Premeds have historically suffered in Organic Chemistry.  It’s a necessary class for most medical schools and common knowledge is that it “helps students” in their future careers as doctors.  Organic Chemistry, oddly enough, is just a really fucking hard subject for most people.  Its a grueling combination of route memorization of reactions, reagents and nomenclature as well as the application knowledge to “novel” problems in the form of determining mechanisms, arrow pushing and application of those memorized facts to solve a problem.

For instance.  You know Br2 adds across double bonds so if you give a premed an olefin and Br2 she should undoubtedly get it correct.  That’s the kind of thoughtless garbage they wish organic chemistry was.  It’s not.  Sometimes you get a question where there reaction is a simple alkyl Grignard on acetic acid.  Your typical premed will blindly alkylate acetic acid to create a gem diol and…. in a slightly agonizing attempt to remedy a structure which she knows looks weird, she will subsequently do some other strange shit to it… like make some crazy peroxide radical with pirates.  They must have missed the part where Grignards are also bases?

Let’s hope they don’t miss the part where NSAIDS aren’t just pain relievers.  Lots of drugs do more than just one thing.  You combine them together, they sometimes do shit neither does independently.  Sort of like an organic chemistry problem?  Nahhhh… couldn’t be.  That would horrendously disprove their point.

Most organic TAs can tell you the huge numbers of premeds that walk into their laboratory and are clearly not ready to solve simple organic problems and thus should NEVER be allowed to work with living people.  They memorize shit, they do that really well.  It’s scary, actually, how well some of them do it, but their problem solving techniques really show through on exams in organic chemistry and in the labs.  Nevertheless, it’s the position of certain medical professionals that Organic Chemistry is too hard and unnecessary for doctors.

Recently published in the New England Journal of Medicine, Dr. Jules L. Dienstag explores the needs of modern medical students and concludes [second semester ] organic chemistry [the harder of the two semesters,] isn’t amongst them.  Dienstag makes a good point – of the four years in school, should so many of them be devoted to subjects of such little relevance to doctors?  Which is an ageless question, in reality, that has been asked by students since Aristotle.  “Why do we have to know this shit?”

Doctors need to know simple arithmetic – they don’t need anything past algebra.  They need to know the fundamentals of biology, you know, birds aren’t people and frogs start out as tadpoles.  The kinda shit that really helps prep a doctor.  Proteomics may sound fancy, but no doctor is going to seriously care or have need to care the exact structural deformities in hemoglobin when treating sickle cell patients.  “The blood sells are fragile and look funny” is about the extent they really need to know.  The real trick good doctors play is the ability to take the myriad of environmental and physical clues along with a slightly biased patient history and assemble a diagnosis that’s correct.  This trick isn’t usually taught in nursing school, though it’s hoped the nurse picks it up.  In nursing school they’re taught the techniques involved over the course of four years.  Anatomy, venipuncture, intubation, how to connect people to dialysis machines without bleeding them out and some pharmacology.   Doctors, in contrast to nurses, have a pedigree which is designed to force them to think critically and act quickly.  Nurses are techs… they need to know only what is relevant to their job, which is occasionally preventing a doctor from killing a patient through ignorance or stupidity.  Doctors, on the other hand, are expected to anticipate not knowing the answer and quickly figuring shit out.  That’s why you sue the doctors and not the nurses.  Little in college prepares you for that like Organic Chemistry, even though, in the end, you will never need to know what the fuck Grigniards do or that they’re bases and nucleophiles or whatever the hell the difference is.  Being a doctor is more than just memorizing anatomy, a list of common diseases and their treatments and having some particular technical skill set like reading MRIs or removing livers.  It’s about critical evaluation.  It just like what we, the proud grad students are doing here.  While Organic Chemistry is obviously germane to our undergraduate education, the ability to uncompromisingly recite reaction conditions will not earn us (though it will certainly give us) a PhD.  We are here to learn to think critically about scientific situations. We are here to learn how to write and communicate about them effectively1.  The fact that we end up being really good at a bench is rather secondary to all that since, in the end at least, a PhD is best served by conducting his ideas into action by management of problems and not by banging your head against the sash of one’s hood.  Our skulls simply can’t take that for more than 10 years.

(1) This is a point I think is always poorly emphasized in graduate school.  The ability to write about what you observe and talk about it is as important as the ability to actually do it.  Firstly, if you can’t communicate but do something really good, someone else will just take credit for your shit, assuming someone else figures out what you just did.  Secondly, PIs that do not let students write do them a great disservice.  Not enough can be said about the ability to write clearly and many, many students do not devote enough time to the practice of writing.