<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>
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