Why exactly is OChem a premed requirement?

<p>*When Patti Van Leer took organic chemistry in college, she found herself dreaming about carbon molecules and chemical reactions. But as she continued her medical education, she couldn’t see why she had been forced to slog through the course, a tormentor of young souls that has persuaded countless would-be physicians to consider careers in law.</p>

<p>“I have yet to see anything related to organic chemistry in medicine,” says Dr. Van Leer, who graduated from medical school earlier this year. “I’m not sure why it’s still a requirement.”</p>

<p>Neither are some leading medical educators, who are now re-examining the premed curriculum, largely unchanged for decades. The year-long introductory course in “orgo” – the shorthand lingo muttered on campus with fear and loathing – may soon be pared back to make room for other subjects.</p>

<p>The Diels-Alder reaction, an organic-chemistry classic, helps explain the impetus for change. The reaction comes in handy if you are into chemical manufacturing. But, do doctors really need to know a bunch of different ways to combine two molecules to form a ring of six carbon atoms?</p>

<p>“In my many years of medicine, I have never heard the Diels-Alder reaction mentioned once,” says Robert Alpern, dean of the Yale School of Medicine.</p>

<p>During her second semester of orgo, Kara Naber, an undergraduate at the University of Minnesota Duluth, found herself sketching chemical reactions in the steam on her shower door. Facebook members can vent in an Organic Chemistry Victims Support Group, as well as in groups with more vivid names.</p>

<p>At the same time, some subjects that are central to modern medicine aren’t part of the standard pre-med curriculum. “All the fascinating things that are happening in biochemistry, in genetics – they don’t have to take that,” Dr. Alpern says.</p>

<p>Organic chemistry is unlikely to vanish from the premed universe. Doctors do need a basic understanding of the subject, which deals with the behavior of carbon molecules, the building blocks of life.</p>

<p>And orgo does thin the premed herd by weeding out those who can’t keep up. “That kind of learning, where you have to learn tons of things in your head at once and make stupid mnemonics, is like a summary of medical school,” Dr. Van Leer allows.</p>

<p>But momentum is gathering behind a more relevant curriculum that would neither sacrifice rigor nor drive away students who would make good doctors.</p>

<p>In a recent essay in the New England Journal of Medicine, Jules Dienstag, dean for medical education at Harvard Medical School, suggested integrating organic chemistry with biochemistry for undergraduates interested in medicine and biology. Indeed, Harvard College already offers a course along those lines, Dr. Dienstag says.</p>

<p>The Association of American Medical Colleges and the Howard Hughes Medical Institute have convened a committee to create guidelines for the basic science all entering medical students should know, as well as what science should be taught in medical school. The committee’s recommendations for pre-meds are likely to include subjects such as biochemistry and genetics. Another likely addition is statistics, which is essential for making sense of the studies published in medical journals, says Dr. Alpern, who is co-chairman of the committee.</p>

<p>Current admission requirements vary slightly among medical schools, but applicants are typically required to have taken one or two semesters of calculus and a year each of biology, general chemistry, organic chemistry and physics.</p>

<p>Rather than create a new list of course requirements to replace the old list, the committee will describe subject areas students should be familiar with. The aim is to give colleges latitude to experiment with interdisciplinary classes.</p>

<p>It will take several years for the changes to be phased in. Individual medical schools have to change their admission requirements, and students who have already started college won’t be forced to change course in midstream, or be tested on the Medical College Admission Test in subjects they haven’t studied. The MCAT will ultimately need tweaks, and the group responsible for writing it is “following the issue closely,” Karen Mitchell, director of the MCAT, said in a statement.</p>

<p>But over time, the changes are likely to be significant. And if Darrell G. Kirch, chief executive of the Association of American Medical Colleges, has his way, the shift will ultimately go beyond which science courses pre-meds take. Dr. Kirch, a philosophy major who went on to became a psychiatrist, hopes medical schools will push applicants to pursue more coursework in the humanities and social sciences to improve bedside manner, among other things – “soft skills” some say have been overlooked as the profession has shifted toward specialization and technical expertise.</p>

