Undoubtedly, you've heard about this story, but if you haven't, here's a rather depressing story from the New York Times about the NYU administration's firing of Maitland Jones Jr. from teaching one of their large organic chemistry lectures:
In the field of organic chemistry, Maitland Jones Jr. has a storied reputation. He taught the subject for decades, first at Princeton and then at New York University, and wrote an influential textbook. He received awards for his teaching, as well as recognition as one of N.Y.U.’s coolest professors.
But last spring, as the campus emerged from pandemic restrictions, 82 of his 350 students signed a petition against him.
Students said the high-stakes course — notorious for ending many a dream of medical school — was too hard, blaming Dr. Jones for their poor test scores.
The professor defended his standards. But just before the start of the fall semester, university deans terminated Dr. Jones’s contract.
Derek does a great job of covering the issues from a philosophical side, and so I urge you to read his post. I have two items to add. One of them is a factual question that I would like answered, and the other is yet another philosophical cud-chewer.
Most of the discussion of this article (God help us) has been on Twitter, and there have been a lot of opinions and not many new facts to add. It's clear that the students had legitimate questions about the style and format of grading; I'm not a chemistry professor, and so I don't have an informed opinion there. But there have been at least two instances of former students claiming that Professor Jones would specifically announce and make fun of the low score (or the low scorer) of the exam.
If true, this is pretty appalling. If Professor Jones was saying "someone got a 5% and boy are they a dummy!", that seems quite cruel. If Professor Jones was saying "John Smith got a 5%, and boy are they a dummy", that is clearly a FERPA violation and a fireable offense. The claims are unclear as to if it was either the strong or weak version. Either one is bad, in my opinion. I'd really like this question run all the way down to the letter, but that will probably never happen.
For the philosophical question, it is fascinating to me how large organic chemistry seems to loom as a barrier for pre-meds. First, they seem to view the class as unnecessary gate-keeping and there are a shocking amount of people who claim that organic chemistry has nothing to do with medicine. I will basically not entertain responses on the second point, i.e. I think organic chemistry is extremely relevant, and those who say otherwise are basically entertaining a future with physicians who are scientifically illiterate. But here's my real question: if I accept the premise that organic chemistry is the gate for gate-keeping, where do the anti-organic folks propose to move the gate? Biochemistry? The first year of med school? Physics?
(As a practical matter, the seemingly unique American practice of having a 4-year undergraduate degree that is lightly or heavily sprinkled with science and then another 4 years of medical school seems a bit indulgent, but I rather like the idea that physicians get a good solid liberal education.)
So there's my question, readers - what's the best way to educate physicians other than the current way? Is there a scientific field (I dunno, biology? engineering?) that is better suited?
Agree that organic chemistry is very relevant. One of the commenters to the In the Pipeline blog said "The majority of us prescribe pills whose mechanisms we have long forgotten for diseases we poorly understand with very little certainty that we are adhering to the most contemporary clinical trial data, beyond the most superficial familiarity with broad guidelines. We order every test in the book out of fear of missing something that could lead to a lawsuit." and that should terrify us all. I REALLY want my doctor to be one who finds organic chemistry simple, because the complexities of biological systems are a heck of a lot tougher.
ReplyDeleteAs a patient, I don't care if physicians know about malpractice, running a business, keeping up with regulations - I want them to know every possible detail about my disease and how to treat it.
Another commenter's reply (to a different comment): What you are talking about is a mid-level understanding of medicine, such as a nurse practitioner or physician's assistant." Exactly. Physician's should be learned people who have exceptional depth of knowledge and ability.
Not to disparage PA's and nurse practitioners - the first PA who ever treated me had worked for Woodward for a time.
I'm going to repost what I wrote on the horrendous NYT comment page with some minor amends -
ReplyDeleteI have a PhD in chemistry from NYU. I didn't personally know Dr. Jones, but heard plenty of mixed reviews about his teaching methods.
The concept of huge weed-out classes is kind of gross when people are paying oodles of money to attend a school. Furthermore, in my experience, a lot of chemistry professors are absolutely terrible teachers; couple that with giant lectures, and you have a recipe for disaster. Teaching methods that worked for some in the past don't work for others (and frankly, holding onto those methods for the sake of "worked for me" amounts to a survivor bias). These huge lectures don't help - where is the individual attention that students might need to learn the language of organic chemistry? From some overworked grad student TA, who may or may not be that great at teaching themselves?
As for the usefulness of orgo for physicians: in my experience, that idea is frankly ridiculous. The problem solving skills you allegedly get from orgo can be picked up elsewhere. In my own chemistry journey, organic chemistry is a distant memory which has had limited applicability to my own PhD and current medical-adjacent career. Those illustrious problem solving skills were better learned in other classes and hands-on research. Chemistry has done a really poor job marketing itself.
