DOI: 10.1097/01.COT.0000407952.36869.5a
,
Issn Print: 0276-2234
Publication Date: 2011/11/10
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Excerpt
Googling just now, I see that the accepted course requirements today are the same as they were when I applied for medical school in 1972: a year of general biology, physics, general (inorganic) chemistry, organic chemistry, calculus, and English. I imagine they added English just to demonstrate that physicians aren't all Philistines.
Organic chemistry? Physics? Calculus? (Note bene on calculus: one semester, the only math course I took in college, aced it, and never looked back. I still like to brag on that.)
The mandatory “rite of passage” science courses taught me nothing of value about dealing with or treating my patients. I understand the philosophy behind them well enough. Medicine is a branch of science, and proving you can understand (or at least pass courses in) science probably eliminates a good many incapable of understanding the principles of modern medicine. I get that.
But I have yet to use organic chemistry in a discussion with a patient. I have been dying for 30 years to tell the story of Kekule falling asleep and dreaming of a snake chasing its tail, then waking up and drawing the structure for benzene. In fact, that story is pretty much the only thing I remember about organic chemistry. But the situation has never arisen: I just can't squeeze it in to an adjuvant therapy discussion, no matter how hard I try.
I imagine physics is still valuable to a few of my colleagues in orthopedics and radiation therapy, though I suspect the physics they learned as a sophomore in college bears little relation to the physics they use today.
Even from a science standpoint these courses make little sense. No biochemistry? No biostatistics? No molecular biology? Well, admittedly, there was almost no molecular biology in 1972, but what's the excuse now? Are oncogenes going away sometime soon? Is the human genome going kablooey? Perhaps one of my colleagues on an admissions committee can tell me why the requirements haven't changed in a half-century or more, and why they are so ridiculously divorced from medical relevance. Indeed, I wonder how many good doctors organic chemistry has prevented? Far more than it has inspired, I'd wager.
No, the courses I still use were not required for admission. I took two semesters of Shakespeare. Reading Shakespeare makes you an instant expert on human behavior: love, hate, greed, passion, grief, joy, and every other human emotion or characteristic one cares to name. French literature, my other great love in college, served much the same purpose. Balzac, Camus, and Montaigne all still teach me a great deal about how I and my patients interact with the world.
Comparative vertebrate anatomy (I was a Zoology major) came in handy later on, but my most useful course was Herb Howe's “Greek and Latin Origins of Medical Terms,” offered through the Classics Department at the University of Wisconsin. Howe was a professor of classics, not of anatomy. I credit my survival in the first two years of medical school to what he taught me about parsing complex medical terms. He also interspersed wonderful tales of classical mythology amongst his dissections of medical lingo. Mostly, though, he taught me that medicine was a language as much as it was a science.
