Sign of the Times [NYU organic chemistry course]

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I quoted him same as the articles quoted him. The chair recommended that his role be reduced, so that he only teach Chem majors. That means taking away his responsibility to teach non-majors.

Perhaps. But according to the WS article, it was Jones who rejected this solution, not NYU. He refused to even discuss the possibility.

From the WS article, it sounds like Jones is the one who wanted to be mollycoddled. He refused to even consider just teaching only the Chem-majors. The university wasn’t amenable, so they let him go.

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This is what you said here.

This is what you said above.

Those are opposite things.

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You’re right. I mistyped it and will change it. Thanks for the correction.

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Agree. As I said way up thread, as a physician, I think O-chem is integral to medicine: med school is for students going into all fields, including MD-phD, and as such they have to have a strong grasp of Biochem and pharmacology, among other areas. O-chem is a key prerequisite to these courses. The coursework that has to be accomplished in med school relies on a strong undergrad foundation and the ability to think deeply, problem-solve quickly, put in many late night and weekend hours reading and studying, etc.
The list of grievances of the NYU students reveals many of those students are not, in their current state, cut out for medical school.

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So much of practicing medicine IS chemistry—most of my annual physical is spent with my doctor’s nose in his laptop going over my lab results. Decisions he makes are normally made based on chemical results.

I taught HS Chemistry, including AP, for 40 years—if my doctor showed shoddy knowledge of organic/biochemistry, I would question his/her abilities.

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I disagree. I would venture to say that outside of lab researchers, almost no clinical physicians utilize the knowledge gained from taking pre-med science classes that wasn’t already learned in high school. This is especially true for primary care physicians, surgeons and other surgical subspecialties, radiologists, emergency physicians, PM&R physicians, and pathologists. This is especially true for the subject of organic chemistry. That is why organic chemistry as well as other science classes are not part of the curriculum or are a pre-requisite for many overseas medical schools including those in Canada and Great Britain. It is also why organic chemistry is not a required pre-med class for NYU’s own medical school. It is a fallacy to suggest that the best clinical doctors graduate from the best medical schools and had the best test scores and highest undergraduate GPAs. There is a lot more to the practice of medicine than studying hard and getting top grades in college. IMO, there are a lot more important factors that go into making an excellent physician.

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If NYU agreed, its very own med school could lead the way in pioneering different requirements or standards for admission. It can certainly choose to accept those with C or D grades in Orgo, or those who never took it. Apparently this is not widespread enough that many of its own pre-meds feel a need to begrudgingly take it.

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That’s why these classes are considered weed out classes. Medical schools would have no other way to quickly eliminate students from their enormous annual applicant pool- unless they utilized a lottery system.

I’m not saying that grades and test scores aren’t important. I think some level of high scholastic
achievement is important. I remain unconvinced that a college student with a 99% score will become a better doctor than a classmate with a 85% score.

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What skills are required for physicians, and how they should be selected/screened would make for a great separate topic. I am genuinely curious about how technology (including AI), advances in testing and the increased roles of PA/nurse practitioners have affected the role and skills required of physicians.

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What are other measurable characteristics that tell us ahead of time that a person will become a good doctor? Do we have a model? In the absence of that, we go by just academic achievement. If we know better, we can also incorporate other factors into the decision making

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The purpose of a college curriculum is to ensure that a student has acquired a basic set of knowledge and skills that s/he might need in her/his career. It’s highly unlikely that any one of us, in any profession, would use or need all we’ve learned in college. Even if the knowledge learned isn’t directly related, it can often provide us with insights and suggest solutions.

Also, if a weed-out course is a necessity due to the reality of too many premed students, it needs to be relatively challenging by definition. If it weren’t organic chemistry, it would have to be something comparable. Some students would face similar issues.

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A few posts have quoted an op-ed piece that stated, “…the mission of every university is to provide the opportunity and resources to allow every student to succeed in the mastery of subjects they choose to pursue.

I don’t think this is realistic. Colleges can’t fix all of our societal inequities. The first 18 years of life matter. Personal aptitude, intelligence, the strength of acquired skills, and work ethic all matter. No matter how much you wish for it, some fields won’t be open to everyone, even with massive resources thrown at them.

I’m intelligent and privileged, but I wasn’t cut out to be a theoretical physicist, a novelist, or an astronaut. My kids are smarter and more privileged than I am. Even while excelling at a rigorous and high-performing high school and graduating with many AP credits, there were fields they were locked out of. If they had entered college wanting to be a United Nations interpreter, it wouldn’t have happened with two years of high school Spanish they gave a lackluster effort (but, thanks to grading inflation, credit for an excessive amount of graded work, and a lack of differentiating students’ performance, they still got an A). If they decided they wanted to make a career in a symphonic orchestra, 4th-6th grade band wouldn’t have been enough for a college to work with.

I’ve always felt that OChem wasn’t designed to weed out students, but rather it weeds out students because of the nature and difficulty of the material. In 2019, 53,371 students applied to medical schools. Only 21,869 of those applicants were accepted into at least one medical school. So that means 54% of applicants who weren’t weeded out by their performance in foundational classes still got rejected to every medical school they applied to. There are a lot of pre-med students who flounder after rejection. Some of those weeded out changed their focus and were better off.

