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Questioning the Premedical Paradigm

Enhancing Diversity in the Medical Profession a Century after the Flexner Report

Donald A. Barr, M.D., Ph.D.

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This book raises fundamental questions about the propriety of continuing to use a premedical curriculum developed more than a century ago to select students for training as future physicians for the twenty-first century. In it, Dr. Donald A. Barr examines the historical origins, evolution, and current state of premedical education in the United States.

One hundred years ago, Abraham Flexner's report on Medical Education in the United States and Canada helped establish the modern paradigm of premedical and medical education. Barr’s research finds the system of premedical education that evolved...

This book raises fundamental questions about the propriety of continuing to use a premedical curriculum developed more than a century ago to select students for training as future physicians for the twenty-first century. In it, Dr. Donald A. Barr examines the historical origins, evolution, and current state of premedical education in the United States.

One hundred years ago, Abraham Flexner's report on Medical Education in the United States and Canada helped establish the modern paradigm of premedical and medical education. Barr’s research finds the system of premedical education that evolved to be a poor predictor of subsequent clinical competency and professional excellence, while simultaneously discouraging many students from underrepresented minority groups or economically disadvantaged backgrounds from pursuing a career as a physician. Analyzing more than fifty years of research, Barr shows that many of the best prospects are not being admitted to medical schools, with long-term adverse consequences for the U.S. medical profession.

The root of the problem, Barr argues, is the premedical curriculum—which overemphasizes biology, chemistry, and physics by teaching them as separate, discrete subjects. In proposing a fundamental restructuring of premedical education, Barr makes the case for parallel tracks of undergraduate science education: one that would largely retain the current system; and a second that would integrate the life sciences in a problem-based, collaborative learning pedagogy. Barr argues that the new, integrated curriculum will encourage greater educational and social diversity among premedical candidates without weakening the quality of the education. He includes an evaluative research framework to judge the outcome of such a restructured system.

This historical and cultural analysis of premedical education in the United States is the crucial first step in questioning the appropriateness of continuing a hundred-year-old, empirically dubious pedagogical model for the twenty-first century.

Reviews

Reviews

Barr is to be commended not only for writing such a readable and thought-provoking book but also for bringing this important issue back to the center of discussion and framing it to allow the current model of premedical education to be rethought in a way that will conform to the needs of the profession and to the needs of society as a whole.

Barr is to be commended not only for writing such a readable and thought-provoking book but also for bringing this important issue back to the center of discussion.

Barr’s is a multifaceted book, so a variety of disciplines will find various chapters useful to their goals. Teachers of education policy will find the sections on educational disparities and pedagogical innovation of great interest; while medical historians and medical humanities programs will enjoy the chapters on the history of and research on premedical education. Clinical Research training programs will find the last chapter useful as a case study in protocol articulation.

About

Book Details

Publication Date
Status
Available
Trim Size
6
x
9
Pages
240
ISBN
9780801894169
Illustration Description
8 line drawings
Table of Contents

Preface
Introduction
1. Who Drops Out of Premed, and Why?
2. The Historical Origins of Premedical Education in the United States, 1873– 1905
3. A National Standard for Premedical Education
4. Premedical

Preface
Introduction
1. Who Drops Out of Premed, and Why?
2. The Historical Origins of Premedical Education in the United States, 1873– 1905
3. A National Standard for Premedical Education
4. Premedical Education and the Prediction of Professional Performance
5. Noncognitive Factors That Predict Professional Performance
6. Efforts to Increase the Diversity of the Medical Profession
7. Nontraditional Programs of Medical Education and Their Success in Training Qualified Physicians
8. Reassessing the Premedical Paradigm
9. Another Way to Structure Premedical Education
Notes
Index

Author Bio
Donald A. Barr, MD, PhD
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Donald A. Barr, MD, PhD

Donald A. Barr, MD, PhD, is professor emeritus at Stanford University in the Department of Pediatrics. He is the author of Health Disparities in the United States: Social Class, Race, Ethnicity, and the Social Determinants of Health; Introduction to Biosocial Medicine: The Social, Psychological, and Biological Determinants of Human Behavior and Well-Being; and Crossing the American Health Care...