<p>“There are far too many people who would be superb doctors who somehow imagine that, because they don’t see themselves as organic-chemistry experts, they should not pursue medicine as a career,” Dr. Kirch says. *</p>

<p>[This</a> Class Is Certified Organic: Indigestible, and Perhaps Perishable - WSJ.com](<a href=“http://online.wsj.com/article/SB122152898348840633.html]This”>http://online.wsj.com/article/SB122152898348840633.html)</p>

<p>wow… this as im studying for my organic test friday</p>

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That’s a BS. One cannot be a superb doctor without the brain to ace Orgo, IMO.</p>

<p>todpose:</p>

<p>They probably shouldn’t have let me into medical school, then. :/</p>

<p>OP,</p>

<p>I haven’t read your entire post… but I agree that having a ‘basic understanding of Orgo’ is much more relevant than requiring 1 year worth Orgo courses. I would like to see basic Orgo being taught intertwine with Biochemistry. Why? In my humble opinion (as a Pharmacologist, not a Biochemist, by the way)-</p>

<p>*Understanding of basic Orgo facilitates the understanding Biochemistry. *Biochemistry provides the ability to understand physiology at a molecular level. This is extremely important IMO.

  • If one is unable to understand the molecular processes, one does not really gain a complete, in-depth understanding of normal physiology (cellular signalling, intracellular processes, gene silencing, nuclear response element binding, nuclear receptors to name a few).
    *Without a sound understanding of normal phyisiology, it would be even more difficult to understand ‘disorders or aberrations’ in physiology.
  • Having gaps in understanding of Mammalian Physiology is not a luxury a Physician can afford.</p>

<p>Let me think of a very simple example - Cholesterol sythesis.
Cholesterol synthesis has multiple steps involved along with various enzymes for each step of synthesis.
If one does not understand the structure of Cholesterol, you can not understand the role of HMG CoA nor HMG CoA inhibitors, therefore aberrations in enzymes involved, dyslipidemia, metabolic disorders, aberrations of specific enzymes and their impact on ratios of product/precursor, changes in ratios that actually are implicated in atherosclerosis, and even down to physiological effects seen as lenticuar opacities in metabolic disorders etc.</p>

<p>Without understanding the organic steps involved in the conversion of Cholesterol to pregnenolone, and 17-O Pregnenolone to Aldosterone, Cortisol, and androgens - You miss out on both mineralocorticoids and glucocorticoids!!!</p>

<p>Hey! I certainly am not planning on going to doctors who do not understand basic Biochemistry! I refuse to put my life in such an MD’s hands…</p>

<p>Funny thing is that I do not “see” patients everyday. I am a Clinical Researcher at a Pharma company…miles removed from the “real patient”. If I take the time to study my Biochem and Orgo. I expect people who hold people’s lives in their hands to step up to the plate and learn their basic science well.</p>

<p>Pharmagal:</p>

<p>No one is saying that an understanding of cholesterol’s properties is useless - no one is saying that basic understanding of organic molecules is stupid.</p>

<p>The article the OP quoted is saying that what IS useless is asking (future) doctors about things like Diels-Alder synthesis and the Wittig reaction. I daresay that very few practicing MDs know what those are, and I doubt their lack of knowledge endangers their patients’ outcomes in any way.</p>

<p>Look, professional school admissions has never been about knowledge. Otherwise, everyone going into med school would be bio majors, everyone going into law school would be political science majors, and everyone going into business school would be econ/business majors. Instead, what professional schools want out of an undergrad experience is proof that the student has the SKILLS to succeed in the professional school. Students whine about orgo because you have to memorize so much. That’s also the reason why they whine about med school. Unfortunately, it’s a necessary evil. You need to demonstrate the ability to memorize a large amount of material. The amount of material you need to memorize in orgo is nothing compared with what you’ll have to do in med school but it’s a start. If there are other memorization-intensive college courses, perhaps we should make college students take them too.</p>

