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Why Organic Chemistry Is So Difficult For Pre-Med Students
Hugh Pickens DOT Com writes "Science writer and 42-year old pre-med student Barbara Moran writes in the NY Times that organic chemistry has been haunting pre-meds since 1910, when the Carnegie Foundation for the Advancement of Teaching released a landmark report calling for tougher admission standards to medical school and for medical training based on science. "The organic chemistry on the MCAT is chemistry that students need to know to succeed in medical school," says Karen Mitchell, senior director of the MCAT Program. Basically, orgo examines how molecules containing carbon interact, but it doesn't require equations or math, as in physics. Instead, you learn how electrons flow around and between molecules, and you draw little curved arrows showing where they go. This "arrow pushing" is the heart and soul of orgo. "Learning how to interpret the hieroglyphics is pretty easy. The hard part is learning where to draw the little arrows," writes Moran. "After you draw oxygen donating electrons to a positive carbon a zillion times, it becomes second nature." But the rules have many exceptions, which students find maddening. The same molecule will behave differently in acid or base, in dark or sunlight, in heat or cold, or "if you sprinkle magic orgo dust on it and turn around three times." You can't memorize all the possible answers — you have to rely on intuition, generalizing from specific examples. This skill, far more than the details of every reaction, may actually be useful for medicine. "It seems a lot like diagnosis," says Logan McCarty. "That cognitive skill — inductive generalization from specific cases to something you've never seen before — that's something you learn in orgo." This takes a huge amount of time, for me 20 to 30 hours a week writes Moran. This is one thing that orgo is testing: whether you have the time and desire to do the work. "Sometimes, if a student has really good math skills, they can slide through physics, but you can't do that in orgo," says McCarty ."
I wasn't pre-med, I was a chem major and the hardest class for me was orgo due to the same reasons mentioned above.
Dumb it down, just like everything else.
Or maybe it's just me. I found physical chemistry more challenging.
Students learn organic by memorization. It is unfortunate but it's the truth. That said, we expect med students to excel at memorization and regurgitation so OChem is a good tool for learning that. The problem though is that we de-incentivize actual comprehension as the students learn that they won't need >90% of what they memorized in OChem later on (if we exclude that which is acceptable to look up in a reference later).
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
Solving organic chemistry problems is one of those things supercomputers and massively distributed projects are set up for.
Horrors ! What's a premed to do? Surely they don't expect them to actually understand something?!?
(Actually I switched to Math in my senior year).
Organic Chemistry was a breeze compared to Physical Chemistry. Just my opinion.
I am very small, utmostly microscopic.
Ever tried physics? It's all about applying rules to situations you have never seen before and it is not just restricted to carbon-based molecules.
... I can attest that anything that keeps them humble is not a bad thing. Yes, my dear MD, you are human, too.
When the brightest student in my organic chemistry class can only get about 60% of the answers correct on the first exam, that should tell you they are teaching the subject matter poorly.
That's SOP for orgo (not 1st hand experience I admit), but why should people be able to get anything approaching a 100% on a test? Orgo or not, it means the ability to test how well a student understands the material is difficult because the detection curve is compressed towards the top. It also favors being able to regurgitate or recalculate what you've been shown, as opposed to really testing how well you know a subject. Give students problems that are so challenging that they're unlikely to get all of it, or at least unlikely to get all such questions.
It's tough for students who are used to being able to get almost all the problems. There was a prof at my alma mater that always took this approach and was very upfront about it at the beginning of the semester. He was not a sadist, or even a ridiculously hard grader, so he'd tell people not to get upset even if they thought they did poorly. Wait for the grade. Inevitably some girls would walk out crying (sorry for the stereotype, but it was true), and guys just asked directions to a train track to lie across. When they got their grades back, frequently they'd done well. It's a good approach, but you have to get used to it.
First, a disclaimer to prove I don't mean this as bragging - I sucked at gen chem. I found it painfully tedious - Basically 100% having humans do things that computers do much, much better.
