Most of us blindly accept that students preparing to be doctors should be subjected to the most demanding, rigorous, God-awful course of studies as undergraduates. I mean, that soft, liberal arts, humanistic stuff is OK, but “real” professionals – like doctors – need to be tested by fire and lesser candidates “weeded out.” Applying to med school is the academic equivalent of survival of the fittest. My college roommate was pre-med. I saw what he had to get through. I have to admit that as a health-care consumer, I’m glad he endured a hellacious course of studies. I want to have confidence that my doctors have been prepared well. Knowing they were pushed to the limit somehow provides reassurance.
Oops! Hang on a second. A study reported by David Muller, MD and Nathan Kase, MD from the Mount Sinai School of Medicine of New York University in New York challenges the prevailing wisdom that “tougher is better.” Their findings appear in the August 2010 volume of Academic Medicine (Volume 85 – Issue 8 – pp 1378-1383) and compare the performance of those medical students who followed the more traditional, “rigorous” undergraduate program – organic chemistry, physics, and calculus – with those who took “softer” undergraduate courses and majored in liberal arts. Their results? “Students without the traditional premedical preparation performed at a level equivalent to their premedical classmates.” In fact, the authors say there is a need to “remove content that is ‘irrelevant to medical practitioners, researchers, and administrators’ and that serves only as a mechanism for weeding out students in a ‘trial by fire.’”
Yikes! All along I thought rigor helped me get the highest-quality medical care. Seems like all I got were stressed out docs no better prepared to care for me than their counterparts who pursued a less demanding course of studies. (And those humanity-types probably can engage me in some interesting conversation!)
What does all of this mean? For one, forget the whole “rigor translates into enhanced performance” mantra that permeates the educational landscape. Creating “hoops” does nothing to promote quality, even in professions traditionally viewed as the most demanding. A much better predictor of success is reasonable capacity laced with heartfelt motivation to be the best you can be. I wonder how many potentially wonderful doctors (or lawyers, or teachers, or accountants, or auto mechanics, etc.) we have “screened out” for reasons that may be capricious. Looks like higher standards may have little to do with increasing capacity.