Chemistry in the Premedical Curriculum: Considering the Options

Jul 9, 2013 - The ACS Guidelines for Undergraduate Professional Education in ... Develop information on innovative curricular models already being ...
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Chemistry in the Premedical Curriculum: Considering the Options Joel I. Shulman* Department of Chemistry, University of Cincinnati, Cincinnati, Ohio 45221, United States ABSTRACT: In 2009, the Association of American Medical Colleges and the Howard Hughes Medical Institute released a report entitled Scientific Foundations for Future Physicians (SFFP). This report, produced in response to “concerns about the science content in the current premedical and medical education curricula”, emphasizes competencies for premedical school students rather than mandating specific courses for admission to medical school. This commentary addresses the opportunities and challenges for the chemical education community presented by SFFP, some models that have been created or suggested for teaching chemistry in the premedical curriculum, and some issues that colleges and universities should keep in mind when considering their response to SFFP. KEYWORDS: First-Year Undergraduate/General, Second-Year Undergraduate, Biochemistry, Curriculum, Organic Chemistry, Testing/Assessment, Bioorganic Chemistry, Nonmajor Courses

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introducing a revised MCAT in 2015.2 Two of the four sections of the new MCAT2015 will focus on biology and chemistry: Biological and Biochemical Foundations of Living Systems; and Chemical and Physical Foundations of Biological Systems. The natural science sections of the exam will cover “introductory biology, organic and inorganic chemistry, and physics concepts” as well as “biochemistry concepts at the level taught in most first-semester biochemistry courses”. At the same time, HHMI initiated a series of NEXUS (National Experiment in Undergraduate Science Education) grants to support the development of SFFP competency-based modules and curricula.3 Included in NEXUS is a grant to Purdue University for increased emphasis on biological chemistry in foundational chemistry courses.

or many decades, the majority of students majoring in chemistry or biologyand students in other majors hoping to go to medical, dental, veterinary, or pharmacy schoolhave taken the same first two years of chemistry: a standard general chemistry course followed by organic chemistry. Few curricula have recognized that a large percentage of general chemistry students and, at most colleges and universities, the majority of organic chemistry students have a strong biological interest. However, this traditional curricular model for teaching chemistry is changing. A catalyst for this change occurred in 2009, when a joint committee of the Association of American Medical Colleges (AAMC) and the Howard Hughes Medical Institute (HHMI) issued a report entitled Scientif ic Foundations for Future Physicians (SFFP).1 This report was produced in response to “concerns about the science content in the current premedical and medical education curricula”. Two charges to the SFFP Committee specifically addressed the undergraduate training of premedical students: Consider the means and consequences of establishing the concept of “science competency” (learner performance), rather than academic courses, as the basis for assessing the preparation of medical school applicants. Identify the scientific competencies that premedical students should demonstrate before entry into medical school. Emphasis should be on defined areas of knowledge, scientific concepts, and skills rather than on specific courses or disciplines. SFFP defines a broad series of eight scientific competencies expected of premedical students. At least half of these premedical competencies relate to chemistry, most specifically E4, “Demonstrate knowledge of basic principles of chemistry and some of their applications to the understanding of living systems”, and E5, “Demonstrate knowledge of how biomolecules contribute to the structure and function of cells”. SFFP spawned two initiatives by AAMC and HHMI. As a means of assessing the SFFP competencies, the AAMC initiated a “fifth comprehensive review of the Medical College Admission Test” (MCAT), or MR5, with the goal of © 2013 American Chemical Society and Division of Chemical Education, Inc.

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SFFP PRESENTS BOTH OPPORTUNITIES AND CHALLENGES FOR THE CHEMISTRY COMMUNITY What are the implications of SFFP for chemistry in the premedical curriculum? Importantly, it presents an opportunity to engage the medical community and other stakeholders about the importance and roll of chemistry in premedical and medical education. SFFP, with its emphasis on competencies and away from specific course requirements, also provides an impetus for more chemistry programs to take into account the academic interests of their studentsnot only those with medical school ambitions, but all students with a biological interest. Many chemistry programs have previously taken note of this and have reorganized their chemistry curriculum in interdisciplinary ways, introducing more biological examples into both general and organic chemistry. But, at the same time, SFFP presents a major challenge for the chemistry community: How best to meet the needs of students within the constraints of a given programmatic infrastructure. Among the 668 chemistry programs that the American Chemical Society (ACS) approves to give ACScertified degrees, there is a wide range of size, missions, student demographics, and resources. Large programs can, and often Published: July 9, 2013 813

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Traditional (One Year Each of General Chemistry and Organic Chemistry)

do, offer separate tracks for chemistry students with different interests and career goals. But among ACS-approved schools, 70 have only four or five tenure-track faculty members and do not have the resources to offer different courses for different constituencies; many other smaller programs may be in the same situation. It is therefore vital to recognize that responses to SFFP cannot be one size fits all. The ACS Guidelines for Undergraduate Professional Education in Chemistry,4 developed and administered by the ACS Committee on Professional Training, recognizes this and provides the flexibility for programs to respond to SFFP in a wide variety of ways.

