damn bad. We don't want you. Go be a project/product manager or an assembly line worker. We don't need you here.
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.
P.P.S. I'm doing Science and I'm still alive.
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?
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.
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?
As a PhD in the research dpt of an academic hospital, I can tell you that such classes are really beneficial. Not in the least so that MDs finally understand what they are working with. Make no mistake: Doctors generally have no clue *why* for instance a lymphe node has swollen, or even what many antibiotics actually do. This complete lack of mechanistical insight in disease and cures by MDs has boggled my mind since I came here (and I have to teach them lab skills). Some background info on their actual work is no luxury.
If an experiment works, something has gone wrong.
The second semester of O chem is mostly synthesis which is useless to physicians.
As a pre-med undergrad at UC Berkeley, I think it needs to be taught. I have been through a year of it (including labs) as part of my requirements, both for my major (molecular cell biology) and for med school. It was one of the hardest subjects I have ever taken. The kid next to me during the final for the second semester of it didn't write a single thing in three hours. I just heard him flip, flip flip.
It isn't about the course content. To be an effective doctor you don't need to remember how to synthesize carbonyls. Find me a clinical physician who can take me through the steps of glycolysis. Organic chemistry is a gauntlet. It's an incredibly difficult subject that doesn't smile kindly on rote memorization. Rather, a complete understanding and application of knowledge, often in seemingly-unfamiliar settings, is required to excel in the course. Yeah, some people made hundreds of flash cards, and some of them probably did well. But the longitudinal thinking that one has to go through to really shine in ochem is also needed in medicine.
Also, especially at Cal, classes like ochem are needed to pare down the pre-med pool. The merits of "weeding" kids out can be discussed, but there's no doubt that ochem is good at that.
Beware the Jubjub bird, and shun the frumious Bandersnatch.
IAABP (I am a biology professor).
IMHO O-chem as it is taught by most chemistry departments is completely useless for pre-med students. There ought to be a lower level biochemistry course in its stead as a pre-req for pre-meds. Most MDs will NEVER have to worry about organic synthesis and crap like that; they WILL need to worry about metabolic pathways and enzymatic reactions.
NO CARRIER
IAAD (I Am A Doctor), and organic chemistry has less to do with the practice of medicine than general physics. (Really. Try understanding the limitations of an MRI machine without some physics background.)
I say get rid of organic chemistry and add in a requirement for something in the humanities, a year of a language, or something else that may actually come up when dealing with patients.
Or better yet, a year of economics, as physicians are notoriously bad at things dealing with money. I would suggest business management for a year, but is that even available as an undergraduate course?
Help! I'm a slashdot refugee.
It seems that more and more, doctors (like engineers, administrators, etc) are becoming specialists, rather than generalists.
Unfortunately, this sometimes has the effect of giving the specialist tunnel vision. ie - they only see things from the perspective of their specialty. They tend to ignore the sometimes obvious things that a generalist would notice.
There are definitely reasons for becoming a specialist, but being a generalist, and having the broadest based education that you can has a lot to offer as well.
Who is general failure, and why is he reading my hard drive?
I agree that the brute force approach will get A grades in o-chem, but don't you think that maybe our doctors ought to learn how to think like scientists?
Hell, yes! They should think like scientists, but they don't. A majority of physicians in the US approve of teaching Intelligent Design alongside evolutionary theory, after all.
Further educational devolution (no pun intended) for doctors will not serve any good purpose. Ever looked at the prescribing information for a drug? How in the world is a doctor supposed to understand all that without a background that includes organic chemistry?
The actual subject material of organic chemistry has no direct relationship with medicine. Nobody has ever asked me to elucidate the molecular structure of protein X and synthesize it from scratch. When I started medical school with all those bloody didactic lectures, I felt as though I was at a severe disadvantage for scoffing at the biological sciences.
However, organic chemistry is as close to the 'hard' sciences (physics, math, computing, etc.) as some (most?) biology majors get. Organic chemistry mimics the learning process of medical school. During class, you're taught maybe 10 basic principles which allow you to predict and understand how molecules interact. In the lab (I mean a real synthetic organic lab where they build molecules, not the three-hour follow-the-recipe thing), one is given the opposite situation: given this molecule, how does one arrive at a set of starting materials? It is analogous to medicine. Patients don't (usually) come to the office and say, 'Doctor, I've got a pleural effusion.' They say, 'I'm short of breath' and then you have to figure out the disease. You have to be able to work backwards.
We have a saying, "Diseases don't read textbooks." Disease can present in odd ways. The old-school doctors -- the guys who actually have read their pathology and understand their disease processes -- can figure it out. Others can't. Most of the premed kids don't give a rat's ass about mechanisms. They don't care about understanding. They're focused on getting good grades and pretending to be altruistic. They don't like organic chemistry because it is 'hard' and 'difficult to get good grades'. They don't like organic chemistry because it's simply different, and consequently mentally challenging, frustrating and sometimes incomprehensible. (And smelly.)
Guess what? Organic chemistry is a pretty good preview of what medicine is like on the wards.
And as for suggestions of 'more biochemistry', I'd have to say that I haven't noticed a lot of biochemistry involved in medicine either. Most of us have forgotten, or could only give you the most basic outlines of the active site for any drug -- and that's only if the mechanism of action for a drug is known. The last time I needed to know about the Krebs cycle was...for the MCAT, I think. I'm not even sure it showed up then. I did learn about cholesterol synthesis in an organic chemistry class...now that IS relevant to today's doctor.
With respect to research -- most people are not born researchers. Most people who work at a university-affiliated 'academic' center do research because it's a condition of their employment. Truly gifted researchers are few and far between. Organic chemistry isn't human alchemy -- it can't turn a dimwit into a genius. I suppose it could help some people learn to formulate proper hypotheses and experiments.