Not every student will succeed in the mastery of the subjects they choose.

Universities have a role to play in leveling the playing field and erasing years of inequality. I believe their responsibility is to develop scholars, and critical thinkers, and to
fuel the promise that lives within their students, but not to provide unlimited resources to individual students. As a society, we should demand that from preschool through 12th grade, students receive the resources they need to master the skills necessary to succeed in life. For some, that will take a direction other than college. Colleges should have college-ready applicants who have been prepared to succeed.

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I would like some recognition that it is a two-way street. Colleges can provide resources, but if students choose to not utilize those resources, such as by not attending class, then that is on them. Personal accountability for actions.

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Medicine is not a monothilic field. Every specialty has its own specific attributes that are extremely important for its physicians.

But in general and on the top of my head,
here are some important requirements that do not seem to be systematically assessed by medical school admissions offices.

  1. Good communication skills-at it’s heart, medicine is a service industry. A physician’s job is to heal the sick and communication is the first and most important step. If a physician cannot get the patient to accurately explain (because of social, cultural, interpersonal differences) what is going on or if the physician cannot effectively communicate his thoughts with the patient, this will likely to diagnostic and/or treatment failure and dissatisfaction by both parties.

  2. Empathy and compassion. Physicians who lack these attributes are more likely not to spend the extra time and effort with their patients and miss subtleties which might lead to better care. Patients also feel like they receive better care by physicians who exhibit those traits. Making the correct diagnosis, advising the correct treatment, or having superior surgical skills is not the only thing of importance; it’s equally important (if not more so) being a caring human being who people can relate to and trust.

  3. Humility. Physicians make mistakes and the field of medicine is constantly changing. An arrogant physician is less likely to be introspective, acknowledge error, and to seek help when warranted. An arrogant physician is less likely to change his/her practice when something new comes along or to drop a practice that is new when further clinical evidence suggests it’s not working.

  4. Intellectual curiosity and flexibility. A recent medical school or residency/fellowship graduate is not fully formed. There is still much to learn and experience for the remainder of their careers. Two patients with the same presentations often have differing diagnosis. It is important not to overlook that and rely on rote practices.

  5. Wisdom- a physician can be a genius but consistently make bad judgements. That often improves with experience, but not always. That is why many very good clinicians previously worked in other allied health fields or even other careers.

  6. Work ethic. Lazy physicians often make bad doctors.

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What’s the definition of “too many” here?

If there are plenty of (or even too many) premed students, why do we have a documented shortage of doctors? Obviously the life of a physician is difficult, as many of us know from personal experience. Yet our entire society suffers with their increasing shortage. It astounds me that the answer to that problem by most is to stick with the status quo of education delivery. Even docs who have made through the system decry their lifestyle while at the same time insisting that it must be so simply because it was so for them. I suggest there’s no actual evidence that the system needs be so.

Based on experience here, I’m sure there are plenty who assume that I’m suggesting dropping academic standards for pre-med education. Allow me to reiterate that this is not my position. I suggest that we be open to changing, or at least examining, how education can be delivered most effectively in order to meet those same academic standards for a population of students that is larger and more diverse than in the past. I remain unconvinced that the students at issue were not asking for that.

If the doctor shortage can be addressed at least in part by being more sensitive to the needs of a larger group of students in learning the necessary material, perhaps there would fewer on-call hours, fewer physician mental health problems. And better access to high quality care for our entire society.

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The doctor shortage is the result of deliberately limited medical admissions to preserve the high salaries of doctors. It worked quite well at that task for decades.

Providing additional resources to students is not free. Costs of attending NYU this year exceed $83k. It isn’t clear to me that anyone wants to pay the pricetag for additional resources they expect.

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I’ve definitely heard and read about inherent limitations in access to medical training, but not as a deliberate attempt to keep the cost for medical expertise at a premium. Do you have a citation for this claim?

It’s my understanding that since the physician shortage was recognized, there have been increases in new medical school establishment in the US.

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Actually it was used as the basic example of setting barriers to entry to preserve salaries in my econ class over 40 years ago, and contrasts sharply with, for example, law schools, which increased the supply of lawyers in response to increased applicant interest, led to a glut of lawyers, and stagnant salaries for them. I will see if I can find a cite.

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Responding to this edited addition. I think most people do not need such education in the simple financial equation that resources cost money.

More meaningful observations might be sought about cost-effectiveness. Are the resources currently on offer effective enough in the producing the academic outcomes we seek? Or is there another mix of resources that might cost more, but produce relatively greater outcomes?

I don’t have the answers to those questions, but I’m thinking the NYU administration is acutely aware of them and using them to guide their actions, appropriately so IMO.

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I can understand that stagnant salaries would result from increased supply of any specific trained cohort. That again seems simple. The question is whether salary control is itself the sole driver of training access.

Here’s a recent article re: increased access to medical schools being driven by the recognition of physician shortages.

(I think this is open access, but if not, I can copy in the abstract at least)