;)
But I aced Orgo with fairly little effort. It just makes sense, once you master those basic rules - You have your carbon skeletons, your functional groups, your resonances, then mix in chirality, spice it up with a few inorganic substitutions, and bam!, the rest becomes like a good, satisfying puzzle - Spin the structures around in your head, and see where the electrons "want" to go.
If Orgo has a reputation for being hard, it has that only by virtue of having boring ol' gen chem teachers trying to explain something outside their comfort zone. I consider myself lucky to have had something of a "reformed hippie" for a prof, with a godlike skill for getting us to see not what happens, but why.
Put another way - If you can't solve the problems without consulting lookup tables and using a calculator, you have no shot whatsoever at understanding something at an intuitive level. When you can memorize all the rules in your first month or two, the rest becomes just fun.
Then again, a "friend" of mine did a lot of psychotropics back then. That might have helped.
The same C like syntax in almost all modern languages that are desktop oriented where you need to keep track of things like registers on the cpu, bottlenecks, and then in advanced object oriented classes how abstract java based frameworks work.
What makes success? Time and desire to finish your program.
Hibernate and java 2 EE or Drupal can take months to learn how they work before you can do anything useful which I find irritating.
Journalism and art majors have things quite easy compared to chemistry, medicine, engineering, or computer science ones. Business can be easy too if you do not focus on finance or statistics but even that is half way between the time and hardness of art vs medicine.
http://saveie6.com/
It's one thing to understand the quantum mechanical underpinnings (thank you Linus Pauling) and quite another for the calculations involving same to be tractable. I've always loved the idea of chem as a branch of physics, but AFAIK it's simply not tractable. I believe some work is being done on it with supercomputers, but it's far from solving everything.
Solving organic chemistry problems is one of those things supercomputers and massively distributed projects are set up for.
Unfortunately, not yet; algorithms for solving these problems typically don't scale well past 8-16 cores.
The problem is that there is no inherent logic, like math or physics.
It's a (big) bunch of rules and exceptions on how to mix 'ingredients' together.
So if you can let lose of all the 'but why?' questions and just follow the recipe, you'll do great.
That wasn't me, though. I've never really got the hang of it, although I love science, so I was happy to leave all those carbon rings behind after high school.
After having talked to numerous doctors on whom have been part of admission selection committees for different medical schools this is the consensus I have reached as to why Orgo is required for medschool. Orgoanic chemistry is looked at as a weed out class. In particular, they believe that good grades from second semester (quarter 2,3) in Orgo prove the ability of the student to be able to solve complex problems because the later part of most organic chemistry courses focus on synthesis. They believe that good grades in second semester orgo will translate into a doctors ability to see the long term solution and that good grades are indicative of an ability to plan a multistep process for patient recovery.
No, it's to get every student to do as well as they can. The best schools, especially in the early grades, work on that. Kids doing well don't need as much help as those who are not. However, it doesn't mean everyone has equal capability, regardless of how hard they work or how good the teaching.
If there was ever a topic best taught as an interactive game this would be it.
Have Walter White teach it.... where do I sign up?
I have a PhD in molecular biology, an taught medical students
I don't think they need to know much organic chemistry; it us just torturing them cause...thats how we have always done it.
The idea that a clinician needs to know enol/keto tautomerism, or acid base stability of esters and amids, or stuff like that is laughable
>>Why Organic Is Chemistry So Difficult For Pre-Med? Cuz it's hard. Duh. Physical Chemistry was my hardest class in getting a ChE.
Facts take all of the premium out of arm waving - T. Reynolds
Dude, calm down. You need to rotate your time cube 20-30 degrees coreward.
I've graduated from med school about 9 years ago and I still remember organic chemistry just as if I've closed the book yesterday. I had to learn it in high-school, I had to learn it in medical school. It is hard to learn, but it does help a lot. Fact is you can't know all the drugs that are out there being prescribed. But if you ask the patient for the box and have a look at the active ingredient name, you can immediately place it in one of the major groups. At least you will not confuse a pain relief drug with a psychotrope or an anti-hypertensive. It's just as useful as most of the disciplines studied in medical school. It helps a future doctor form reflexes towards substance recognition that will baffle even some of their colleagues and impress the hospital pharmacist :)
I have a PhD in chemistry, so I've been through all the classes mentioned.
