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I wish I had received this letter as a freshman pre-medical student. I hope it is helpful to you.
I never planned on it turning out this way. I signed up for a course in adolescent psychology, a strange move for a science major, but I thought that psychology might by an easy minor. That almost became one of the most short-lived decisions of my life, for I seriously considered dropping that class when I discovered that five papers were required. After all, I was a pre-medical student, why should I have to write papers? Papers require too much thinking. Premeds have it too tough already. Why should I have to do any thinking? Now, wait a minute, did I say that? I'm afraid I did, and I'm afraid I believed it, too. As I look back, I realize that I was in an educational rut. I was using my college experience simply as a tool to get into medical school; if I learned anything along the way, well, that would be a nice but unnecessary extra. To be sure, something was wrong with my pre-medical education. It was a programmed system of rote memorization in a narrow realm of courses, the emphasis on learning being very low on the priority list.
The vast majority of pre-medical students are science majors. Now, there is nothing wrong with being a science major, if, after all, one is genuinely interested in science. However, when these students are asked why those chose a science major, most will respond, "It's a good major for medical school." Herein lies a great tragedy. First of all, less than half of all premeds actually enter medical school. This leaves a significant number of individuals who choose their major purely on the basis of getting into medical school with either a useless degree or a degree in a field where they have no interest. Fortunately, this problem, being practical in nature, can be corrected. There are, however, other ramifications not so easily resolved.
Most premeds are well aware of the admissions statistics. Why, then, do so many premeds choose the science major? Could it be that medical schools require a science major? A brief scan of the Medical School Admissions Requirements reveals that medical schools, in general, are not particularly concerned with one's undergraduate major. Statistics also show that choice of major is not a factor in predicting success in handling the medical school curriculum. What is the reason, then? The real reason seems to involve much more than a simple ignorance of statistics. It has to do with cloning. Too many premeds feel that they must copy exactly what other accepted applicants have done out of a mistaken notion that here is a certain, specified program one must follow.
Soon after I was accepted into medical school, I gave a presentation to pre-medical students regarding medical school interviews. I told them that one question they would probably be asked is, "Why do you want to become a physician?" No sooner had I finished this sentence than a hand shot up in the back of the room. The individual attached to that hand then asked me, "What was your answer?" What was my answer? What difference does it make what I said, as if my answer was somehow correct because I was accepted into medical school. Well, this same mimetic tendency pervades the premed's choice of classes and major, too. Too many premedical students choose their entire college curriculum based on the choices of other premed students who have gone before them. Some students even copy other students' extracurricular activities.
It is a tragic situation when a person feels that he must surrender his individuality in order to fit a mold that he perceives his success is dependent upon. It is even more tragic when his perception is false. In my conversations with medical school personnel, both in interviews and in less formal encounters, I have found that most seek the individual who stands out, the one who is different from the rest. Individuality can, then, conceivably increase one' chances of acceptance. Therefore, one can prepare for medical school without compromising or surrendering his individuality or integrity.
Well, then, what classes should a pre-medical student take? Surprisingly enough, there are no courses a pre-medical student should take, except the few required courses. The question should be rephrased: what classes does the pre-medical student want to take? The answer, of course, is anything he desires, the most important consideration being that the student enjoys it. The same goes for major. Pre-medical students can major in anything they wish. There are a significant number of non-science majors who go to medical school. Even foreign language majors get accepted. This, however, should not be interpreted as a plug for the non-science major. Majoring in a non-science area simply for the sake of being different does not constitute individuality. The premed who does this is still letting the process dictate what he will do with his education.
In addition to this imitative tendency, premeds also tend to choose classes on the basis of their ease. As compared to some students whose main concern is between passing and failing, the premed's concern lies between an A and an A-, and his level of paranoia may be several times that of the average student. As a result, many premeds choose their electives and general education courses simply on the basis of what is easiest. During my freshman and sophomore years, I found myself doing this at each semester registration. My first and foremost question regarding each class was, "Can I get an A in it?" It is this type of strategy that makes pre-medical education a contradiction in terms.
All premeds should ask themselves: "Does a person who deliberately avoids challenging situation, such as difficult, make a good physician?" The answer is an obvious, resounding, "NO!" What society desires to invest thousands of dollars into the training of potential physician who have spent their entire education being satisfied with the bare minimum? What patients could feel comfortable with a doctor that has put a higher priority on grades than on learning? And finally, what doctor can feel truly confident in a difficult situation realizing that he has always taken the easy way out? No, I'll be the first to acknowledge the importance of grades in the evaluation of a potential medical student, but to the exclusion of all else and to the point of dictating a student's choice of classes? No way.
