CHEMISTRY COURSES IN PRE-MEDICAL EDUCATION* JACK
P. MONTWMERY, UNIVXRSITY011 ALAEAMA, UNIVERSITY, ALABA~
The American Medical Associetion has established as the minimum requirements in chemistry, for admission to medial colleges, eight hours of inorganic chemistry, including qualitative analysis, and four hours of organic chemistry. In a large number of colleges and universities this minimum i s supplemented by additional work in organic chemistry and at least four semester hours in quantitative analysis, with the occasional further addition of elementary physical chaistry. This practice has resulted in such fine recognition by the medical collqes that they are now giving great preference to those students with the maximum of chemistry and merely the minimum is far from suficient. The trend i s toward student guidance into more and more chemistry in his pre-medical work and. the opinion i s expressed that further developments should include a more thorough organization of chemistry teaching, for such students, along the Zines of a course which shall be unified i n respect to i m r ganic, organic, and quuntitative, and at the same time sequential within itself and in respect to physiologial chemistry which i s early encountered i n the medical college.
. . . . . .
Not so very long ago when a young fellow wanted to study medicine he hied himself to a medical school, paid his fees, and started to work. About all he had to show the authorities were evidences of good character, recommendations from one or two active physicians, ability to pay the tuition fees required, and some determination to work. The medical school did not presume that he had had any special preparation in language or science. Even when the prospective medical student could show evidence of previous courses in physics and chemistry the medical school insisted that he take general chemistry over again. Pre-medical students of today know that getting into a medical school is now far from being such a simple matter. Not only must he present various recommendations and stand an aptitude test, but the Board of Admissions is likely to scrutinize his record right back through his high-school and college days, and if anything in that record of the past few years is wrong he may have to decide reluctantly to become a business man instead of a physician. Through the joint efforts of the American Medical Association and the American Association of Medical Colleges many of the fly-by-night medical schools and "degree factories" have been eliminated and medical education thoroughly standardized. There is quite a contrast in the foregoing, and yet a period of time of only about twenty-five years was involved in the change. It would surprise many of our pre-medical students to learn that a number of our most prominent physicians, including some of our medical faculties, never had to endure the pre-medical course as we now understand it. * Presented before the Division of Chemical Education of the A. C. S. at the Indianapolis meeting, March 3O-April3, 1931. 1348
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The departments of chemistry, biology, and physics in most of the American colleges and universities have become greatly developed and strengthened in the past quarter century. About eighteen or twenty years ago, when these departments began to win recognition, the better medical colleges began to require two years of college work for admission. Even these medical colleges still taught general chemistry and did not expect much preparation in science prior to admission to the medical course. It was soon apparent, however, that the very type of student who wanted to study medicine was the one who in his college course had elected chemistry, biology, and physics. This fact soon led the medical colleges to require not only the two years of college work but that the two years should include a certain number of hours in laboratory science. The arts colleges of our various universities, noting the trend of the times and desiring to be of guidance to the prospective medical student, began, about seventeen years ago, to organize pre-medical courses with specific curricula. This movement, participated in by a few a t first, has spread to nearly all of the important institutions. It is noteworthy that the administration of the premedical course is almost entirely in the hands of the non-medical faculty. This is the case even where the medical college is on the same campus, or in the same city, as is the arts college. The American Medical Association early sought to standardize certain minimum requirements for admission to medical colleges, but at the same time has wisely advised that the minimum really be considered just what the word implies. At the present time only the exceptional student, having valuable assets of maturity, personality, and proved ability, can hope to gain admission to a Class A medical college when offering merely the minimum. For 1930 the minimum requirements were sixty semester hours in an approved college. The minimum requirements in chemistry were twelve semester hours, including eight in inorganic chemistry, with qualitative analysis, and four in organic chemistry. Most of the universities and colleges, with a prophetic eye, in the establishment of pre-medical courses, have always required more chemistry than the minimum of the American Medical Association. One result of the thorough attention given to chemistry in pre-medical education was that students from institutions emphasizing chemistry had a better chance of admission to medical colleges. Another result is that the member institutions of the American Association of Medical Colleges look to the arts colleges to furnish students already well taught in chemistry. As an evidence of this, the only chemistry now offered in medical schools is physiological chemistry. I t is obvious that merely the minimum requirements of the American Medical Association could hardly be expected to fit the student for physiological chemistry or to give him any background in materia medica. Medical colleges actnally expect a much better preparation than the minimum in chemistry
