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Dropping Orgo, Adding Epi

September 16, 2008

The WSJ carries an article today re-igniting the recent debate over how important of a role organic chemistry should play in the pre-med curriculum.

Rather than rehash what has been said in several places (for several years) about dropping organic chemistry, I want to propose a replacement for at least the second semester of orgo–epidemiology.

Epidemiology is a crucial component of how medicine is practiced today.  The link between smoking and lung cancer, obesity and diabetes, inactivity and heart disease are only a few important health facts largely unearthed through epidemiology.  All of our drug trials rely on epidemiology to demonstrate a drug’s effectiveness and detect its side effects.  With prescription drugs as a vital tool in the physician’s arsenal, knowing how these drugs are vetted is an important part of using them effectively.  A firm understanding of epidemiology allows physicians to spot flimsy evidence provided by pharmaceutical companies and their drug reps who sometimes take creative license with the scientific evidence generated by their trials.

An important skill in our rapidly changing medical world is being able to understand new knowledge, evaluate it and its relevance, and then appropriately apply that knowledge to one’s specific patient base.  Traditionally, new knowledge is passed on to practicing physicians through the academic medical journals.  Unfortunately, medical students are rarely (if ever) taught how to critically evaluate journal articles or determine whether or not they may be applicable to their patient population.  Adding some epidemiology training to the pre-med curriculum would give students a sound foundation on which to develop these critical thinking and evaluation skills.

Mixing a basic epidemiology curriculum with foundational biostatistics would provide much more practical knowledge for pre-med students while asking them to stretch their minds in a much different way than the traditional paradigms suggested by the basic sciences.  Such training is crucial to developing doctors able to handle the increasingly complex nature of modern medicine.

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