PREMEDICAL TRAINING ROY I. GRADY AND JOHN W. CHITTUM The College of Wooster, Wooster, Ohio
A
FEW years ago, the student whoexpected to study medicine was advised to consult the catalog of the medical school he expected to enter and then plan his premedical course accordingly. Such advice is good if the student can be certain that he will be admitted to the school of his choice. Because most medical schools of today have a great many more applicants for admission than they can possibly accommodate, the person who wants to be reasonably sure of being accepted by some school sends in his application to several different medical schools. It therefore becomes necessary for the student so to plan his course that it will fulfil the requirements for admission to any school. There are three sources of information available for the student who wants to know how to be well equipped for the study of medicine. He can study the catalogs of the medical schools. But he will find in many instances that the catalogs give the minimum requirements of the American Medical Association only. He can go to persons within his college who give guidance on vocational subjects or to his own professors. Unless these persons have made a real study of the situation their information is not complete, and quite frequently includes considerable mfsinformation. Finally, the prospective student may talk to physicians of his acquaintance and attempt to learn from them what courses are desirable. While it may be a valuable experience to talk to the physician, the student cannot hope to get much help in the selection of his studies. The individual physician has not had contact with many different medical schools, and, unless he has kept in touch with the changes in curricula, his advice will not meet the situation. The deans of the medical schools are the only ones who have a broad vision based upon experience. They are the only ones who are in position to judge how the
various medical students are aided or handicapped by the nature of their premedical training. In 1930 an attempt was made to help the student in his preparation for the study of medicine. A questionnaire was sent to the deans of some of the Class A medical schools asking them to appraise various college courses as to the& premedical value. This partial information1 was found to be so helpful that the authors believed it worth while to bring it up to date and to extend it by including reports and comments solicited from all the Class A medical schools of the country. As in the earlier study a questionnaire was sent to the deans with the request that they designate what courses, (1) they require, (2) they recommend, (3) they are doubtful as to the value of, and (4) they do not desire. The following schools .and universities replied: Alabama, Baylor, Boitirn, Chicago (Rush Medical), Cincinnati, Columbia, Cornell, Creighton (Nebraska), Detroit College of Medicine and Surgery, Emory, Georgetown, George Washington, Georgia, Hahnemann Medical College and Hospital of Philadelphia, Harvard, Illmois, Iowa, Johns Hopkins, Long Island College of Medicine, Louisville, Loyola, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Northwestern, Ohio State, Oregon, Pennsylvania, Pittsburgh, Tulane, Union (Albany Medical), Utah, Virginia, Yale, Washington, Western Reserve, Wisconsin, Women's Medical College of Pennsylvania. Summaries of the appraisals are given in Table 1. Since it is important for the student to equip himself for the best possible work in medical school and in after life i t is desirable that he give careful consideration to those courses which are either required or recom1 GUADY, ROYI., "Chemistry in the college curriculum of the premedical student." J. Cn~aa,Eouc.,9,111 (Jan., 1932).
TABLE 1
Svsrnara~ow R s a r s s
RecornNot Scm. Rcpuir- rnand- Daub6 D 6 hrs. ins ing f1. siring
Rcruirinb orRmommending
Another states :
Biology: General Zo6logy Vertebrate Anatomy Phvriolo=v nit. ~mbryalogy Animal Histology Histological Techn.
"The most uniform complaint I encounter from medical faculties is the inadequacy of students in handling English. I certainly think that six hours of English in a three-year program is hardly adequate."
Genetics Chemistry: General Inorganic Qualitative Anal. Quantitative Anal. Ad". Quant.Anal. organic, 1 s t .em. Organic, 2nd sem. Food and Nutrition Physical Eeonomier
freshmen is their lack of knowledge of the English language and no appreciation of the roots from which the words have been formed. A dictionary apparently to the modern student is a book to be avoided."
Quite a number of the deans are expressing a decided preference for German instead of French where both cannot be taken. They prefer a usable knowledge of one or the other to a smattering of both. This trend toward the preference for German seems to be a development of the past six years. Other comments by the deans, which should prove helpful, follow:
.
English:
Freshman Literature General Literature French. Elementary 2nd year German. Elementary 2nd year Greek History. European American Latin: 2 yrs. High Sehmi 4 y r s High School cieero and Liuy Math.. Trigonometry Anal. Geometry Philo~ophy Physics Adv. Physics Psychology
"I think the important thing is t o provide in the premedical education a general preparation rather than specifically preprofessional."
Another writes: "In general, it is not desired that courses be taken which anticipate courses t o be given in the medical school, such as physiology and biochemistry. It is desired that students entering the medical school should have a good background of general education. This should not be limited to scientific courses, but should give the student a basis for advancing the knowledge not only of the chemistry of the body, but also of human beings as such."
Another:
Bible Soeiolow ~-
*Required or rsommended by a majority (twenty-two or more).
mended by the deans of the Class A medical schools. For this reason we have added another column in Table 1 indicating the total number of schools either requiring or recommending each subject. In this column those subjects which are required or recommended by a majority (twenty-two br more) of the schools are marked with an asterisk. While the table clearly indicates the courses which are considered essential or desirable, the comments of the deans show that there is a flexibility which cannot be indicated in any table of data. In some schools there is a tendency to select a high-cl+s candidate even though he may not have taken some of the courses which are highly recommended. c The dean of a mid-western school writes as follows:
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"I think that we are all tending to much more generosity in subject matter of premedical curricula than seemed to be true a few years ago. I think we can say very definitely now that one of the major objectives of premedical education is t o acquire a cultural background that will equip the medical man t o hold his own in competition with other college graduates in all matters of general interest and culture."
The preparation in English is not entirely satisfactory. One dean writes: "As professor of anatomy I have met the incoming students for the past twenty years, and the greatest criticism I have of the
"Subjects such as ~ h ~ s i a l o whistolom. , embriolom, . . . . hiochemist&, etc., a part i f the-essential c&riculum of medical schools, should not be taken in arts and science colleges because of the waste of time t o the student. I mean to say, there are many other things that medical colleges do not teach that are sufficiently important that he cannot afford the time of duplications."
Another: "Animal histology, histological technic,.and genetics seem t o me of somewhat doubtful value in the $remedical work. A working knowledge of them is pretty apt t o be gained in medical school and they therefore represent a duplication. I t seems t o me it would be much better to replace them with social sciences. politics and government, or history."
It should be kept in mind that i t is impossible and undesirable to specify a standardized premedical course. The taking of numerous scientific and general courses in college will not necessarily insure success as a physician. Other factors such as those which derive from the qualities of the student, the teachers, context of courses, opportunities, and any others over which the student has no control have much to do with future success. In this connection the dean of an eastern medical school writes: "I am convinced that there are several factors even more important than the courses taken. First of all, a medical student should be a man of character and ability and thoroughly enthusiastic about the practice of medicine. He should have a pleasing personality and be conscientiously interested in making the world better."