Organic is, in fact, the only one you absolutely CAN memorize. Unlike the math-based chemistry classes where you have to learn principles, which the pre-meds struggle mightily with, the memorization-heavy organic chemistry is the one that is considered to be similar enough to medical school that it is used as a weed-out.
This is particularly true of organic *synthesis*, vs. organic *mechanisms*. Mechanistic organic is often presented as a first semester organic class, and that does actually require knowledge and understanding. Synthesis, however, is nearly straight memorization, even if you don't want to.
I was happy when the pre-meds stopped taking the major-level chemistry classes (mostly after organic). It made my physical chemistry classes much more interesting. It didn't keep the one pre-med in the class from whining the entire time that he wasn't getting the answers spoon-fed to him from the book, though.
So I don't know where the author is coming from, because they completely got it wrong.
I know the answer but I'm curious: Please explain why you believe "There's no way that would occur!"
I browse on +1 so AC's need not respond, I won't see it.
Well, ....until you come to measure it.
May the Maths Be with you!
It's a lot of work, but it's really not that hard to understand. I aced my chemistry classes in college. The only reason my classmates didn't do the same is because they didn't review study along with studying current topics, and they didn't do enough sample problems either. The problem is it's a lot of work, not that it's hard. I think the main problem in chemistry classes is trying to jam too much material into one semester when not everyone has enough fortitude (or time) to spend on a single class. Professors themselves are often overcome with how much they are expected to cover in a single semester, often rushing though material in a way that can't be considered a learning process. I have had multiple professors tell me to keep studying after classes are over to make sure I am ready for the next class. I even study for classes before the term starts by finding the syllabus for the class ahead of time.
My younger self was an absolute fuckwit, at times. He also managed to last long enough to turn into my older self, who tries to not be too smug about how much he has improved. My younger self also was busy making the mistakes my older self has learned from. As a completely off topic example it took me about 5 years to figure out there were some things I did that women absolutely hated, and another 5 years to figure out that maybe I should stop doing them.
College ain't supposed to be easy.
In CS, the killer is usually electro-magnatism or calculus-level probability.
In Physics, it is usually diff-eq's.
In math, it is usually partial diff-eq's.
Yes, the exceptions to the "rules" in org-chem is maddening...but if it wasn't, prescriptions and pharmaceuticals would be easy. Instead, they are rife with mistakes, side effects, false-positives, and a lot worse, and if you don't have the background to understand at least to a degree why, then I'll be damned before I let you write me a prescription for anything.
But seriously, this is college leading to one of the toughest post-grad programs our society has to offer. It is supposed to be hard. Deal with it or get out.
"But remember, most lynch mobs aren't this nice." (H.Simpson)
-- Joe
Here's a saying which has a glimmer of truth to it:
I've seen variations on this, but my google-fu is weak today and I can't seem to track down its origin. Is there someone here on /. who can point me to its source?
Pre-med students need straight As or they change majors.
John McAfee 'It was like that time I hired that Bangkok prostitute; to do my taxes, while I fucked my accountant'
One thing computers can do is drug design. Input the structure of the molecule, gene, protein, etc., that you need to cause some useful interaction to occur and computers can come up with the structure of a new drugs to cause the result you want. Of course, the basic structure and chemistry (physical and chemical properties) of the substrate substance must be well understood. Then the fun begins for organic synthetic chemists to make the best choice for synthesis. And of course, the new drug must be tested.
In a time of universal deceit, telling the truth is a revolutionary act. George Orwell
I absolutely suck at memorization, so what I did was learn the why of the reaction - which generally was just geometry based (which part of the electron cloud was physically easiest to access - ie steric hinderance); charge based (which atom most 'wanted' the electrons') and energy based (which configurations would be energetically stable with minimum strain and best sharing of electrons).
For my O-chem final - my brain almost completely forgot all of the standard reactions, but I was able to reconstruct reactions and what reactants and environments I needed based on what I wanted the molecule to do; and derive what products to expect based on the above method.