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The traditional model for teaching chemistry may be best for many programs, especially for smaller programs that are resource limited. However, even if the traditional model is used, there is ample opportunity to emphasize the biological relevance of chemistry. For example, when discussing catalysis in either general or organic chemistry, enzyme catalysis, including the role of proximity within active sites of enzymes and the influence of nonbonding interactions, can be introduced. Organic chemistry provides myriad opportunities to intersperse biological examples rather than leaving “bioorganic” chemistry to the end of the course, as most textbooks do. Simple examples might include discussing peptide bonds and protein conformations when other examples of carboxylic acid derivatives are covered, introducing monosaccharide structure and mutarotation when discussing hemiacetal and acetal formation, and describing how the body converts the hydroxyl group into a leaving group by forming phosphate or sulfate esters. Emphasizing reactions of biological relevance (e.g., NADH as a reducing agent, Claisen condensation to form acetoacetyl CoA) is an additional approach.

ACS TASK FORCE ON SCIENTIFIC FOUNDATIONS FOR FUTURE PHYSICIANS

Following the release of SFFP, an ACS task force was convened, comprising members of the ACS Committee on Professional Training and the Society Committee on Education. This task force has as its goal to advise and coordinate ACS efforts related to SFFP, with a focus on four areas: Maintain contact with AAMC as they move forward with MCAT2015. Maintain contact with HHMI and its NEXUS grantees as they develop curricular innovations in response to SFFP. Develop information on innovative curricular models already being introduced by chemistry programs to better meet the needs of preprofessional students, particularly concerning the teaching of general and organic chemistry. Develop means to disseminate information on the above activities to the chemistry community. The task force has focused on general and organic chemistry, because the material traditionally covered in these courses relates to many of the competencies to be tested by MCAT2015, and because the principles developed in these courses underlie biochemical understanding. It is the assumption of the task force that competencies in biochemistry are adequately covered in freestanding biochemistry courses.

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Second Semester of Organic Chemistry Offered as a Choice between Bioorganic or Mechanism and Synthesis

In this case, general chemistry is followed by a one-semester organic course. This first semester would introduce most of the major concepts of organic chemistry, including major functional group chemistry and spectroscopy, without going into great detail. Students would then be offered two choices in the second semester, depending on their goals and interests. Premedical and other biology-oriented students could take a bioorganic course, which would emphasize organic reactions and interactions with biological relevance. Other students could choose a course that would include a strong emphasis on retrosynthesis and physical organic chemistry. This is an approach that Oberlin College, for example, has taken for nearly 20 years. 1-2-1 Approach

Purdue University is using its HHMI NEXUS grant to develop a two-year curriculum consisting of one semester of general chemistry, two of organic, and one of biochemistry. In this model, general chemistry has a strong acid−base emphasis with connections to biochemistry, while organic focuses on reactions and mechanisms that have biochemical analogies. Of course, this model presumes that first-year students arrive at college appropriately prepared so that one semester of general chemistry is sufficient for success in organic. The advantage of this approach is that preprofessional students complete all of their chemistry and biochemistry in two years.

MODELS FOR CHEMISTRY IN THE PREMEDICAL CURRICULUM

The task force identified five major curricular models currently in use or being planned as a way to meet the chemistry competencies articulated by SFFP. Each of the five has variations. However, all five can be constructed to meet the guidelines for an ACS-approved program.4 It is important to note that the Committee on Professional Training does not favor any of these approaches over another. Many of these curricular models were discussed at two symposia (“Chemistry and the Premedical Curriculum”) in 2012: The Biennial Conference on Chemical Education5 and the 244th ACS National Meeting.6 Larger programs may be able to provide resources for a distinctly different track of chemistry courses for premedical and other preprofessional students than for other students. However, the options described below should be pertinent for any students in their first two years of chemistry, including chemistry majors.

Organic First

Several schools have introduced this curricular model. For example, Juniata College has taught “biologically flavored” organic chemistry to first-year students for nearly 20 years. This is not simply a traditional organic course; rather, it introduces some general-chemistry concepts with relevant biologically related material intercalated throughout. This first-year course can be followed by two semesters of mainstream chemistry courses (e.g., inorganic and analytical) or by a mainstream chemistry course and biochemistry. Washington and Jefferson College has used a similar curricular model since 2005. 814

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students fit into a modified chemistry program if they have taken a traditional general chemistry course at a different institution?8

It should be noted that Brenner and Ringe7 have suggested that “The traditional, two-year sequence of general and organic chemistry should be streamlined to a single-year of life-oriented chemistry” to be followed by one or two semesters of biochemistry for premedical students. The “organic first” curricular model approximates this, but it is not evident that any programs have tested whether students are sufficiently prepared for a biochemistry course after just one year of chemistry; indeed, I believe most chemistry educators would argue that they are not and that preparing them adequately for biochemistry in this way would be very difficult.