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and it is a gratifying fact that in most of our pre-medical courses the minimum is wisely greatly exceeded. A review of current catalogs of sixty institutions listing, in one form or another, pre-medical courses reveals a very healthy situation in most of them regarding the importance of chemistry in pre-medical training. I t is regrettable, however, that some of the institutions reveal a weakness, or a lack of realization of their importance, in advising prospective medical students as to the great desirability of some of the chemistry courses which they offer, in general, to the whole body of students. The catalogs examined were those of Separated State Universities, State Universities including Land-Grant Colleges, Separated Land-Grant Colleges, Independent Endowed Colleges, and Denominational Colleges. Almost without exception, the closer the relation of the institution with a medical college, from the administration standpoint or geographically or both, the greater is the catalog description of pre-medical requirements and the detailed advice to pre-medical students concerning chemistry courses regarded as essential, while the poorest advice is available in the cases of some Denominational Colleges and Independent Endowed Colleges which have little or no relation with medical colleges. While not unexpected, this result may serve to call to the attention of chemistry teachers in these institutions the importance of becoming informed of the situation. Following is a compilation of the chemistry courses included in the pre-medical curricula of the institutions referred to above: Eleven provide the minimum requirements of the American Medical Association, but make no further suggestions. Nine of the eleven list other courses in chemistry in addition to the minimum, but they appear to be entirely elective. Seventeen provide the minimum requirements and strongly urge the election, on the part of prospective medical students, of additional chemistry courses, including a second semester of organic and four hours of quantitative analysis. Five of these, in addition, suggest elementary physical chemistry as desirable. Twenty-eight require, in addition to the minimum, four hours in secondsemester organic chemistry and four hours in quantitative analysis. Fifteen of these include also, either in plain terms or by implication, four hours of elementary physical chemistry. Five suggest additional courses in both qualitative and quantitative organic. Although somewhat aside from the main discussion, the details of student guidance in the various catalogs may be of interest. Eleven institutions with state support and two Independent Endowed Colleges strongly urge pre-medical students to graduate with the A.B. degree before beginning medicine and to include from twenty-four to thirty hours of chemistry, comprising the American Medical Association minimum
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with the addition of second-semester organic, four hours of quantitative, four hours of elementary physical, and some electives in chemistry. Some of these institutions, and others, provide for the A.B. degree upon completion of a specific three-year pre-medical course followed by the first year in medicine, the year in medicine in some cases to be taken in the medical school of the institution awarding the degree and in other cases to be taken at any Class A medical school. So far as can be learned, all these three-year medical courses include the American Medical Association minimum with the addition of four hours in second-semester organic and four hours in quantitative. Some of them include elementary physical chemistry and electives in chemistry. A few institutions still offer a course, which is rapidly becoming obsolete but which was popular some years ago, the combined B.S.-M.D. Under this plan the student takes two years of specific pre-medical work followed by four years of medicine. At the end of the second year of medicine the degree "B.S. in Medicine" is given and the M.D. degree is awarded a t the end of the fourth year in medicine. In all cases the pre-medical part of the work included the American Medical Association minimum in chemistry with four additional hours in organic and four hours in quantitative. Finally, the more isolated colleges give practically no guidance to students except to list the American Medical Association minimum. Those of us who seek to place our pre-medical students in the best medical schools are fully aware of the following facts: (1) A few medical schools require for admission an A.B. degree including from twenty-four to thirty hours in chemistry. (2) All the medical schools give preference to those holding the A.B. degree with a major of thirty hours in chemistry. (3) The student who has had a three-year pre-medical course, with from twenty to twenty-four hours in chemistry, has an immeasurably better chance for admission to a medical school than the two-year man, even when the American Medical Association minimum requirements with additional hours in chemistry have been met. (4) It is now practically impossible for any student to enter medical college with the minimum American Medical Association requirements in chemistry. From the above it is evident that our wide-awake departments of chemistry, in their contribution to pre-medical education, have been consistently anticipating the requirements of the best medical colleges. Admission to medical colleges has rapidly developed into a competition in which the well-prepared student is likely to have a great advantage over about half a dozen others applying for the same place. In this respect the medical colleges are giving excellent recognition to the teaching of chemistry in the arts divisions of our universities and colleges. This is a source of great gratification to many chemistry teachers, but it is likely that we shall have to do even more as we proceed with this particular phase of our work.
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Since the study of medicine is itself so well standardized and organized, the time is approaching when the chemistry courses in pre-medical education will have to be unified, and at the same time made properly sequential. Some institutions already have special sections for pre-medical students in inorganic chemistry, including qualitative analysis, organic chemistry, and quantitative analysis. Even though these courses are taught by three different men it is possible to unify the entire twenty hours so that there may be constant repetition of certain principles with the avoidance of repetition of less essential details, the idea being to deliver the student to the physiological chemistry course in the medical school in such good order that he need not waste time and energy getting under way.