A proper premed curriculum, IMHO, contains a good mixture of: physical sciences (calculus, algebra, STATISTICS, physics (some basic electronics and quantum mechanics)), programming (information storage, manipulation, retrieval and general problem solving skills), chemistry (organic, analytical, and physical), anatomy and physiology, English and preferably a second language (because you need to communicate with your patients and/or lawyers), basic psychology (see point above), and perhaps some biomedical ethics/philosophy/history
After learning how to think and solve problems, learning enough molecular biology, biochemistry, microbiology, etc. to be a good doctor is a relatively minor matter.
The o-chem I took (and I'm a mathematician, so how I ended up with it is a long story) was mostly "name that molecule" and "memorize these reactions."
You're absolutely right about it being abstracted into meaninglessness. I only wish I had a good idea of the fundamentals of how electrons behave, then I wouldn't have memorized (and later forgotten) almost everything I knew about the subject.
I don't think it's nearly as hard as some people make it sound, but that may depend a lot on your ability to memorize information. I can store a LOT of information, but it tends to evaporate all too quickly. So I was able to pass all those tests, but the knowledge didn't last very long at all. Fortunately, I'm no doctor.
On the other hand, I had a great physics course that was a lot more like what you describe. We didn't do fancy equations, we did lots of modeling and we had to prove simple things, like what a frictionless block on a frictionless incline on a frictionless surface would do (slide off... and roll over). I learned more from that than most courses. I wish there were more courses like that. But the whole reason it was like that was because we had a TA who was getting a masters in education who helped the professor shape the course.
You don't find that very often.
That's okay, a lot of medical school is massive brute force memorization too. (Anatomy comes to mind in particular, but it's hardly the only one.)
No. It's only that massive amount of idiot are hanging around med schools and prefer brute force methods instead of trying to put their brains to more efficient use. ... is a sign that lots of students are stupid ... is a sign that the teaching system is broken and doesn't present the data the way they should.
To take your example of Anatomy, most of the naming is just describing in latin/greek from where to where a structure is connected (the muscle attached to the sternum, the mastoid process and the clavicle is simply called sternocleidomastoid muscle). Most of the nerve connexion start to make sense once you start looking a little bit at embryology. Nature *does* make sense. A weird sense (as nature isn't intelligently designed as much as having evolved through emergent systems). But nonetheless makes sense.
The fact that countless student are too brain dead to notice it and prefer stupidly learning everything by heart...
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but doesn't mean that medical school is necessarily brute force memorization. For the record, I never brute force memorized anything in my medical studies and still managed to get my medical degree.
If anything, some basis in organic chemistry, physics and other hard science (and even more : statistics), are *vitally necessary* to help the doctor acquire a good scientific critical sense.
Otherwise, they would quickly buy into any snake oil marketed by efficient charlatans even if it blatantly violated several laws of physics or chemistry that they should have understood (but only brute force memorized them instead).
Disclamer: I have a medical degree, and had worked as anatomy teaching assistant, among others. Had also plenty of time to develop computing skills thank to not loosing my time by brute-memorizing stuff stupidly.
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
But I don't think that it should be a pre-med requirement. I was a physics major, loved math, and found chemistry exciting. However, I look at what a doctor does on a daily basis and realize that I rarely if ever use the skills I learned in organic chemistry. And this isn't just about what a doctor should learn in school - organic chemistry is a major component of the MCAT medical school entry examination.
I've read a lot of the arguments (here and elsewhere) for organic chemistry.
"Doctors need to know the basic science behind what they do" - as a physicist, I realize that undergraduate organic chemistry does not accurately represent the basis for chemical reactions. It certainly gives you a language for lab and industrial synthesis. But until you take at least physical chemistry, the rest is hand-waving. I think that chemistry should be taught to pre-meds, but feel that biochemistry is best matched to actually understanding the way that drugs work, for instance.
"We need a weed out course for all the idiots" - fair enough. But there are many potential weed out courses with equally compelling claims to relevance. Take differential equations, for instance. It's one of the first places in math that you learn how to ask a scientific equation and actually have the skills to construct an appropriate model. And I guarantee you that it would weed out a lot of people. Or physical chemistry - if you really want people to know the basis of chemistry (as chemists see it), you should use the traditional chemistry major weed-out course. Or take an advanced statistics course - much more applicable to the actual accumulation of new knowledge as a doctor. The ability to critically read journal articles is probably the most important scientific skill for most practicing clinicians.
"Doctors need to be more scientific and understand how basic science works" - couldn't agree more. But organic chemistry does not accomplish this. The best way to learn how basic science works is to do basic science. Research in a basic science lab would be an excellent pre-med requirement. Not a class focused on using pre-derived reactions to create a final product. That's just a mathematical proof in another name.
"Organic chemistry is mentally challenging and builds mental rigor" - this is not really true as it's normally taught in the first two semesters. It's mostly an exercise in memorizing individual pieces of a language and then being able to use that language to create a previously unknown sentence. To that end, logic classes are more helpful to form a generalized framework for approaching new problems. And plenty of classes challenge the mind - pick pretty much any math class, any upper level physics class. Heck, being able to critically read a work of literature or critically view a work of art challenges the mind. That's what college is for.
Anyway, pre-medical education is an interesting topic which is currently being debated in medicine. The most recent comprehensive treatment of the subject was in the New England Journal July 17th by Jules Dienstag, head of medical education at Harvard. From personal experience under him, I can say that he is well qualified to help plan for a future where physician-scientists will have to incorporate ever more vast expanses of knowledge in order to treat patients effectively.