I was one of the people that found ochem easy, but pchem quite difficult.
Pauling's chemistry involved valence bond theory (VB) but today most modern chemistry involves molecular orbital theory (MO). An up to date course in organic chem will have a great deal of MO theory, for instance in an understanding of the bonding and chemistry of aromatic compounds and such things as sigmatropic reactions with the use of Woodward-Hoffman rules. Today's chemists need to know both MO and VB theories and where each is appropriately used. These bonding theories are an important basis for all chemistry and give direction to understanding what and why chemistry occurs. Organic chemistry courses that just involve memorization of named reactions is a thing of the past and shouldn't be tolerated.
In a time of universal deceit, telling the truth is a revolutionary act. George Orwell
I actually did well in orgo. Anyway from my point of view the book we used tended to ramble on and on before getting to the point. At one point there was page after page and they never got around to simply writing out a sodar equation. (Which the prof just told us, it was only a few terms.) I swear the guy writing our book hated algebra. I found myself writing in the margins "I bet he's rambling when it's just concept X" and so many times I'd be right. Of course since the book was so disorganized even the order things were introduced were really screwed up. (They introduced resonance structures right at the beginning of the book. Unfortunately the first time they actually applied those concepts were right in the middle of the book. So effectively they wanted you to learn this week one of semester one and then ignore it until the first couple of weeks of semester 2.) Oh and before anybody reads any stupid orgo books, yes orgo 1 and 2 requires memorization of chemical equation. Anybody that tells you differently is just wrong and you will pay if you listen to them.
Did you know 80 to 90% of the moderators on slashdot wouldn't recognize a troll even if one dragged them under a bridge.
Organic chemsitry is not a fascinating subject in its ownright. And even though it falls in the purview of physics -- like, uh, everything -- it is best understood apart from physics, as a unique lense. Just as biology is not best understood as complicated chemistry, but rather as a completely different perspective.
It demonstrates the raw power of abstraction. For example, ask an experienced organic chemist to propose a synthesis of any arbitrary molecule. A good one will normally be able to come up with something plausible in minutes, and refine it to something practical in hours. A physical chemist, let alone a physicist, even with the incredible computing resources for the complex quantum mechanical calculations required wouldn't be able to tell you how to make it if you gave her months! Guarenteed.
That is the power of organic chemistry. It teaches you how a handful of simplifications, fuzzy rules, and fictional symbols can give you incredibly unique and practical skills. This is not unlike treating the human body as a group of organs, cells, cellular machines, etc., rather than subatomic particles. Of course it's all physics, but viewing systems through appropriate paradigms can yield incredible results.
If people see "orgo" as just a test of rote memorization, their professors should be ashamed -- they've missed it point.
Hey mate, spare a sig?
http://xkcd.com/435/
FTA: "I asked two medical school deans â" Dr. Robert Witzburg at Boston University and Dr. Lee Goldman at Columbia University â" about admission philosophies. Both are proponents of holistic review, the newish idea that medical schools look beyond grades and test scores to evaluate the whole applicant."
What this really means is that we are getting to many Asians. We need slots for the children of donors, and big wigs, and for affirmative action cases.
In the land of the blind, the one-eyed man is king.
On the contrary, a 42 year old is typically a much more efficient worker. He knows what works and what doesn't and how to get things done and the skills he must use daily are highly practiced. What he lacks is the seemingly boundless energy and often stubbornness of youth. That's also of value, because it helps the young spend the time to develop skills that take years to master.
It's probably true that 42 year olds don't learn as fast as the young, but they typically have less to learn having learned a lot already.
O-chem is useless for practicing physicians. Took it, did OK at it, passed the required tests in undergrad and early med school, never used it again. Licensing boards understand this; there is no organic chemistry on the final board examinations for Internal Medicine.
In fact, thinking you understand low-level chemistry and biology can be dangerous for a practicing physician. For example, beta-blocker blood pressure medicines slow your heart rate and make your heart "squeeze" less strongly. We were initially taught that you should never give them to patients with heart failure -- their hearts didn't beat strongly to begin with. Given a basic understanding of the underlying biology withholding the medication made sense. Until someone studied them and found that for patients with mild heart failure beta-blockers reduced hospitalizations and death. And we had been withholding them for years. Whoops.
