Chalif: Pre-Health Trepidation

by Eric Chalif | 10/3/12 10:00pm

I arrived on campus a short three weeks ago, and I have already been inundated with an overwhelming amount of pre-med advice, lectures, shadowing opportunities and potential research positions. As usual, Dartmouth offers a plethora of possibilities so many that, on top of the pre-health requirements, it seems that I'll fall behind if I don't start early. I've been told that if I don't take any science or math courses as a freshman, I might end up having to spend time and money to complete the prerequisites after graduating.

The number of pre-health courses astounds me. It isn't necessarily the work involved that's discouraging (although I'm not exactly waiting with bated breath for organic chemistry), but rather that these requirements eat up so many of our 35 courses. Twelve courses in effect, a major comprise the mandatory pre-health workload. The new 2015 MCAT will also include a psychology and sociology section tack those two courses onto the count and now you have 14 pre-health courses. The average major at Dartmouth is 10 courses. Plus everyone must take a three-term language requirement and two freshman writing classes. Add everything up and a pre-health student is left with only six additional courses to explore our "liberal arts" college. No wonder so many pre-meds major in a science.

Why must all premeds go through such a narrow process during their college years? How will Lewis dot diagrams, Van der Waals forces, electronegativity, ligand bonding, derivatives, thermal physics and circular motion help us in the medical world? In fact, doctors often use none of this "medical education" in the practice of medicine. Keeping the emphasis on the growth that comes from a broad liberal arts experience will ultimately create more humane, empathic physicians, enhancing rather than comprising their future clinical effectiveness.

None of the pre-health advisors I met with have offered me a satisfactory rejoinder. They all exasperatedly told me that these courses are necessary to become a doctor. Twice, I was told that physics is employed during capillary action as blood flows from arteries to veins. Optics is used by ophthalmologists, and magnetism is used in MRI technology. But can't these concepts be saved for specialty training later on in one's career?

The best response I've received to my skepticism was, "Well, wouldn't you want your doctor to know these things?" Touche! Of course I would. After all, I trust my doctor with my life.

But as I gave it more thought, I realized that all I expect of a doctor is medical competence. Medical schools, however, evaluate applicants based on a student's performance in biology, chemistry, physics and calculus. As medical schools become increasingly competitive, students increasingly feel the pressure to master the trivial minutiae of the sciences. Consequently, pre-health course requirements have become weeder classes rather than incubators for future doctors.

Except for researchers, doctors do not necessarily need to recall the pharmacological organic chemistry intricacies of the medical drugs they use, but instead should be expected to understand the body's physical responses to medicine. Knowing the chemical construct of a medicine the exact molecular formula, the activated receptors, the inhibited proteins won't improve the doctor's clinical care of a patient. Likewise, a neurosurgeon doesn't need to be an expert in neuroscience in order to become extremely competent in operating on the brain. Neither would a cardiac surgeon need to calculate antiderivatives, nor a pediatrician calculate energy quotients.

To combat this problem of subverting the undergraduate years into a pseudo-vocational school, the Mount Sinai School of Medicine has established a program called the Mount Sinai Humanities and Medicine Early Acceptance Program. A pre-health student applies to this program during sophomore fall and is admitted into the program his or her sophomore winter. It would be like applying to college at the beginning of 10th grade. If accepted, the student is guaranteed a spot at Mount Sinai Medical School after graduation without the inconvenience of taking the notorious MCAT exam. After being admitted, a student can always change his or her mind and not go. Although some pre-health requirements remain, they are fewer in number and the accepted student must major in a non-science field. Nevertheless, his or her identity as a future physician begins even during college by attending summer terms at Mount Sinai. This is the perfect program for the student who doesn't want to "major" in pre-health, but instead wants to explore the diverse richness that a school like Dartmouth has to offer.

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