More than a century ago, Carnegie Foundation research scholar Abraham Flexner completed an assessment (.pdf) of medical schools’ curriculum in North America that acted to reform medical education. While the academic environment is greatly changed since Flexner’s day, the transformation is not as significant as some may think. As Dean Philip Pizzo, MD, writes in the latest issue of his newsletter, these changes have been “more evolutionary than revolutionary:”
It is true that medical schools, including Stanford, have sought ways of better integrating clinical and preclinical education and training – but, for the most part, these remain discrete and even separate experiences.
In a similar vein, the “premedical education requirements” have also changed relatively little – even from the time when I applied to medical school some decades ago.
Central to the discussion of how to improve medical education is the importance of students studying the humanities or the social sciences to develop a “broad educational experience.” Pizzo points out that some institutions are experimenting with formats that encourage such learning, but that students may be reluctant to take courses that seem insignificant in the pre-med path. He writes:
Some schools, the University or Pennsylvania being an excellent example, offer suggested areas for undergraduate study as an alternative to “requirements” (see: http://www.med.upenn.edu/). I believe this is an area needing further discussion and we will be examining whether we should move to a similar “recommendation” model at Stanford. As someone who concentrated in philosophy as an undergraduate (like a number of my colleagues who have spent their subsequent careers steeped in science) I do believe that students should have an opportunity to explore broadly and deeply in many different disciplines before entering medical school. But this will require some further discussion — since many students are still concerned about deviating from the tried and true path to medical school, which remains traditional and somewhat limiting if not inflexible.
Pizzo goes on to explore other potential changes in undergraduate education and medical school requirements, including recently approved changes to the Medical College Admission Test (MCAT). His full thoughts are worth a read.