There is a greater issue that must be dealt with in addition to the premed's attitude towards choosing classes. A significant change is also needed in the premed's entire approach to learning. I remember my experience in a physics class I had a couple of years ago. Unlike some of my other classes, physics was rather difficult for me to understand. I found, however, that if I could simply memorize formulas, I could do quite well on the test without understanding a thing. Unfortunately, I later realized that I hadn't learned much about physics. I had memorized for the purpose of receiving a grade, and that's all I got, a black mark on a piece of paper.
I had quite a different experience in a class a year later. This class, being rather controversial in nature, was designed to provoke thought. Therefore, my approach to this course entailed quite a bit of thinking and integrating information from many other areas including science, religion, and the social sciences. After finishing the class, I saw the interrelationships in all of these so-called divergent, and sometimes opposing, fields. Through this process of collation and integration, I actually learned the material. Instead of being memorized and forgotten, sociobiology has stayed with me to this day. Much more important than this are the benefits I have received from applying these principles of learning to all of my other coursework and into areas outside the academic setting.
Memorizing, then, is not the best way to learn, but it the easiest mechanism to get by in a class. When one considers, however, the vast amount of knowledge in the world, one realizes the folly of such a strategy. The premed may want to approach his education with a different philosophy towards learning. The focus on learning should be changed from memorization to a desire to integrate and apply the principles learned in novel situations.
Physicians must be prepared to deal with novel situations all of the time. Illnesses are not quite like questions on an exam. On an exam, one at least has the advantage of knowing the question. In an illness the question being asked is not altogether clear. Memorization of fact alone, therefore, does the physician nor the patient little good. The doctor must know how to integrate all he has learned and use it to discover the problem. Only after this task is accomplished can the physician begin treatment.
Learning also involves the ability to be creative. A scientist is not someone who knows everything about science, not is it a person who performs routine laboratory work. A scientist, rather, is a person who is able to define a question and creatively design an experiment that will hopefully yield an answer to that question. A scholar in the field of humanities is not someone who knows everything about the great works of literature, art, and music, but rather a person who is able to, for example, read a work of literature and synthesize a valid interpretation of that work. A doctor, likewise, is not someone who has a pat cure for every disease, but rather, a person who, after isolating a new disease, is able to collate his information to creatively and effectively treat it. Students, therefore, need to focus their energies on finding solutions to new problems rather than just memorizing the solutions to old ones.
Now, it would seem extremely unfair to place the entire blame for the relative lack of concern for education on the premed student alone. Many memorize material. Many professors who criticize premed students because of their lack of desire to learn do little to provide an atmosphere to stimulate this learning. Some faculty members openly express their disdain and disgust at having to teach; they would rather be in their laboratories or attending seminars. This is certainly a sad situation, one that deserves the attention of a university's administration. Nevertheless, this does not, in any way, justify a premed's attitude that true learning is not important. Students have a responsibility to make the most of their education regardless of the quality of their professors. One cannot go through life placing the blame for missed opportunities on others. If a professor is less than adequate, a student must rise to the occasion and become more than adequate to make up the difference. Perhaps if more students indicated their desire to be better students, it might motivate their professors to be better teachers.
I suppose I've painted a pretty grim picture of present-day pre-medical education. Indeed, it is a complex problem that has numerous ramifications for our education system in terms of students' and teachers' attitudes towards learning. Ironically, the answer to the problem may be rather simple; it may be summed up in one word: independence. The independent premed student chooses his major, classes, activities, etc., on the basis of what he wants, not on some preconceived notion of what he thinks he is supposed to do. The independent premed also approaches his education with a deep sense of personal responsibility for his own education. He understands that his role in the learning process consists of more than soaking up words and facts from the mouths of professors and pages of books, much more. It consists of a genuine desire to understand, grasp, and conceptualize material, with the final goal being to apply one's learning to practical situations in all areas of life.
Needless to say, I didn't drop the psychology class; rather it became the first of many classes in which I was required to think and write papers. My experience in that class pulled me out of my educational rut and made me recognize my role in my own education. No longer was I content to be a sponge. Rather, I learned how to think, and what a marvelous experience that is. Not only have I broadened my class horizons to include humanities and social sciences, but also I have been able to add new perspectives to my science class. I suppose my great benefit from college has been learning how to learn, and if that's all I get out of it, it will have been worth it.
Good luck in your pre-medical education. I hope this letter helps you to retain your independence and to enjoy your pre-medical education.
When this article was published, Dr. Bloxham was the chief health professions advisor at Brigham Young University, Provo, Utah; Mr. Moberg was an M.D./Ph.D. student at the University of Illinois under the Medical Scholars program.
This letter had been posted at http://www-scf.usc.edu/~chem105a/FROSH.html until an apparent website reorganization removed it (August 12, 2008). The text was taken from a snapshot cached by Google on August 7, 2008.
Copyright is held with the National Association for Advisors of the Health Professions (1984).