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Should Organic Chemistry Be a Requirement for Med School?

It has become a tradition for pre-med students to fear and complain about the dreaded organic chemistry course. As much as they hate it, organic chemistry is a requirement for getting into most medical schools. However, some schools are beginning to question if it should be a determining factor in whether a student is able to pursue a career in medicine.

"I think organic chemistry, in its purest form, has less relevance to the modern physician than his predecessor decades ago when organic chemistry, physics, biology, and general chemistry were chosen as the prerequisite courses for entry to most American medical schools," said Dr. Tim Wu, an assistant professor of surgery at University of Pittsburgh School of Medicine.

Organic chemistry is the study of carbon-based compounds. It has been considered a crucial element of medical training, because it relates to the study of carbon organisms (like the human body.) It is also the basic science behind the manufacture of medications. But organic chemistry requires the development of a unique skill – visualizing molecules in three-dimensional form – which can be challenging for some students. Traditionally, a premed student must complete 1 year of biology with a lab, 1 year of inorganic chemistry with a lab, 1 year of organic chemistry with a lab, and sometimes biochemistry courses. But some outside thinkers in the world of academic medicine are wondering whether organic chemistry should be an absolute requirement for all pre-med students. In fact, they suggest that requiring organic chemistry might exclude some very talented and bright students from continuing on the pre-med path.

Harvard Medical School is currently in the process of altering its curriculum to place less of a focus on organic chemistry. Starting with the class of 2016, Harvard will consider interdisciplinary courses that combine biology and chemistry as a substitute for two semesters of organic and inorganic chemistry. According to US News, 17 out of 20 of the top medical research schools require organic chemistry. The main purpose (besides the necessity of having this type of knowledge in medical practice) is that schools are trying to prepare their students to take the MCAT, a test in which currently 40-50% of the questions are based on organic chemistry.

The Icahn School of Medicine at Mount Sinai is taking the shift one step further. The school, one of the top medical schools in the country, currently accepts a handful of undergraduates who mainly study humanities or social sciences (and who maintain at least a 3.5 GPA.) in a program called Humanities and Medicine Early Assurance Program or HuMed. Dr. Nathan Kase, the Dean Emeritus and Professor of Obstetrics, Gynecology, and Reproductive Science at the Icahn School, said, "As an outgrowth or next step following the success of the HuMed program, Sinai has a new admissions assessment process called 'FlexMed' that will add even greater flexibility to the premedical education profile over the next three to four years for at least half of the entering class." This FlexMed program allows sophomores in any major to apply for early assurance to the school. These students would be free to explore their area of study without having to take the traditional science courses or the MCAT.

The Dean for Medical Education, Dr. David Muller, is one of the driving forces behind The Icahn School's curriculum change. "I believe there is a trend away from requiring organic chemistry, and that the momentum will pick up in the next two to three years," he said. "Most educators agree that clinically relevant biochemistry and molecular biology are far more useful than Orgo."

Dr. Wu agrees that upcoming medical students can prove they have what it takes to become successful physicians without the year of organic chemistry. "The future of medicine is on the molecular level, and so an understanding of genomics, molecular biology, and nanotechnologies will be valuable," he said. "Many in academic medicine, including myself, have a great interest in mining large databases on patient-related characteristics and trying to draw conclusions that will help in decision making. So statistics, computer science, and an understanding of 'big data' is quickly becoming a hotbed of research activity in our nationís medical schools."

Not everyone is willing to break the respected and accepted paradigm of required premed courses. An Assistant Director of an Ivy League medical school only agreed to comment if her identity was not disclosed. However, she was willing to note that the school is also considering making some changes to its curriculum. Her statement read, "We evaluate organic chemistry as one of the required courses, not as the most important course. Understanding the chemical reactivity of organic molecules is necessary for understanding biochemical and pharmacological principles. The first semester of organic chemistry is usually a prerequisite for biochemistry, and will probably remain so. Starting with the 2015 entering class, our requirements have changed to one semester of organic chemistry and one semester of biochemistry – instead of one full year of organic chemistry. The Chair of our Admissions Committee does think that one semester of organic chemistry should be required. However, if the content from organic was weaved into another course, that could potentially be acceptable."

There is an argument that organic chemistry is a required component of the premed curriculum because students without this background might struggle in other related courses further into their education. On the other hand, by requiring the course, medical schools might be eliminating potential doctors who possibly just view things from a different perspective. The world of medicine is constantly changing, and many think that the curriculum should reflect this progressive movement. But are all medical schools ready to step outside the box?

"Academic medicine as an institution changes slowly," Dr. Wu said. "We are a group who are comfortable with tradition, and it is likely that these courses will remain at the heart of the premedical curriculum for years to come."

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