Last week, in response to a New York Times article about a medical school with a program to admit students who have not taken physics, organic chemistry, or the MCAT, Chad Orzel expressed some qualms:

On the one hand, I tend to think that anyone who is going to be allowed to prescribe drugs ought to know enough organic chemistry to have some idea how they work. On the other hand, though, I would shed no tears if the pre-med physics class disappeared entirely– most of the students resent having to take physics, and I’m not wild about being used as a weed-out course for somebody else’s major program, which is a combination that easily turns into a thoroughly miserable experience for everyone. …

Still, I’m a little uneasy about people getting to be doctors without taking science in college at all … I suspect Mount Sinai has good results from this program because it’s just about the only one going, and they get their pick of the very best students, who are able to pick up what they need from “summer boot camp.” I’m less comfortable with the idea of making this a general policy– a lot of the students I see struggling in pre-med physics are struggling because of things that would not be positive features in a doctor.

Nowadays, in my capacity as a philosophy professor, I’m actually teaching more chemistry and physics and biology majors, and fewer pre-meds, than I did back in the days when I was a chemistry graduate student. If I recall correctly, all but one of the undergraduate courses for which I was a teaching assistant in my chemistry program were part of the pre-med sequence, including not only first term organic chemistry and the qualitative analysis laboratory course, but also physical chemistry for pre-meds.

I think it’s safe to say that the pre-meds were not always enthusiastic about the material we were trying to teach them.

Indeed, “What am I ever going to use this for?” was an oft heard question in those courses:

“When am I ever going to need to balance a redox reaction when I’m performing brain surgery?”

“How is knowing the difference between S_N1 and S_N2 reactions going to help me deliver babies?”

“What the hell does understanding how a refrigerator works have to do with orthopedics?”

I’m not that kind of doctor (nor do I play one on TV), so I’d probably refer these questions to people like PalMD or Orac or Pascale. (I will note that I recognized some nice chemical content in Pascale’s post on salt and bloat, so I’m guessing that she wouldn’t be writing any pre-meds a doctor’s note to excuse them from chemistry altogether.)

The course prerequisites for medical school, however, have been set by the medical schools. One would hope that they have some good reason for setting them — whether because they impart information and skills directly applicable in the work of being a physician, or because they impart information and skills that will be assumed in the coursework to be completed in medical school, or because they expose students to patterns of thought and problem-solving strategies that are expected to be useful to them in tackling the medical problems they will be tasked to address.

It’s also possible, I suppose, that medical schools have selected the slate of courses required for admission in order to thin out the numbers of applicants that they will have to sift through to build a class. If that’s the case, though, one wonders why they would choose just the hard-enough-to-get-rid-of-the-chaff courses that they did. Why Newtonian physics and not quantum mechanics (or hell, even E&M)? Why organic chemistry or “baby P-chem” rather than the thermodynamics course the chemistry majors have to take (followed by the quantum chemistry course those chemistry majors need to take)?

If you really want to weed them out, why not a serious first order logic course?

I, personally, think the whole philosophy of the “weeder” course is problematic. Moreover, I suspect that setting up intro science courses to “weed out” some large proportion of the students taking them from moving on to the next course in sequence (or to the professional program for which these courses are prerequisites) probably does as much to undermine students’ understanding of the course material, or enthusiasm to engage with it, as the objective difficulty of the material itself.

Maybe if medical schools have more people interested in applying to them than they know how to handle, they should do their own dirty work as far as screening applicants goes. The alternative is to create legions of physics and chemistry professors who would be just as happy not to have to deal with premeds at all.

Myself, I feel more comfortable with a doctor whose brain is hungry for knowledge, someone who wants to learn not only because it means picking up useful information about our world and how it works, but also because it’s fun. I have no idea if this kind of attitude tends to lead to better physicians or more successful medical students, but my hunch is that it may lead to human beings who are better prepared for life in the fullest sense.

That seems like an important thing even for premeds.