Medical student studying 590 x 250 px
Photo credit: healthydebate.ca

Hey, all you docs out there…remember Organic Chemistry? How about Physics? And Calculus? When your liberal arts friends were partying Friday afternoon, you were probably still in a lab. In addition to the fierce competition for A’s, a pre-medical undergraduate curriculum often means you don’t have time to broaden your horizons by taking a writing class or studying ancient Chinese history. And, how about all the time you spent preparing for the MCAT so that your scores would be competitive when your non-pre-med classmates were starting to look for paying jobs in the “real world”? Think back now. Did any of this help you succeed once you got into medical school?

 

Challenging traditional pre-med requirements

A paper recently published in the August 2010 issue of Academic Medicine explores the topic. David Muller, MD and Nathan Kase, MD, in a paper titled, “Challenging Traditional Premedical Requirements as Predictors of Success in Medical School,” examined the academic outcomes of 85 medical school students who trained in Mount Sinai School of Medicine’s Humanities and Medicine Program (HuMed) compared with 606 of their classmates who matriculated into the traditional program.

Students in the HuMed program did not have to take the MCAT and they did not have to take Organic Chem, Physics or Calculus. In fact, humanities and social science majors were welcomed. Students are usually accepted into the HuMed program in their sophomore year. After that, they are only required to maintain a 3.5 GPA (instead of the 4.0 that most pre-meds are shooting for). The hope is that these students will explore academically challenging courses because they aren’t just aiming for the “A”.

 

How did they do?

Despite not having the typical pre-med experience, the HuMed students performed at least as well as their more traditionally educated classmates. In fact, they received more clerkship honors in psychiatry and, more importantly, they tended to choose primary care and psychiatry residencies as opposed to surgical subspecialties and anesthesiology.

There are some very appealing aspects of the HuMed program. First of all, the students are encouraged to take a year off before enrolling—now there is a concept—see the world, grow up a bit more, get your life in order before diving into medical school. They are also required to take a Summer Enrichment Program where they get introduced to the basic science part of the medical school curriculum.

It is interesting that HuMed students not only excelled in medical areas that emphasize interpersonal skills (e.g., primary care and psychiatry), they were also significantly more likely than traditionally educated peers to dedicate a year to scholarly research and to be awarded a Doris Duke Clinical Research Fellowship. About the only “negative” findings were that HuMed students had slightly lower scores on the U.S. Medical Licensing Exam (Step 1) and they were more likely to require a nonscholarly leave of absence for academic or personal reasons.

It is too early to say whether HuMed students will go on to become better doctors as a result of this more humanistic approach to the pre-medical experience. That will require following this cohort of students over their practicing careers. But I say, hooray to Mount Sinai for offering a different way to get into medical school.

It is fitting to close this post with advice from Lewis Thomas (in the 1970’s) to the nation’s Medical School Deans:

[Announce that] “…henceforth, any applicant who is self-labeled as a ‘premed,’ distinguishable by his course selection from his classmates, will have his dossier placed in a third stack of three. Membership in a ‘premedical society’ will, by itself, be grounds for rejection. Any college possessing something called a ‘premedical curriculum’, or maintaining offices for people called ‘premedical advisors’, will be excluded from recognition by the medical schools.”