In the world of science, new discoveries and knowledge add foundational context from which the future of medicine must learn to incorporate and adapt. Higher education communities have raised concerns about whether or not premedical curricula have kept up with these changes; what seemed to work yesterday may not be what works tomorrow.
Congruent with this mindset is the concept that prerequisites (or for that matter any scripted course of undergraduate study) should not be so overwhelming that the applicant seems pressured to emphasize (major in) science in lieu of other academically rigorous disciplines, especially those within divisions of humanities and social sciences.
Approximately three years ago, the College of Human Medicine (CHM) put together a committee of premedical experts to review our legacy prerequisites. One thing that came out of committee discussion is that there is no “one size fits all” in the world of preparatory premedical coursework that sufficiently meets the needs of all medical schools and its applicants.
Flexibility in the curriculum, though, did come forth as a key concept in trying to meet the many types of qualified applicants that exist in today’s changing world. This coincides with schools, including our own, taking a more holistic approach to reviewing applicants once they apply to medical school.
Starting with the 2016-17 application cycle, a new set of course prerequisite models will be implemented.
The New PrerequisitesIn order to meet the needs of as many applicants (both traditional and nontraditional) and undergraduate institutions, CHM embraced a flexible approach in providing various options (or pathways) to meeting premedical course requirements as follows:
OPTION A: MCAT-Influenced Preparation ModelThis model follows a historically traditional pathway of prerequisites that should prepare students for both the MCAT exam and an entry-level undergraduate medical curriculum:
- Biology with lab (1 year)
- General Chemistry with lab (1 year)
- Organic Chemistry with lab (1 year)
- Introductory Physics with lab (1 year)
- College Algebra or Statistics (1 semester)
- Biochemistry (1 semester)
- Social science coursework: Anthropology, Economics, History, Political Science, Psychology, or Sociology (1 semester)
- Upper level (defined as 300-400 level, junior-senior level coursework, and coursework that maps as upper-level by MSU transfer criteria) Biological sciences (1 semester); examples include coursework in (but not limited to):
- Advanced Cell Biology
- Molecular Biology
OPTION B: End-point Coursework ModelThis option describes what courses need to be taken, but not the path to achieve the end point. Undergraduate institutions work with their students to help decide acceptable pathways to these end-point courses that may include (but are not limited to) traditional course requirements, condensed courses, novel curriculums, AP credit, and online course work. A number of strongly recommended, but not required, courses are included in this option.
Any applicant selecting this option must document the required end-point courses that have been taken/planned as well as the list of pathway courses taken/planned that led to that end-point. Applicants will also indicate which courses in the recommended areas have been taken and which ones are planned.
The following courses are required:
- Biological sciences: 1 semester of upper-level Biology; see option A for examples
- Biochemistry: 1 semester
- Introductory Physics: 2nd semester
Additional coursework in traditional liberal arts divisions (science, humanities, and social sciences) outside Biology, Chemistry, and Physics is strongly recommended by the Committee on Admissions. Examples include coursework in (but not limited to):
- Computer Science
- Foreign Language
- Political Science
- Religious Studies
OPTION C: Course Competency Maps ModelApplicants eligible for this admissions criteria option are limited to those enrolled at institutions with departments that have constructed course-competency maps which have been submitted to the College of Human Medicine and approved by the Committee on Admissions.
The current model for this option is derived from premedical competencies described in the 2010 Howard Hughes Medical Institute -Association of American Medical Colleges report, Scientific Foundations for Future Physicians.
To qualify for admission, an applicant must complete any combination of courses whose combined content has been mapped by its faculty to cover the 37 learning objectives from this report, which emphasize the following eight entry-level medical student competencies (See pages 22-35 for a description of all 37 prematriculation learning objectives).
- E1-Apply quantitative reasoning and appropriate mathematics to describe or explain phenomena in the natural world.
- E2-Demonstrate understanding of the process of scientific inquiry, and explain how scientific knowledge is discovered and validated.
- E3-Demonstrate knowledge of basic physical principles and their applications to the understanding of living systems.
- E4-Demonstrate knowledge of basic principles of chemistry and some of their applications to the understanding of living systems.
- E5-Demonstrate knowledge of how biomolecules contribute to the structure and function of cells.
- E6-Apply understanding of principles of how molecular and cell assemblies, organs, and organisms develop structure and carry out function.
- E7-Explain how organisms sense and control their internal environment and how they respond to external change.
- E8-Demonstrate an understanding of how the organizing principle of evolution by natural selection explains the diversity of life on earth.
OPTION D: Novel Curricular Tracks ModelApplicants eligible for this admissions criteria option are limited to those enrolled at institutions that have devised novel premedical curricula that have been submitted to the College of Human Medicine and approved by the Committee on Admissions.
For institutions interested in developing novel curriculum for its students, it is strongly advised that the basis of this curriculum be grounded in the liberal arts divisions of science, social science, and humanities. The institution should provide commentary that explains how this novel curriculum integrates learning objectives which they believe provide competencies for entry-level medical students.
A grade of C (2.0 on 4-point scale) must be achieved in the novel curriculum coursework in order to meet prerequisite standards.
ConclusionIf you are thinking about a future career in medicine, develop a good relationship with your academic and/or pre-health advisor at your school. Share with them the content of this blog and our website as early in your undergraduate studies as possible such that together you can determine which of these prerequisite course options are available at your school and will best serve your intellectual needs and special interests.
Joel Maurer, MD, FACOG, is Assistant Dean for Admissions in the College of Human Medicine and Associate Professor in the Department of Obstetrics, Gynecology and Reproductive Biology at Michigan State University.