Hopkins coined the term "residents," as it was the first hospital to make its training doctors live at the hospital. (One hundred years later it would make its undergrads live at the library!).
Hopkins also coined the term "rounds" to refer to when doctors would go on to visit their patients, because of the circular dome where the patient wards were located at the hospital. We have the first medical school that required an undergraduate education to attend, in order to attract true students and move away from quackery.
Hopkins more or less invented, in combination with a whole long history of medicine from all over the world reaching back to the days of Hippocrates and Galen that I will glaze over right here, the modern medical education.
No one will deny the complexity that has arisen even in the last decade with more biomedical knowledge and technology that can seemingly treat and cure all but the most pestilent of pests. The ranks of specialists and sub-specialists have swelled in the past few decades and now physicians are gaining increasingly more degrees to keep up with even their own specialty.
Hopkins has been an agent of change in medical education since the beginning and must be the catalyst of change for pre-medical education as well. The standard curriculum includes a year of chemistry, orgo chemistry, biology, physics, calculus and English (with corresponding labs).
All of this is simply a waste of time. Indeed the curriculum is necessary as an introduction to the vast knowledge needed as only a base of medical education, but for a healthcare profession, it's totally inadequate.
The standard courses themselves are part of an antiquated curriculum that does not prepare the future physicians of the United States with the background needed to digest the rapidly expanding information.
Calculus should be replaced with statistics (look at a medical journal and find the second fundamental theorem of calculus, then look for a two-sample T test). With this new era of "evidence-based medicine" those without a statistical background might find themselves at a competitive disadvantage.
A second semester of organic chemistry? One semester is adequate for a pharmacology class. Hopkins should replace the second semester with biochemistry, essential when dealing with the new biotech discoveries.
English? What about a communications class that teaches the fundamentals of public speaking and presenting an idea effectively?
As for biology, it's a fine introductory class, though an advanced level of genetics, developmental biology, etc. might be preferable.
The lack of knowledge about the U.S. healthcare system is alarming. Sure, the school teaches how proteins are formed and how electricity is conducted, but not how are doctors paid? What role does the federal government play in a doctor's practice? Why are there access problems in the wealthiest country in the world? Why are there so many sick people in the poorest?
I suppose I am a bit biased in this regard, being a public health major, but talk shop with physicians at dinner or at your next visit; their discussion will not focus around Diels Alder reactions and Ramaschandran plots, but Medicare reimbursements, patient compliance and acronyms. Why are these topics not covered in the premed curriculum but learned abrasively as these young physicians hit the ground running?
Teamwork is noticeably absent from early education. Doctors are nearly required to be autonomous thinkers but most decidedly must be team players. Nurses, technicians and administrators all factor in to patient care; the physician just seems to be the quarterback at times. Learning to work effectively within a team will reduce medical errors and increase efficacy for treatment. With complex case management for patients with multiple conditions, proper communication is essential.
Working early on with nursing students and other allied health professionals would be ideal. BME students have design teams throughout their academic career where they learn to think "outside the box" and take on a mentor role, why not have the same for premed? A once-a-week seminar or workshop where students can learn about the intricacies of health care from patient ethics to HMOs seems to be a good idea. When they eventually take on the medical field, they will have insight over their peers on how to best deal with these complicated questions that arise outside of the exam room.
These suggestions are a start. Hopkins has the resources to turn out bright students who are knowledgeable about health care before they step into the medical realm.
Starting with curriculum and teamwork seminars to start the mental juices flowing might be all that is needed to prepare a young physician early on to tackle some of the unanswered questions in health care as well as medicine. Hopkins invented medical education for the 20th century: It can invent pre-medical education for the 21st century.