<p>I am in agreement that Orgo could be taught intertwined with Biochem. So, that’s not my point of discussion.</p>

<p>As a greying Clinical Researcher, when I read CC, my impression of many in the US younger generation is that there are way too many Premeds constantly complaining and whining about this course and that course. </p>

<p>Often heard about how they are getting ‘wasted’ partying but have little time to understand basic sciences.</p>

<p>When I visit India and China for family/business, I see the exact opposite. I see kids in these countries not complaining but working hard to get over any hurdles in their path, taking the time to go to tutors, reaching out to get the help they need to get a better understanding of subjects… and there are hundreds of thousands of them applying themselves without complaining!</p>

<p>As a naturalized citizen, I really would like to see more American kids striving the way Indian and Chinese kids are striving in Sciences… </p>

<p>In this age and time of job outsourcing (we are outsourcing MRI and PET image-reading to India already!), if Premeds in US do not apply themselves 300% like our Asian counterparts, the future will be rather bleak I am afraid.</p>

<p>Sorry folks, didn’t mean to divert from OP’s subject.</p>

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<p>And orgo and biochem aren’t even that hard!</p>

<p>Looking back, the pace of these college courses is nothing compared to what we have to do in med school. We went over glycolysis, TCA cycle, pentose phosphate pathway, fatty acid synthesis pathway, beta, alpha, omega oxidation pathways, urea cycle, gluconeogenesis, and pyruvate dehydrogenase as well as some cell bio in 4 days in med school. That was half a semester’s worth of material in my biochem class at Cornell. So, I see no reason why we should be whining about having to take biochem or orgo in college. In fact, I think all med schools should make biochem mandatory for admission.</p>

<p>not to slight how much info that is… but that was all review, right?</p>

<p>btw, impressions of med school?</p>

<p>It was review for the people who took biochem in college (hence, I think biochem should be mandatory for all premeds) and obviously not review for people who’ve never taken biochem before. I personally took biochem around 3 years ago so I had forgotten a lot of the specifics about the pathways (like the enzymes involved and stuff).</p>

<p>As for med school, I’m really enjoying it right now. We are limited to only 2 hours of science lecture per day and I really like the non-science (afternoon) curriculum. All med schools have these “doctoring” courses where you learn the “soft” stuff (like ethics, communication skills, physical exam skills, etc.) and I find them very interesting although there’s a lot of reading and writing involved. </p>

<p>The biggest surprise I’ve encountered is how much I like PBL. While interviewing, I’d say 2/3 of the med students I met either didn’t like PBL or were neutral about it. Having to look up the learning issues is a pain but during the actual PBL sessions I kinda feel like House (minus the knowledge). </p>

<p>And, extracurricularly, I’m fairly involved: doing intramural ultimate frisbee right now, intramural basketball is coming up, I’m co-founding a mentoring organization, and I’m also in a few other student organizations. None of this matters one bit for residency apps which kinda makes them more enjoyable because I know I’m doing these activities because I want to.</p>

<p>I can’t offer a med student’s perspective (as I’m not one), but I know one thing for sure.</p>

<p>If orgo is replaced by some other class as a requirement (without a decrease in difficulty), people will simply start *****ing and moaning about the new class instead.</p>

<p>And if there is a decrease in difficulty, other aspects will have to replace it somewhere. After all, it’s not like they’re removing organic AND increasing the number of seats.</p>

<p>oh man, another way to make doctors even stupider. i at least have confidence in the fact that they can cram every mundane medical fact into their brains. orgo is basically a test of one’s memory (and a little creativity with retrosynthesis) but if we can’t even test potential doctors on this from a young age then my trust in doctors will only decrease.</p>