You don't want your doctor prescribing things based on their understanding of biology. You want them prescribing on the basis of clinical trial data and statistics.
Intro Physics professor here. Pre-meds quake in terror when they enter my classroom. (I'm a good guy, really, but they know that physics is going to make them do something they're not good at.)
The summary mentions that good math skills will get you through physics, but few people with good math skills choose pre-med. Most of them are encouraged to become engineers instead. People choose (or are encouraged into) pre-med for one reason: because they're good at memorizing stuff.
Solid memorization skills will give you straight A's through high school, make you an undergrad biology whiz and will help a lot in chemistry. But memorization does you almost no good at all in physics -- at least, not in my physics class where I give you a sheet with all the equations on it. What you need to pass physics, and the "arrow pushing" part of orgo, are problem-solving skills. How is this new problem like things I've seen before? Which of my tools is the right one for the job? How do I apply it in this situation? What's unusual here, and how do I deal with it?
The summary is right: this thought pattern is medical diagnosis in a nutshell. (I, personally, just call it "intelligence", but I'm biased because it's something I'm good at.) Whatever you call it, I do not want to be treated by a doctor who can't do it.
"the brightest student in my organic chemistry class can only get about 60% of the answers correct... She was a 4.0 student in biochemistry." I had exactly the opposite experience for her, and I think there's a reason. (Bear in mind, I took organic chem and biochem more than 40 years ago, and biochem at least has changed greatly since then.)
In organic chemistry (I refuse to call it orgo), I was able to learn a small set of principles (relative bond strengths of single, double and triple bonded carbons, to take a simple example); from that small set, I was able to deduce most everything else. I got a high A in organic chem. Same in quantitative analysis, only more so. Then came biochem. It was an undergrad - grad course, meaning that if you got a C you were viewed as flunking. I passed, with a very low B.
The difference was that almost nothing in biochem appeared to follow from basic principles. The Krebbs cycle, for example, had to be memorized. And I was no good at memorization; in organic chem, I had needed to memorize very little, everything was logical. I suppose if you are God, then biochem follows more or less logically; but then if you're God, you can remember it anyway. But I think that's the big difference between organic chem (and quantitative analysis, and probably most other forms of chemistry), vs. biochem: mostly logic vs. mostly memorization. That's not to say there's no logical thought required for biochem; we wouldn't know anything about it if we didn't employ logical methods to reason through what is otherwise a soup of data. But when you're learning biochem, you have to slog through a lot of data and not so much theory.
So I'm not convinced it has anything to do with the teaching methodology. I think it's the material, and how you as an individual approach learning it.
I made a D in Comparative Anatomy. Me and my lab partner's dissected cat vanished right before the final and we couldn't use it to study so I flunked the test. In Organic Chemistry lab the prof was the pre-med advisor and had a perverse sense of humor, like he would wander into the lab and with an obvious flourish pull out a test tube and scrape some random stuff into it and wander out looking innocent. I did OK with my work (we had something like 5 unknowns to identify) but one of them was changed after I nearly passed out working with it. The TA looked it up, asked the prof, and then got me another one. Apparently the original had some nasty side effects.
All I remember of that course was a husband and wife tag team who wrote indecipherably on overheads in a 500+ class classroom. In my view the course only existed to act as a filter to knock down averages of pre-med students. Did that well for me. Two years of straights A's then a 58 and an unplanned career in computer science.
As a college student, I did my "year" of organic chemistry during summer term in between freshman and sophomore years. That was a smart move for me, because it let me concentrate entirely on "Orgo" and nothing else. I made a notebook of different reactions concepts during the course, which helped me grasp the concepts, and I found that being a chess player was helpful figuring out to synthesize a target molecule during tests. My mother was a chemistry major, and she taught chemistry in high school; so, doing well in any chemistry class was a priority for me. I went on to complete a combined B.S.-M.S. in Biochemistry in 4 years, and later went to medical school.
