This book raises fundamental questions about the propriety of continuing
to use a premedical curriculum developed more than a century ago to
select students for training as future physicians for the twenty-first
century. In it, Dr. Donald A. Barr examines the historical origins,
evolution, and current state of premedical education in the United
States.
One hundred years ago, Abraham Flexner's report on Medical Education in
the United States and Canada helped establish the modern paradigm of
premedical and medical education. Barr's research finds the system of
premedical education that evolved to be a poor predictor of subsequent
clinical competency and professional excellence, while simultaneously
discouraging many students from underrepresented minority groups or
economically disadvantaged backgrounds from pursuing a career as a
physician. Analyzing more than fifty years of research, Barr shows that
many of the best prospects are not being admitted to medical schools,
with long-term adverse consequences for the U.S. medical profession.
The root of the problem, Barr argues, is the premedical
curriculum--which overemphasizes biology, chemistry, and physics by
teaching them as separate, discrete subjects. In proposing a fundamental
restructuring of premedical education, Barr makes the case for parallel
tracks of undergraduate science education: one that would largely retain
the current system; and a second that would integrate the life sciences
in a problem-based, collaborative learning pedagogy. Barr argues that
the new, integrated curriculum will encourage greater educational and
social diversity among premedical candidates without weakening the
quality of the education. He includes an evaluative research framework
to judge the outcome of such a restructured system.
This historical and cultural analysis of premedical education in the
United States is the crucial first step in questioning the
appropriateness of continuing a hundred-year-old, empirically dubious
pedagogical model for the twenty-first century.
