Reform at the Med School

The Faculty of Medicine has begun a debate which will probably lead to sweeping reforms in medical education at Harvard. In a report presented to the faculty last week, a special subcommittee has recommended the first major changes in the curriculum in over 50 years.

The subcommittee proposes that a new curriculum be adopted with two major aims:

* To increase the flexibility of the program and thus meet the various needs of individual students that arise from differences in background, interests and plans for future careers in medicine.

* To cultivate more independent thinking and scholarship to insure continuing assimilation of new knowledge after graduation.

The achievement of these aims is long overdue. At present, the Medical School accepts students with a greater variety of undergraduate preparation. Yet all students are required to participate in the School's only program, a four-year course with no electives offered until the last five months of the fourth year.

Obviously the needs of a student who has specialized in biochemistry as an undergraduate are different from those of a music major. Under the existing regulations, they must take the same courses. Moreover, a student headed for a career in psychiatry must follow the same program as a student whose primary interest lies in mathematical biology.

The Medical School has traditionally underestimated the degree to which entering students know their own interests. By offering the same program to everyone, it may frustrate special aptitudes and preferences.

The Subcommittee also recognizes that there has been too much emphasis on factual material and not enough on understanding general concepts. Students are burdened with a vocabulary more formidable than that required for most foreign languages, and they are compelled to memorize mountains of scientific data.

Symptomatic of the faults of the present curriculum was the protest last December of 20 second-year students, who requested permission to withdraw from lectures and, with faculty supervision, try an experiment in self-education As evidence of the new attitude towards reform at the Med School, the students were immediately given permission to carry out their plans.

To add flexibility to the curriculum, the report urges a reduction in the amount of factual information and memorization pressed upon the student, and a greater emphasis on elective courses. The report recommends the teaching of a "core curriculum" which would be required of all students and would consist of material that all future physicians must learn. In addition, students would spend a large part of their time on elective courses.

The subcommittee suggests several methods of teaching both core and elective courses, but the most desirable would present the core in blocks of time that would alternate with blocks of time reserved for elective courses. The report suggests that the academic year be divided into blocks of 20, 15, and 10 weeks, with the first and third devoted to the core, and the second to the electives. By having the second block correspond with the second semester in the rest of the University it will be possible for Med students to take courses in other Faculties, and similarly for students in other parts of the University to enroll in courses at the Med School.

This change should help end the unfortunate isolation of the Medical School. Nothing can be done, of course, to eliminate the physical separation between the Med School and the rest of the University, but students on both sides of the Charles stand to gain from increased contacts.

Although it is expected that the Faculty will quickly approve the aims of the report, there will undoubtedly be some difficulty in dealing with the specific recommendations.

One proposal certain to arouse opposition would substitute interdepartmental teaching for the present system which gives each department absolute control over the courses it teaches. The report recommends the establishment of three councils in the Biological Sciences, Behavioral and Social Sciences, and Clinical Sciences. These three councils would be responsible together for teaching the core curriculum. Each would be expected to provide students with an integrated course, drawing on the facilities of the departments it oversees.

This proposal would reduce the importance and autonomy of individual departments, and many will resent it. But the advantages of interdepartmental teaching are substantial. By imposing control from the top, it would permit the faculty to survey the entire program and thereby prevent the overlap which now plagues the curriculum. The report of the Subcommittee on Curriculum Planning should be studied carefully by the faculty and improved where necessary But it will be unfortunate if the debate stretches out for more than a year, making it impossible to institute the system next September.