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<p>I would actually say that may be part of the problem: maybe professional school admissions should be about actual knowledge. Since you brought up the example of business schools, I would say that it still baffles me that there are people who are getting into elite MBA programs such as HBS that have precisely zero work experience and didn’t major in business or economics. Granted, there are very few such people. But they do exist. {On the other hand, what baffles me even more is that there are business school professors who also have never held a real job nor did they ever study business.}</p>

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<p>Nobody is denying that you have to demonstrate proof of your ability to memorize a large list of facts. The real question is why are you only able to prove this ability only through OChem specifically? Why can’t you prove this through other, perhaps more pertinent ways? What’s so special about OChem?</p>

<p>Let me give you an example. Let’s say that I get a bad grade in OChem because I don’t like it. But I then take memorization-intensive and medicine-related courses in Biochem, Physiology, Anatomy, and get fantastic grades. Why shouldn’t that override my OChem performance? After all, you guys have said it yourself, those more advanced courses are more relevant than OChem to a practicing doctor. </p>

<p>But as it stands now, that doesn’t really happen. You have to know OChem for the MCAT, whether you want to or not. It doesn’t matter whether you know any of the advanced topics. You still have to know OChem because that is what is tested. But why? What’s so special about OChem? </p>

<p>I’ll give you another example. I know a guy who’s a true trivia buff: he was the leader of his school’s College Bowl team and he’s even appeared (and has been a multi-day champion) on Jeopardy. I think nobody would dispute that this guy had an unbelievable ability to memorize long lists of facts. </p>

<p>But because he was a premed in college, he still had to learn OChem. Why? Again, what’s so special about OChem? Nobody seriously disputed his memorization ability: I think his College Bowl success all by itself should be enough to convince anybody of that fact. Granted, OChem wasn’t that hard for him, but the point is, he still had to learn it just to “prove” that he had strong memorization abilities, despite the fact that that should have been self-evident in his resume. For example, why couldn’t he have just sent in videotapes of his appearances on Jeopardy and College Bowl to prove his memorization ability? Why, after all that, does he still have to take OChem? What’s so darn special about OChem? </p>

<p>I think the real takehome message is that there are multiple ways to prove that you have the memorization capabilities of a doctor. OChem is not the only way to prove that you do. But as it stands, you have to do OChem whether you like it or not, whether it’s relevant or not, and whether you can prove your abilities through other ways or not. In other words, OChem has been elevated to a special, unique status that it probably does not deserve. </p>

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<p>The topic on the table is not whether premeds are complaining about the current premed requirements. The article specifically states that it is practicing doctors who are complaining about the requirements. And not just any doctors, but highly esteemed doctors, such as the Dean of the Yale School of Medicine, and the chief executive of the AAMC. When even these people are questioning the requirements, there may be some validity to the complaints.</p>

<p>Consider the following snippets:</p>

<p>*When Patti Van Leer took organic chemistry in college, she found herself dreaming about carbon molecules and chemical reactions. But as she continued her medical education, she couldn’t see why she had been forced to slog through the course, a tormentor of young souls that has persuaded countless would-be physicians to consider careers in law.</p>

<p>“I have yet to see anything related to organic chemistry in medicine,” says Dr. Van Leer, who graduated from medical school earlier this year. “I’m not sure why it’s still a requirement.”…</p>

<p>The Diels-Alder reaction, an organic-chemistry classic, helps explain the impetus for change. The reaction comes in handy if you are into chemical manufacturing. But, do doctors really need to know a bunch of different ways to combine two molecules to form a ring of six carbon atoms?</p>

<p>“In my many years of medicine, I have never heard the Diels-Alder reaction mentioned once,” says Robert Alpern, dean of the Yale School of Medicine.</p>

