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By Margaret Harris
Should all prospective doctors have to pass a basic physics course as part of their pre-medical training?
I’m guessing that for most physicsworld.com readers, the answer to this question will be a resounding “yes”. Indeed, the idea that physics can be useful in a wide range of careers is a recurring theme in our Once a physicist column, where we profile people who originally studied physics, then went on to other fields.
Yet even though it makes sense for all medical students to be familiar with certain scientific concepts, it does not necessarily follow that this preparation has to take place before they get into medical school. That, at least, is the thinking behind the humanities and medicine programme at Mount Sinai Medical School in New York, the subject of a provocatively titled article – “Getting into med school without hard sciences” – that appeared in yesterday’s New York Times.
A note for non-US readers: in the US, medicine is a postgraduate course. Students who plan to go to medical school can earn first degrees in all sorts of subjects, including the arts and humanities. However, most medical schools do require applicants to take a selection of “pre-med” courses – including organic chemistry and, yes, introductory physics – alongside their other classes, to prepare them for the medical-school curriculum.
What makes Mount Sinai’s programme different is that it is open to students who didn’t take such courses as undergraduates. Instead, the so-called “HuMed” students complete short introductions to physics and organic chemistry at a summer “boot camp” before starting medical school in the autumn. It’s an approach that seems to work: a recent study (published in the peer-reviewed journal Academic Medicine) found that the HuMeds perform just as well in medical school as their traditionally prepared classmates.
I cringed at some of the attitudes on display in the article (particularly that of the HuMed student who said she “didn’t want to waste a class on physics” or chemistry as an undergraduate), but I have to admit that requiring would-be doctors to take a physics course often has more to do with “toughening them up” than it does with teaching them essential skills. And the study also showed that that HuMed students tend to select specialties such as general practice or psychology, where their lack of scientific preparation is perhaps less of an obstacle.
Still, the next time I need an X-ray, I’d prefer a doctor who knows a little physics.
I’m afraid I have to agree with Margaret. In fact I would make the case much stronger…it should be a requirement that all MD’s have had physics…..and calculus too, since there is no real understanding of physics without calculus. It seems insane that anyone at the pinnacle of a profession such as medicine, with it’s massive interface with general physical knowledge, -should not have been exposed to such fundamental quantitative ideas expressed in natural processes by calculus and physics…
As both a research Ph.D. physicist (full time for the past two years) and a physician (practiced full time for 23 years, now only part time), I can attest that the approach of Mount Sinai is going to produce less competent physicians who are more prone to magical rather than scientific thinking. Much of medicine is rote memorization so that scientific background means little. However, medicine is increasingly based upon scientific understanding. Despite this, far too many physicians believe in; cause and effects, treatments, and practices patterns that are not scientifically based. Such things as concerns about cell phones and other low energy electromagnetic devices are obvious examples.
Students in their premedical educations in the United States need more hard science course work rather than less or disasterously, none.
One could apply the same logic to any field, and say physics and other sciences should in some respects be mandatory. As to how far one takes it, I wouldn’t like to say, but there’s lots of scope for debate. For example calculus is mathematics, which isn’t actually science. Where do you draw the line? I don’t know. But sadly in the UK it’s perhaps a little moot, the science curriculum has been rather dumbed down, so maybe that’s the first thing to address.
Perhaps physicians do need hard sciences like physics. I’m not a physician, so I don’t claim to know. But neither this post, nor any of the commenters are actually making the case. Take the author’s line “Still, the next time I need an X-ray, I’d prefer a doctor who knows a little physics.” Why? Does the doctor service the machine? Does interpreting an X-ray require knowledge about photons and wavelengths, or merely an understanding of the skeletal structure?
As for the spectre of junk science like scares about cell phone radiation, those issues may carry more weight. Even so, how many doctors actually interact with cutting-edge medical ideas? Most don’t have the time. They’re going to wait until those things are hammered out in peer-reviewed journals rather than trying to make the determinations themselves.
It is distressing to find that most US physicians do not know what various imaging modalities represent. They do not understand that MRI is based upon the the distribution of water because the signal is primarily due to the proton in hydrogen that is in water molecules. They do not understand x-rays or ultrasound. Physicians do not understand laboratory measurements and their limitations. The physician is ultimately responsible for the operation of equipment (x-ray, lab, etc.) and so should have a good understanding. Physicians need to be better grounded in the hard sciences to understand their own field. I have practiced internal medicine for 25 years and now I am working in research that draws more heavily upon my physics PhD. Better decisions would be made and less attention would be paid to much of the nonsensical approaches tried in medicine. Note: I have little experience with physicians other than those in the US and I do not want to assume that their training is as lacking in the hard sciences. From what I know, many countries require less training in the hard sciences than the US.
The extent to which physics, chemistry and mathematics have permeated in biology and medicine has made it necessary for physicians to have at the very least a basic knowledge of them. Diagnostic tools have become more sophisticated, and increasingly rely on modern physics techniques. In the near future they will become more important in treatment as well.
As Margaret Harris rightly writes, physicians should at least have a good idea of the effect of radiation in living organisms. It’s clear they will need to have people knowledgeable enough to advice them on these matters, but they also need to be able to communicate with them. Conversely, it’s also important to have physicists who can communicate with physicians, and together reach a consensus of what can be done and what shouldn’t be done.
Granted, there will still be physicians who can recommend treatments for minor ailings on the basis of the final results of detailed studies they won’t make. In developing countries particularly, many physicians won’t even have access to modern techniques, although they may be using modern drugs. However, it is also important to have physicians familiar enough with modern techniques, who can contribute to their development.
Margaret, thanks for the additional link!