Medical Science Educator Volume 20: No. 3

Message from Editor-in-Chief

Peter G.M. de Jong, Ph.D.

Issue 20-3 of JIAMSE is a very special issue in several ways. First of all, every article in this issue focuses on the role of the basic sciences in modern medical education. This year marks the centennial anniversary of Abraham Flexner’s seminal report on medical education in the United States and Canada. In 2006, IAMSE… Read more »

A Solid Building Requires a Good Foundation: The Basic Sciences in the Dutch Medical Curriculum, 1865-1965

Eugène J. F. M. Custers & Olle Th. J. ten Cate

ABSTRACT

This article discusses the development of premedical and preclinical education in the Netherlands between 1865, when the ‘unity of licensure’ was achieved, and 1965, a year which marked the beginning of a series of innovations which resulted in a complete overhaul of the classical medical curriculum. It will be argued that Dutch premedical and preclinical education during the century between 1865 and 1965 was featured by a comprehensive treatment of the natural and preclinical sciences in order to provide students with a ‘solid foundation’ upon which their clinical knowledge and, eventually, their clinical competence should be built. However, the curriculum suffered from several major shortcomings: it was educationally insufficient, it lacked internal dynamics, it was extremely compartmentalized, and it became increasingly overloaded. As a consequence of both rigid legislation and an obsolete educational philosophy, these curricular shortcomings could not adequately be dealt with. Consequently, in the early 1960s, when the number of medical students exploded, the curriculum more or less imploded under its own weight. New legislation and the foundation of two new medical schools in the 1960s and 1970s, which could design their curriculum almost ‘from scratch,’ finally paved the way for implementing the major curricular innovations at the time already long overdue.

The Timing, Format and Role of Anatomical Sciences in Medical Education

John R. Cotter & Christopher S. Cohan

The Role and Value of Anatomy in the Medical School Curriculum Many basic science and clinically oriented textbooks begin by addressing the anatomy of an organ, system or clinical area. Arguably, the reason the reader is introduced to the pertinent anatomy is that the structure of the body is fundamental to understanding all of the… Read more »

The Role and Value of the Basic Sciences in Medical Education (with an Emphasis on Biochemistry)

Stephen G. Chaney1, John W. Pelley2 & William E. Seifert3

ABSTRACT

Biochemistry is one of the foundational or basic sciences that enable competent physicians to balance the art of medicine with rational, science-based medicine. It is important to the medical curriculum because it is a fundamental discipline for learning other foundational sciences, it teaches how scientific reasoning can be applied to clinical decision making, and provides a framework for solving clinical problems that require molecular insights. While Biochemistry is usually introduced into the first-year of the medical curriculum, competency in applying biochemical principles in the solution of clinical problems is best achieved when they are integrated vertically throughout the four-year curriculum and presented in a clinical context using active-learning strategies. Medical students will be better prepared to learn, understand and apply biochemical principles if they have some prior exposure to some combination of biochemistry, cell biology, molecular biology and genetics during their undergraduate education.

Abraham Flexner: The Value of Medical Microbiology and Immunology as Foundation Sciences in Medical Education

Floyd C. Knoop, Alan Biel & Kirsten A. Larson

ABSTRACT

One hundred years ago a professional educator, Abraham Flexner, published a lengthy Report on the status of medical education in the United States and Canada. The Report underscored, among other criteria, the critical need for fundamental basic science courses including medical microbiology and immunology. In view of modern complexities, including threats of emerging pathogens, drug resistant microbes, bioterrorism, autoimmune diseases and cancer immunotherapy, we have examined anew the Flexner Report to assess the importance of Medical Microbiology and Immunology in medical education and their relation to clinical medicine.

Pharmacology – In the Face of Revisiting Flexner’s View of Medical Education

William B. Jefferies1, Kathryn K. McMahon2, Gary C. Rosenfeld3, Jack W. Strandhoy4, John Szarek5 & Amy Wilson-Delfosse6

What are the sciences that constitute the foundation for medical practice? Pharmacology is clearly one of the basic sciences that form the foundation for medical practice. Our understanding about how at the molecular, cellular, and tissue levels drugs elicit their effects on living organisms (pharmacodynamics) and how these organisms absorb, distribute, metabolize and eliminate (pharmacokinetics)… Read more »

Physiological Perspective of the Role and Value of Basic Sciences

Robert G. Carroll1, Thomas A. Pressley2, & Aviad Haramati3

Introduction It is important to state the central tenet of this paper: A firm understanding of the basic sciences is necessary for the intelligent practice of medicine. It is also important to acknowledge our inherent conflict of interest in writing this paper. As physiologists, we have chosen to make medical student education a major component… Read more »

THE NEUROSCIENCE PERSPECTIVE

Bruce W. Newton & R. Lee Archer

What Sciences Constitute the Foundation for Medical Practice? The Flexner Report clearly showed the practice of medicine has its foundation in the basic sciences. Empirical observations gave way to scientific inquiry as technological advances took place. Anatomy, chemistry and physiology can, arguably, be considered the original basic sciences that spawned histology, biochemistry, cell biology, microbiology… Read more »

Role of Basic Sciences in 21st Century Medical Education: An Asian Perspective

Matthew C.E. Gwee, Dujeepa Samarasekera & Tan Chay-Hoon

Introduction Historically, the development of western style medical education in several countries of Asia was closely linked to the establishment of medical schools and initiated quite early in the 20th century by the colonial governments that ruled these countries at the time. Medical Education in Asia: Our Colonial Heritage Asian countries such as Hong Kong,… Read more »

The Role and Value of the Basic Sciences in Medical Education: The Perspective of Clinical Education -Students’ Progress from Understanding to Action

Louis Pangaro

Introduction It is understandable that the role of basic science in the medical school curriculum should be re-examined at a time when, on the anniversary of the “Flexner report,” decades of change in the practice of medicine, and anticipated changes in the delivery of health care over the coming decades are in the forefront of… Read more »

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