Wednesday, May 10, 2006

Medical school basic science---a follow up

Somehow I can’t quite let this go. Dr. Rangel’s post and my reply on the question of how much basic science should be taught in medical school sparked several discussion threads on other blogs.


Orac weighed in with a lengthy post of his own. One of his commenters referenced my statement about hydrophobic and hydrophilic amino acids and illustrated the self-correcting nature of the blogosphere with---

Pedantically, however, this:"some [amino acids] are hydrophobic and comprise membrane lipid bilayers" is wrong. Lipid bilayer membranes comprise phospholipids. Hydrophobic amino acid sidechains are exposed in integral membrane proteins, allowing the protein to embed within the phospholipid bilayer. Mea culpa. Sloppy terminology on my part. The principal components of cell membranes are phospholipids. Various proteins, the exposed amino acids of which tend to be hydrophobic, may traverse or be embedded in the lipid bilayer. Post revised.

Reflecting on the article about compromised basic science education in Australia’s medical schools Orac observes similar trends in the U.S.---

None of this was news to me, or, I daresay, to most surgeons. When I quiz third year medical students about anatomy in the operating room, even very basic anatomy, far more frequently than I like, I'm amazed at how little some of them know or, with the exception of students going into surgical specialties, seem to care. I've never seen a student quite as clueless as the ones described in the Australian article, but it's nonetheless clear to me that the deemphasis of anatomy and basic science in medical education is not a phenomenon confined to Australia. Indeed, the above article only echoes and amplifies complaints that I've heard for a long time right here in the good old U.S.A.

Though not in academic medicine and therefore unable to directly observe such trends I’ve suspected this sort of thing for some time. Constant tinkering with curricula and the increasing encroachment of pseudoscience in med school courses has been a long time concern of mine.

DB links to the discussion and wonders if we need a new Flexner report. As I said before Abraham Flexner may be turning over in his grave over the current state of medical education. I agree medical education needs another housecleaning. I only hope the next Flexner doesn’t have this vision for medical training proposed a few years ago in BMJ: “….gone will be the days of freestanding courses in biochemistry, physiology and anatomy” and “There will be no exams in anatomy, physiology, or biochemistry, and no one will need to learn by rote the entire Krebs cycle or the names of all those little holes in the skull.”

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