The new MCAT requirements, which add Biochemistry, Psychology, Sociology, along with general statistics to other scientific prerequisites have shifted some of the first year courses to the undergraduate course load. If you are going to do clinical medicine, I can understand some physicians frustration with doing organic chemistry, but knowing organic chemistry is also learning experience in understanding a scientific vocabulary of different pharmaceutical compounds. I think most physicians should learn generic drug names rather than trade names, but most physicians never take the time to understand a drug's chemical structure. If you are a research physician in academia, one can use basic science knowledge regularly, since you are in uncharted territory. Most new pharmaceutical compounds are going to be biomolecules rather than organic chemicals synthesized in the lab.
I have taken some of the online courses available through edX and Coursera, which was revealing to me in what has changed in General Chemistry and Physical Chemistry, but Organic Chemistry has plateaued somewhat in new knowledge. Organic Chemistry lab has changed with the use of NMR and other spectroscopy methods for identifying unknowns rather the qualitative tests you would find in Shriner-Fuson.
Although it may seem strange, I think that some form of computer/IT literacy is going to become a survival skill in medicine, if only for documentation. I think taking typing in high school has helped me as much as any other course in college during my clinical career. Should a physician has some form of web programming literacy for the future as part of his communication skills. That may be as valuable as a fluency in organic chemistry or even biochemistry.
The best example I can give is how doctors would assume that a header is a sign of something huge, when in fact the great majority of the time is the result of dehydration (because people replaced water with favored/sugary drinks) or due to neck muscle tension caused by sleeping with old (or wrong kind of) pillows.
As a current medical student, I would have to say that doctors are well aware that most headaches are harmless. However, in prioritizing differential diagnostic possibilities, the actual probability of each must be heavily weighted with the urgency and severity of the diagnosis -- both for the patient's own safety, as well as to produce defensive documentation in the event of a lawsuit.
When seen by a family doc who has known you for years, it is likely that you will get a recommendation for conservative treatment; the physician has a good idea of what your baseline presentation looks like, and likely trusts you will give a truthful and accurate history to him. On the other hand, walking into an ER may get you scanned and probed thoroughly, especially likely if you have anything in your history that marks you as having even just a slightly special risk, whether this happens to be an actual medical risk, or a risk that you could be -- even unintentionally -- be giving an inaccurate or incomplete history somehow.
Wrong. Wrong. wrong.
Sometimes, if a student has really good math skills, they can slide through physics, but you can't do that in orgo," says McCarty
1) Orgo? WTF? There is no course in the chemistry curriculum called "orgo". It's o-chem, or organic, or organic chemistry, if you're not into the whole brevity thing. There is no orgo.
2) "You can do blah in physics, but you can't do that in o-chem???" Please, deity, make sure this person never becomes a doctor. Or a parent.
Chemistry is not magic. It is not random. It is not subject to the whims of mystical forces. The atoms and molecules one studies in o-chem are governed by the rules of physics. Those rules are described in the language of math. It's like saying knowing English will help you read plays, but it won't help you with Shakespeare.
If you have the background, and are good at math, then pchem is easy. But orgo is just lots and lots of memorization.
What is this I don't even know. I expect that sort of attitude from someone who hasn't taken p-chem, but you should know better. Especially if you take p-chem before o-chem.
As for memorization, I somehow managed to get through organic without it. Even before years of /. and fark wrapped my fragile little mind my memory was shiat. In high school trig there were a bunch of equations we were supposed to memorize--sin2a, cos(a+b), cos(a-b), that sort of stuff. Well, like I said, my memory was shiat. Turns out, if you remember the definitions of sin, cos, and tan, all those other equations and identities can be derived.
So that's what I did. I memorized those 3 definitions, and derived everything else as needed during the exam.
Organic is the same way. Sure, you could get through by rote memorized of a list of facts and statements without bothering with understanding. But the same could be said of just about any course or class.
But it's a lot easier (or it was for me at least) to remember a small set of simple rules, and then apply them. Of course, that requires a step beyond rote memorization to some actual understanding of those rules to know how and when to apply them. So where do you get those rules and that understanding?