<p>…But over time, the changes are likely to be significant. And if Darrell G. Kirch, chief executive of the Association of American Medical Colleges, has his way, the shift will ultimately go beyond which science courses pre-meds take. Dr. Kirch, a philosophy major who went on to became a psychiatrist, hopes medical schools will push applicants to pursue more coursework in the humanities and social sciences to improve bedside manner, among other things – “soft skills” some say have been overlooked as the profession has shifted toward specialization and technical expertise.</p>

<p>“There are far too many people who would be superb doctors who somehow imagine that, because they don’t see themselves as organic-chemistry experts, they should not pursue medicine as a career,” Dr. Kirch says. *</p>

<p>The issue is then not just about premeds needing to work hard on their studies. It’s really about whether premeds are studying hard in learning the right things. Sure, the premed process is painful and nobody is saying that we are going to make the process less painful. However, pain should not exist just for the sake of pain. We should not be forcing students to study hard just for the sake of studying hard. They should be studying hard, and sometimes painfully, because they are learning what they actually need to know. </p>

<p>I liken the situation to going to the gym to work out. If you want to become more fit, you have to feel pain in the gym; after all, no pain, no gain. But not just any pain will do. I can inflict plenty of pain on myself just by dropping a dumbbell on my foot. But that kind of pain is clearly not going to help me become more fit. The pain has to be properly targeted pain. There is no point in feeling pain just for the sake of feeling pain. </p>

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<p>First off, I don’t see where anybody in the WSJ article is ‘whining’, unless you want to contend that the Dean of the Yale School of Medicine or the chief executive of the AAMC is ‘whining’. </p>

<p>Secondly, the article specifically states that OChem should be folded into a biochem course to provide a more targeted and more relevant premed course, as Harvard has done. Hence, you seem to be supporting the point of the article, which is that traditional OChem seems to be obsolete for premed purposes. </p>

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<p>Of course! But the purpose is not to stop premeds from complaining. Premeds will always complain. </p>

<p>The purpose is to have them study the right topics. That is to say - more relevant topics. Sure, premeds will complain about that. But that’s a heck of a lot better than when they complain about studying irrelevant topics. Again, what do premeds care about the Diels-Alder reaction? Doctors are not chemical engineers. They’re not designing petrochemical factories. </p>

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<p>Again, please read the article more carefully. That is why I posted it in its entirety. Nobody is talking about making the process less difficult. </p>

<p>What they are talking about is making the process more relevant. That is to say, replacing the useless parts of OChem with more useful biochem materials. Premeds will still have to study hard. But they will be studying hard about the relevant topics that they will actually need to know as doctors, and not just some irrelevant materials that they will never use in their careers.</p>

<p>Just one thing left to say to you Sakky -</p>

<p>Brevity is clarity.</p>

<p>

LOL… Most, if not all, of sakky’s posts are like that. Every one of his posts is a 1500-word article.</p>

<p>You know, I used to write short posts. Then people would complain that I was overgeneralizing, or leaving out important details, etc. etc. </p>

<p>So I learned that you can’t win. No matter how I write, somebody is going to complain. Hence, I am going to write the way I want, and if people don’t like it, they have the freedom to not read it.</p>

<p>I don’t necessarily disagree with the notion of expanding the premed curriculum to include biochem, stats, anatomy, physiology.</p>

<p>However, yes, I do construe the tone of the article (especially the beginning) as whiny. It’s one course for godsakes. A lot of doctors also complain about how little they use M1 and M2 material in their practice (in fact, studies show most physicians would fail the USMLE Step1 if they had to take it today). Should we do away with the first two years of med school altogether and only do the most clinically relevant things?</p>

<p>Even if we don’t take orgo in undergrad, we’ll have to teach it in med school because being able to recognize electron transfers and chemical structures is important, especially when you are studying drugs. Orgo now accounts for very little of the MCAT. On the MCAT I took, only 9-10 out of the 200+ questions related to orgo. </p>

<p>And if not orgo, what memorization-intensive courses are you suggesting?</p>