Abraham Flexner published his landmark report on undergraduate and medical school preparation of physicians in 1910. Within a few decades and continuing throughout the remainder of the 20th century, there have been admonitions to enhance, overhaul, or abolish the “traditional” pre-med requirements that he established.
The reasons for this dissatisfaction are self-evident:
- The pace of scientific discovery and its clinical application has far outstripped the current century-old requirements.
- The age of information technology has made memorizing vast amounts of content unnecessary.
- The current requirements lack clinical, scientific, and social relevance.
- The traditional requirements are used to ‘cull the herd’ of talented aspiring physicians.
- The requirements disproportionately disadvantage minority and female students who are desperately needed to maintain diversity in our healthcare workforce.
- The requirements consume so much time and effort that few students end up being grounded in bioethics, social justice, and health policy.
- A rigid and highly structured pre-medical curriculum, followed by a rigid and highly structured medical school curriculum, deprives students of the ability to develop the critically important skill of lifelong self-directed learning.
Perhaps most important, the current model has perpetuated “pre-med syndrome,” an undergraduate culture of aggressive competition for grades that runs counter to what we value most in medicine: academic and intellectual rigor, creative thinking, teamwork and collaboration, and social conscience.