Take p-chem. Take p-chem first, and then o-chem. O-chem is just an application of the rules you'll learn in p-chem. O-chem requires no more memorization then any other college course (and perhaps less).
It's all about charges--electrons are negative, hydrogen ions are positive. Like charges repel, different charges attract. If you have a positive charge, that's where your electrons will go. If you have a negative charge, that's where your hydrogen will go. Draw arrows as needed.
*pout*
Seriously kids, grow up. Most of us have some subject or area where we don't do as well. And almost all of us have at least one thing we do very well.
So organic chemistry isn't your thing? Fine, but that doesn't make it some black art that's all rote memorization or a weed-out course that's designed to make you fail. It's just not your thing. Go do something else.
Take inorganic chem, then tell us how much memorization there is for organic.
As a practicing physician I find organic chemistry that I studies (and aced) in pre-med is entirely useless and irrelevant to me. It certainly weeds out people who are not motivated to jump through hoops to get into med school. It is unclear, however, that it selects for the people who would benefit the medical profession (or who would derive benefit from it, for that matter). I personally think it would be a much more sane choice to require software engineering to be included in pre-med curriculum.
To any doctor who says it's useless:
You are not a physician. You are a pill pusher. You don't know shit about how the body works, you don't think about how the body works, and you don't care about how the body works. Ditto your concern for patients. You're just a "grunt" who pushes pills.
A real doctor has some inkling of drug interactions and keeps track of such things. Far too many (9/10) of my doctors over the past 50 years have been mere pill pushers who left it up to the pharmacist to detect when they'd screwed up and prescribed pills that are not recommended to be taken in combination.
Thanks to such lazy fucktards, I'm now bi-polar, and will suffer with that for the rest of my life. All because you lazy assholes didn't flag the bad interactions between SSRIs and Triptans for migraines, leading to a multi-week case of seratonin syndrome and literal brain damage.
Thank you ever so much for pushing your god damned pills on me.
I do not fail; I succeed at finding out what does not work.
...who went into education after seeing what was/wasn't working in both fields...
I loved undergrad organic chem. Loved it. Loved it. Loved it. It was a system used to unlock a puzzle. I still have all my notebooks and routinely lead my students down the garden path and then try and stump them with hexamethyl chicken wire.
My central issue with it was the nature of needing a whole year in order to do biology. First semester was unlocking the system and working out structures, many of which you will see in an actual living creature. Second semester was petroleum industry chem. Which you rarely see in an actual living creature. My context was US small liberal arts college ending in 1980, mainstream year-long textbook, but from that experience I'd recommend first semester mandatory for all biologists, then on to biochem. Which nowadays likely needs three semesters in order to prep you for current genetics / epigenetics / cell signaling, etc. that's exploded since then.
"Win treats sysadmins better than users. Mac treats users better than sysadmins. Linux treats everyone like sysadmins."
It's that sort of thinking that wastes time and effort and money. Mechanistic o-chem is a valuable precursor to biochem. Most of what's in a 300 level p-chem course will never have any practical use in patient-level medicine. And most of what is relevant/ visible in an MD's day is easily covered in a 300-level biochem course. Too many university plans are holdovers from OCD planning that requires everyone to learn in unison, a semester at a time, with a goal of sitting in a lawn chair with a funny hat on a day in May. I'll gladly sit in the chair with a hat for three hours on day one if you can let me get done and get on with my life.
"Win treats sysadmins better than users. Mac treats users better than sysadmins. Linux treats everyone like sysadmins."
"And what bright minds are going to go to 4 years of med school at around $50k per year after college (or even $0 per year if you fix that), then do residency at 80 hours/week for 3-7 more years after that, for around a decade of extra training, to get out making $100k for 60-80hrs week of work with no flexibility, working nights/weekend/holidays, missing family events, kids birthdays, etc etc? Answer; no one you want diagnosing or operating on you. Probably no one, period."
