As the person who teaches the lion's share of the introductory chemistry courses at Tufts, I would like to address some of the points made about the pre-medical coursework mentioned in Monday's Daily entitled "Pre-med students must work hard to make the grade."
First of all, the chemistry courses offered at Tufts are not, and have never been, "weed-out" courses. This department gives its blood, sweat, toil and tears to ensure that students learn the introductory material and that there are proper supports for students who need help. I spend 80 or more hours per week here at Tufts because I love teaching, and my life is dedicated to helping people learn. I will do anything to help foster a love of learning and sometimes even a love of chemistry. I think that anyone can succeed with enough work, but there are limits. There are not enough hours in the week to allow me to write an "A" paper in an English class, and I'm aware of my limitations.
Students seem to labor under the misguided impression that chemistry is a fictitious science created by medical schools to make it harder for students to get into them. The fact of the matter is that chemistry (especially biochemistry) is at the forefront of medicine. If doctors do not have a solid knowledge of all the applicable material, how can they imagine diagnosing a patient?
Students complain when the work requires effort, reading or thinking "outside of the box." Do they expect every patient to come into their office with their affliction tattooed to their forehead? Do they think that they will not have to keep learning as JAMA and the New England Journal of Medicine report new methods of treatment? Do they think they can tell a patient that they do not know much about their prospects because they were really hung over and slept through the lecture on liver cancer? There is a core knowledge that doctors must maintain and update over time, but far more important than this is the dedication, the interpersonal interactions (i.e. bedside manner), and the analytical brainpower they possess.
Ask high school seniors what they would consider being when they grow up and the vast majority would say either doctor or lawyer. How many of you knew about all the different career paths in existence when you came to college? College is meant to broaden your horizons and expose you to the world and all it's facets. Medicine is not the glorious field that many people glamorize it to be or that it once was. Insurance costs have risen, the HMO's control the money flow, the loans can take over ten years to pay back, and the hours are terrible for the first several years after medical school graduation. I think it is very noble and arduous to be a doctor, but I do not think it is a path that is meant for everyone.
And if you think I like having class first thing in the morning, you are mistaken. This is not done as a torture to personally make the lives of pre-medical students more difficult. This is a necessity for a school with lots of science courses meant for pre-medical students, pure science majors, and engineers. Physics, biology, chemistry and math courses must be spread throughout the day to prevent overlapping schedules and to counteract the problem of there being limited teaching classrooms. It was decided before I was born that chemistry would be in the 0/1 block.
Do you really think there is no specific reason why all medical schools expect a proficiency in biology, chemistry and physics? There is an incredible correlation to the successes in the types of thinking involved in solving basic science problems to that of solving medical conundrums. The introductory science courses ultimately teach the analytical problem solving that is the core of mastery of the medical sciences. When you get to medical school, they are going to present you with the information, assuming through their screening process that you already have all the hardware necessary to use it to its full extent.
And I really do not understand why there is such a fear of organic chemistry. It is a very challenging course; there is a lot of material to learn. If you have diligence and good study skills, organic chemistry is very graspable. The rationale for solving an organic chemistry problem is very similar to the logic a person uses in planning a course of treatment for a disease. Knowing about both adverse effects of medicines and possible pre-existing conditions makes a difference. Giving penicillin to a person who is allergic to it is just like reacting a Grignard reagent with a molecule that has a pendant alcohol functional group. In both situations, a person's failure to consider all the information leads to a failure to achieve the desired effect.
It is unfortunate that medical schools put such a focus on grades, because it drives the students to care more about the letter than the learning. I feel that this puts a huge damper on the pedagogical goals of many college professors because the students are blinded by grades. I know there is grade inflation in some departments and at some schools, but what are important to me are both the effort and the skills with which I see the students leaving my courses. I have written glowing recommendation letters for C students and I have refused to write letters for "A" students about which I had nothing positive to say.
I just hope that people can look out from behind their highlighted books to see that there really is a method behind the expectations for medical school-bound students. I know that when I go to the doctor, I want to see someone who is compassionate, intelligent, dedicated, and knowledgeable. If one of those four categories is lacking, it is the patients who will suffer.
Christopher Morse is a Lecturer and Graduate Training Coordinator in the Department of Chemistry.