We can have rigorous classes that are taught compassionately and adapt to the current needs of students. We don't have to make things difficult for the sake of just being difficult, and I feel like many organic chemistry classes fall into being difficult for the sake of being difficult, instead of being rigorous classes where people walk away feeling like they've learned something of value.
Best take I've read so far on the subject
DeleteAs one of the few who found undergraduate organic chemistry to be quite easy, I am sympathetic to the arguments made by the students in this situation.
ReplyDeleteI agree that organic chemistry should be part of a physician's curriculum, however the course materials could easily be slimmed down; the focus on organic synthesis is surely not applicable to physicians outside of the pharma industry itself.
The hiring practices for organic chemistry professors is truly shameful. I don't think anyone would say that they are hired for their teaching ability, but for their institutional credentials and their publication metrics.
Let's hear these students out. Streamlining the physician pipeline is surely needed with the cost of hiring a physician easily topping $300,000 per year.
I disagree that success in organic chemistry is crucial to becoming a “scientifically literate” medical doctor. I don’t think I really became truly scientifically literate (which I’m defining as versed in the scientific method and taking rigorous, systematic approaches to problem-solving in the laboratory) until several years into grad school. Certainly very little of what I learned in undergrad made me scientifically literate in this sense; sure, I knew a lot of facts and tidbits about chemistry and physics and was decent at arrow-pushing and following a recipe book in lab classes, but the type of thinking I did in undergrad was almost irrelevant to the type of thinking I did in grad school. Scientific literacy is crucial for medical doctors, but they’re not learning that in sophomore year orgo, so they shouldn’t be required to take it. I’m not a medical doctor (my PhD is in inorganic chem) but I imagine that SN2 vs. SN1 selectivity (or any other topic covered in a standard two-semester orgo class) is not something my family physician thinks about on a day-to-day basis. I would rather they learn analytical thinking in a more medical-relevant field. An extreme take: Get rid of the requirement of a four-year degree and have medical students start med school straight out of high school like the rest of the world; they’ll be just as qualified. But if you insist on a four-year degree I would slim down the requirements to just bio-relevant classes; no orgo and no physics, and perhaps some math (1-2 semesters of calc at most). You can teach a small amount of arrow-pushing in biochem if you really want to.
ReplyDeleteFirst, I love the fact that you've defined your conception of scientific literacy.
DeleteI have a much lower concept of scientific literacy. It literally means being able to look at "K" on a blood panel and know that it means "potassium" and to have a general sense of what that means (i.e. it is an element, and usually an ion).
If the answer is "these people don't need to know *any* organic", then at some level, we're saying that it's fundamentally OK for doctors to not to understand any biochemistry at any fundamental level. - Chemjobber
in Czech med schools, anatomy was the traditional gate-keeper course (=lots of memorization of every god-damned bone, blood vessel, nerve, brain substructure, tendon, all in Latin names). Organic chemistry was feared too but the "orgo" course was somewhat watered down - not much synthesis (as physicians were not expected to do preparative chemistry) but terminology, classes of organic molecules and so on.
ReplyDeleteInstitutions that teach Spanish language often have multiple offerings: a Spanish for International Business, Reading Spanish for Medical Billing or translation, Spanish for Agriculture, Spanish for conversation, Spanish for majors. The different classes aren't necessarily easier- but they always cover different topics and skills at different levels of detail. If we can agree that there is a level of chemistry knowledge that is important for doctors and nurses, then why aren't enormous universities specifically offering Chemistry for the Medical Sciences as a course after General Chemistry? There are topics that a chemistry major planning to work in the Chemical industry needs to know in depth and topics that a Doctor should know and they aren't necessarily the same. Organic Chemistry should be teaching the topics relevant to that discipline, not be acting as a admission test for Medical School.
ReplyDeleteTo all- the exact name of a reaction in organic chemistry may not be exactly relevant generally to the practice of medicine, but first the discipline arising from the struggle to learn reactions and molecular makeup will apply later to many other endeavors, not just within medicine, but any technical field. And as one mentioned, if you remove the underpinning of organic chemistry, you concurrently also remove the underpinning of biochemistry as well, and add to these that of drug interactions. I fear that will make a hollow, rather poor doctor. I wouldn't want THAT guy to treat me, on top of the possibility that he might have been the equivalent of an undergraduate C- student in medical school. Have it your way, then, unleash the flood of incompetent, ineffective, ignorant "doctors". Start now! Then they'll be there for you when you get old.
ReplyDelete