Science Matters

An organic chemist I know tells her doctors that she is a professor of Southern literature whenever she is in the hospital. That’s because organic chemistry has come to symbolize all the irrelevant science hoops that premedical and medical students jump through on the way to becoming physicians. Today, we are told, medical students should be learning “people skills,” placing medicine in the context of the community and learning how individuals make choices related to their health. These preferences are reflected in the revised medical admissions test rolled out earlier this year, with its newly added questions related to sociology, psychology and the humanities. This summer, as interviews begin at medical schools around the country, candidates who want to make the final cut are sometimes playing down their science credentials in favor of their relational skills.

This seems to me to be a false dichotomy. To be sure, I want my physician to understand how to deal with me as an individual and as a member of my social group. But I also want her to appreciate the underlying molecular nature of disease and to know how to evaluate scientific and statistical evidence about clinical trials and treatments.

The movement away from science springs from a misunderstanding that is not limited to the premed curriculum. Many people have the experience of science taught as a series of isolated facts to be memorized. All physicians recall memorizing biochemical pathways for which they have no use past the final exam in a given course. If there were ever a time when memorization had a place, that time is gone. Facts are cheap and readily available on every smartphone and computer.

The truth is that science is about so much more than memorizing a set of facts. Practitioners with a solid scientific grounding are able to analyze data and put that data in context, rely on what is known from previous studies and extrapolate to the future, and understand how changing environmental conditions are reflected in bodily conditions.

I have taught biochemistry to medical and undergraduate students for over 30 years. Premedical students usually come into my classes expecting to memorize structures, nomenclature, and pathways and are a bit taken aback at the idea that there is anything to learn other than that. By examining experimental data and case studies they become familiar with the core of biochemistry and are able to go far beyond rote learning. Unfortunately I hear back from them once they are in professional schools that, “it was great that you taught us about concepts, but you should have had us memorize more since that is what we have to do here.” As long as the health professions emphasize the acquisition of facts rather than their application, science will be seen as dry, uncreative and mostly irrelevant to the “real” world.

Along with colleagues at Wellesley -- Lee Cuba and Alexandra Day -- I recently published a study of science majors at liberal arts colleges. Our major finding was that science majors who took many courses outside of the sciences were better able to make connections among disciplines. Some medical schools -- Mount Sinai in New York is a prominent example -- have begun recruiting humanities majors to their classes, requiring fewer science courses than for the typical applicant because they are thought to bring different strengths to the profession. This move is well intended, but it misses the point.

Privileging humanities majors in medical school admissions may inadvertently reinforce the opposition between the “soft skills” associated with humanists and the technical capabilities associated with scientists. Long before the health sciences became deeply specialized, renowned physicians such as Hippocrates, Maimonides, John Locke and John Keats were as much philosophers and poets as scientists. Although that kind of Renaissance career may no longer be practical, today a strong liberal arts education in both the arts and sciences provides the most effective preparation for the medical profession.

Medical schools would do better to recruit broadly educated science students who bring the complementary strengths of integration among disciplines and a deep grounding in the process of scientific discovery and analysis to their study and practice of medicine. If we want knowledgeable and competent doctors who are also well-rounded and compassionate individuals, we must stop treating the arts and sciences as mutually exclusive. We must help our students see the connections between what they are learning in the classroom and what they will practice in the “real world,” to see that organic chemistry and Southern literature are not irreparably separate, but that each may have a role in a medical education.