Stanford University
University of California, San Diego
University of California, San
Francisco
University of Hawaii
12. Arts and medicine. Many medical schools have
arranged for their students,
especially those considering a career in
pediatrics, to participate in an Arts for
Children in Hospitals program. It employs
hands-on arts activities one on one or
through music or dance sessions. The goal is to
help medical students learn how
to become comfortable with young
patients.
Since there now exists a diversity of curricula
because of the many possible varia-
tions, it is advisable for the prospective
applicant to become familiar with the programs
offered by the school in which they are
interested (see individual school profiles,
Chapter 7).
THE NEW MEDICAL SCHOOL CURRICULA
A major consequence of the introduction of new
medical curricula is the individualiza-
tion of medical schools. From the time of the
Flexner report in 1910 until Case Western
Reserve University introduced organ-based
learning in 1952, all medical schools were
essentially the same in following the
traditional two-year basic science courses plus a
two-year clinical science curriculum. They
differed only in the size, facilities, and qual-
ity of their teaching staff. With the
introduction by McMaster University of problem-
based learning in 1975, the option for
wide-ranging curricula variations became feasible
and has, in fact, taken place.
The major nontraditional approach to medical
education in the basic and clinical sci-
ences involves incorporating fact-intensive
courses into an integrated curriculum. In this
approach the focus is on general principles
that usually cut across traditional disciplines,
resulting in blocks of time devoted to a
particular organ system in the context of various rel-
evant sciences. Frequently coupled with this
educational format is a technique known as
problem-based learning, in which small groups
of medical students analyze clinical case
histories with the participation of a faculty
member. Each student selects an aspect of the
case to research and at the next session each
discusses what was uncovered, thereby gener-
ating a collaborative learning system. This
system is currently in effect on a limited basis in
about 60 medical schools, about half the
medical programs in the United States. While fully
assessing the effectiveness of this approach is
premature, preliminary findings indicate that
students educated under the nontraditional
system had overall lower scores on Step 1 of the
USMLE, but generally scored higher on Step 2.
Students seem to like the new system, per-
haps because it is less demanding. A full day
of lectures along with tedious lab work has
been eliminated in favor of only a few lecture
hours daily with streamlined labs.
There are some stresses in small group learning
situations, such as one-upmanship to
impress teachers and classmates by students who
enjoy demonstrating their substantial pool
of knowledge. Another problem is that some
students do not pull their weight in meeting
their assignments, making it more difficult for
others. In addition, this new approach
requires readjustment away from the competitive
isolated learning experience. Approaching
a problem in a "holistic" manner, rather than
memorizing a mass of facts as was done dur-
ing the premed years, involves drastic change,
but may prove very worthwhile in the end.
Alternative Medicine
Over the past few decades many alternative
practitioners of healing have gradually
gained some acceptance. In a recent survey it
was found that about one-third of all
Americans use some form of unconventional
therapy, spending close to $14 billion
annually on treatments.
U.S. medical schools have responded slowly to
this change. Thus far, about half
include information about alternative medicine
in their curriculum. These include
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