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CONCLUSION Without a doubt, SFFP and the resulting modification to the MCATs have implications for how chemistry is taught to premedical students. Indeed, even in the absence of SFFP and MCAT2015, chemical educators should be cognizant of the biological interests of a plurality or even a majority of their firstand second-year students and design their curricula accordingly. How this is done will depend on a variety of programmatic considerations, including number of chemistry students a program serves, student demographics, number of chemistry faculty in a department, and what future studies tell us about the effectiveness of various pedagogies in preparing biologyoriented students for their future careers.9

Fully Integrated Foundation Courses

One of the goals of the 2008 ACS Guidelines for Undergraduate Professional Education in Chemistry4 was to provide flexibility in the chemistry curriculum, which would allow for innovative approaches in both program structure and pedagogy. Several chemistry programs have taken advantage of this opportunity. For example, the College of St. Benedict−St. John’s University has replaced the standard first two years of chemistry with four semester-long courses titled Introduction to Structure and Properties, and Reactivity I, II, and III. These courses integrate structure and reactivity in organic, inorganic, and biochemistry; link these topics together so that students can see their relevance to society; and are designed to coordinate with the SFFP and MCAT2015 competencies.

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AUTHOR INFORMATION

Corresponding Author

*E-mail: [email protected]. Notes

The authors declare no competing financial interest.

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ACKNOWLEDGMENTS I am grateful to J. Wesemann and M. K. Carroll for their helpful comments.

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ASPECTS FOR CONSIDERATION How chemistry programs respond to SFFP and the resulting changes to the MCAT will depend on many factors. Whatever approach is taken, it is important to remember that one size cannot fit all. Each program will have to choose a curricular model that fits its student demographics and its resources. Here are some things that need to be considered: Expectations for premedical students are uncertain until MCAT2015 is released and until the effect of SFFP on medical school admissions is understood. Exactly how will scientific competencies be assessed? This will be an evolving situation. Curricular change takes time and effort. It also takes buy-in from the full faculty of a program and does not work well without close coordination among all involved instructors, particularly those teaching general chemistry, organic chemistry, and biochemistry. The logistics of change must also be considered. Are there appropriate textbooks available for redesigned courses? How will the success in student preparation be measured in any new curriculum? Is there appropriate coordination between chemistry and other departments (e.g., biology) during any curricular modification? It is vital to consider unintended consequences when making any curricular changes. For example, how would a change in curriculum affect underprepared first-year students? Will curricular changes affect the options open to preprofessional students who do not gain acceptance into medical or other professional schools? Do major changes in curriculum motivate or discourage students? A major issue for many programs will be articulation. Often, schools bring in transfer students who will have taken a year or two of chemistry elsewhere. A specific example is large public universities that admit students from satellite campuses or twoyear colleges. In addition, matriculated students may take one or more of the core chemistry courses outside of the home institution, for example, during summer break. How will

REFERENCES

(1) AAMC−HHMI Committee. Scientific Foundations for Future Physicians; Association of American Medical Colleges: Washington, DC, 2009. http://www.hhmi.org/grants/pdf/08-209_AAMC-HHMI_ report.pdf (accessed Apr 2013). (2) Association of American Medical Colleges MR5 Initiatives Web Page. https://www.aamc.org/initiatives/mr5/ (accessed Apr 2013). (3) Howard Hughes Medical Institute NEXUS Project Page. http:// www.hhmi.org/grants/office/nexus/project.html (accessed Apr 2013). (4) Undergraduate Professional Education in Chemistry: ACS Guidelines and Evaluation Procedures for Bachelor’s Degree Programs; American Chemical Society: Washington, DC, 2008. http://portal.acs.org/ portal/PublicWebSite/about/governance/committees/training/ acsapproved/degreeprogram/WPCP_008491 (accessed Apr 2013). (5) Chemistry and the Premedical Curriculum. Symposium at the Biennial Conference on Chemical Education; University Park, PA, July 30, 2012. http://portal.acs.org/portal/PublicWebSite/about/ governance/committees/training/symposia/CNBP_030466 (accessed Apr 2013). (6) Chemistry and the Premedical Curriculum. Symposium at 244th American Chemical Society National Meeting, Philadelphia, PA, August 21, 2012. (7) Brenner, C.; Ringe, D. Response to the New MCAT: ASBMB Premedical Curriculum Recommendations. ASBMB Today 2012, March, 12−14. http://www.asbmb.org/asbmbtoday/asbmbtoday_ article.aspx?id=16052 (accessed Apr 2013). (8) Articulation and transfer issues related to two-year colleges are addressed in ACS Guidelines for Chemistry in Two-Year College Programs; American Chemical Society: Washington, DC, 2009. http://portal.acs.org/portal/PublicWebSite/education/policies/ twoyearcollege/CSTA_015380 (accessed Apr 2013). (9) Carroll, M. K. Moving from Recommendations to Innovations: Increasing the Relevancy and Quality of Chemistry Education. J. Chem. Educ. 2013, 90; DOI: 10.1021/ed3008796.

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