Thus, something like Watson will eventually replace them and work 24X7 at a much lower cost and with much greater accuracy overall, although before that, it will let fewer doctors do the work of more:
http://slashdot.org/topic/bi/ibm-making-watson-show-its-medical-work/
A 21st century issue: the irony of technologies of abundance in the hands of those still thinking in terms of scarcity.
"Of course, as others have pointed out, it all boils down to how the AMA keeps MDs artificially scarce so that their wages are inflated way beyond what they need to be. ..."
From: http://en.wikipedia.org/wiki/Flexner_Report ...
"The Flexner Report[1] is a book-length study of medical education in the United States and Canada, written by the professional educator Abraham Flexner and published in 1910 under the aegis of the Carnegie Foundation. Many aspects of the present-day American medical profession stem from the Flexner Report and its aftermath.
The Report (also called Carnegie Foundation Bulletin Number Four) called on American medical schools to enact higher admission and graduation standards, and to adhere strictly to the protocols of mainstream science in their teaching and research. Many American medical schools fell short of the standard advocated in the Flexner Report, and subsequent to its publication, nearly half of such schools merged or were closed outright. The Report also concluded that there were too many medical schools in the USA, and that too many doctors were being trained. A repercussion of the Flexner Report, resulting from the closure or consolidation of university training, was reversion of American universities to male-only admittance programs to accommodate a smaller admission pool.
One of the consequences of Flexner's advocacy of university-based medical education was that medical education became much more expensive, putting such education out of reach of all but upper-class white men. The small "proprietary" schools Flexner condemned, which were contended to have been based in generations-old folk traditions rather than relatively recent Western science, did admit African-Americans, women, and students of limited financial means. These students usually could not afford six to eight years of university education, and were often simply denied admission to medical schools affiliated with universities. While many such doctors continued to practice, they did so under proscribed circumstances and for less pay. It was also more difficult for people of color, residents of rural areas, and for those of limited means to obtain medical care in any form."
Before writing this report, Flexner has studied school children and realized that hands-on learning was better than the rote learning prevalent at the time. His suggestions about that were mostly ignored. Unfortunately, he applied the same idea to medical training where it is for many reasons inappropriate. Ultimately, being a "hands on" problem solving physician is mostly a bad idea. Most illnesses people suffer from relate to diet, lifestyle, poverty, and social stress. See Dr. Joel Fuhrnan or Dr. Andre Weil's writings for examples. Physicians should have been taught the basics in these areas, and learned how to persuade patients to return to healthy cultural basics. Instead, they became pill pushers and procedure pushers, always treating and palliating, but rarely preventing or curing. And over the past century, US Americans in many ways have become sicker and sicker, suffering from "disease of affluence" like heart disease, cancer, diabetes, and gout, with an increasing "frailspan" at the end of life. Yet, we have known a better ways towards health, for thousands of years, including sunlight, eating more vegetables, fasting, humor, and so on.. Still, a good solid maybe 20% of modern medicine is indeed useful and miraculous (like trauma surgery) -- it's just that most of the rest is problematical.. One example -- the scam of most heart surgery:
http://www.drfuhrman.com/library/PCI_angioplasty_article.aspx
"Interventional cardiology and cardiovascular surgery is basically a scam based on a misunderstanding of the nature of heart disease. Searching for and treating obstructive plaque does not address the areas of the coronary vascular tree
A 21st century issue: the irony of technologies of abundance in the hands of those still thinking in terms of scarcity.
Hi folks, Nice to imagine that something about "orgo" is fruitful to the process of making doctors, but I disagree. Organic chemistry has NOTHING to do with day to day doctoring for probably 99.9% of us. I don't have to draw a molecule of penicillin or know anything about how it interacts with other molecules in order to use it for strep throat or syphilis. We need in this day and age doctors who know science, probability, the human psyche, communication, and teamwork. But they don't need to know organic chemistry. And there are other fruitful ways to weed out those who can't hack it in med school. I know because I am a physician and I teach medical students and resident physicians in New York. --JSt
How much would a brake job on you car cost if only automotive engineers were allowed to work in a garage? If everyone drove a Ferrari maybe but most doctors visits are for Ford Model T problems. The AMA holds the keys to the kingdom and are not letting go.