OT? Students don't learn, fire the teacher

Investment Analysis Clubs Macro Economic Trends and Risks
#11

Me, too (well, except for maybe the alcohol part :slight_smile: ) (And the fascinated-by-the-material part, at least wrt O-Chem). (And, breaking the class curve).

(Ok, maybe not so close)

Inner-city public high school. One thousand freshmen, becoming four hundred odd graduating seniors; if you include the twenty-odd second-tier Cal State campuses (as opposed to the eight flagship UC schools) around thirty or so of us went directly on to four-year universities.

I did premed, choosing my UC by the simple criteria of The One Furthest From South Los Angeles.

No real idea what I was doing, much less that UC Davis had a reputation of having a particularly difficult organic chemistry year (source: a friend I made years later who was quoting his Dad, a biochem professor at a Big 10 university), and that the wisest of the premeds took O-chem during the summer at an easier institution.

Anyhow, I went in bare as a premed - choosing a biochemistry major on that criteria - sitting next to students who had gone to good-to-excellent public and private secondary schools.

I worked as hard than anyone I knew, and harder than almost everyone.

…

Retired after nearly thirty years as a triple-boarded hematologist/oncologist, I can report that:

  • No question it was a weeding course. First year chemistry had forced out the most casual, but O-chem (traditionally, sophomore year) took care of at least half of the rest.

  • And it might well have been me. O-chem 128A, B, C were among the few hardest undergraduate courses, with 128B the toughest of the three. A revered grandfather died that term… I got my only undergraduate ‘C’ in 128B…a conspicuous stain on my med school application two years hence

  • No question that almost all of the subject matter was useless as a medical student or a practicing physician. Perhaps 15% was peripherally useful (as opposed to biochemistry, a working knowledge of which is essential - particularly for the most cognitive medical specialties). But, as far as what O-chem is needed to practice first-rate medicine – the small amount that could be taught in perhaps ten or twenty instruction hours

  • with that said, O-chem was very useful in sorting out those who could and would put forth the concentrated effort to absorb and integrate a brutal amount of highly technical interrelated data in a concentrated period of time, and to then exhibit the ability to apply the lessons learned when encountering similar problems - under time pressure, an closed-book

  • For our great-great-grandparents, my understanding is that the study of ancient Greek followed Latin - apparently under the rationale in those pre-hard-science days the goal being nonetheless similar: that while every educated man* needed to know Latin, the harder Greek was reserved to hone, polish, strengthen, make supple – and to sort – the most adept young minds.

  • A different analogy: ‘H3ll Week’, the notorious period that begins Special Forces training and which has a 75% dropout rate

  • My thought then and now was: as regards the subject matter, it might as well have been Sanskrit, or nuclear physics, or even some complex obscure theology as organic chemistry - just so med schools generally agree among themselves on which one they will use - and, like many things, the specific choice was more an accident of history than any rational plan

  • But, some winnowing of MD wannabes is necessary. Pick something.
    …

As far as the elderly adjunct NYU professor: my reading of the entire article is that the truth lies in between…but probably a little more on his side than the students’ (and, the article makes clear - the students didn’t want him fired anyway. That decision lies squarely with quavering administrators)

– sutton
(*and a few women, this being the reality of 18th century Western Europe)

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#12

I can’t let this go by without some qualification. One may not need organic to be a doctor, but the course makes one a better doctor. There are two reasons for this.

The first is that organic chemistry is an important component of biochemistry and pharmacology, two subjects where it is becoming increasingly important for doctors to be conversant with. New drugs come on the market all the time and an increasing number of Americans are taking multiple prescriptions for multiple chronic diseases. As a result, diagnoses and treatments are becoming more complicated. You want a doctor capable of understanding the research literature to evaluate the best treatment option among the several that may be available. Organic Chemistry provides a big chunk of the vocabulary needed to understand that literature.

The second is a bit more abstract. As an active geneticist I know that much of what is being taught to undergrads in my area is going to be obsolete in a few years. Doesn’t really matter because more important than the information provided is the training of the mind to think in more sophisticated ways. I took organic chemistry, and what I recall from the course that made it both difficult and fascinating was that it was a combination of formal rules and intuition. Organic molecules follow rules of physics that make their interactions predictable but they are sufficiently complex that multiple factors must be considered to uncover the predicted outcome. That is quite similar to the type of thinking required to make a diagnosis from symptoms, test results, and family history. Sometimes diagnoses are basic and can be done by a nurse practitioner or physician assistant. But when it gets complicated, it is good to have someone trained at unraveling more complex problems.

Organic chemistry is hard because it demands a more sophisticated level of thinking than most students are used to. Good doctors have to be able to think at that same level.

Therein lies the more important issue to me. Why is such a critical preMed course being taught by an adjunct professor on a yearly contract?

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#13

This topic takes us into should teachers be rewarded for their results.

The best teachers tend to go to the best schools. Those are often in the suburbs.

Meanwhile teaching in the inner city where students need is greatest seems unpopular. Only the dedicated are willing to risk crime driving into the inner city.

They are forever telling us test scores correlate with zipcode. The poor have many social problems that interfere with quality education. They also tend to have weaker schools when schools are funded by property tax.

We need our best teachers at these inner city schools. Perhaps they should get hazardous duty pay. But also a generous allocation of resources to keep schools safe. Security. Mental health professionals to help.

We know many routes out of poverty are available to those who stay in and get a high school diploma. Its worth our while to make that happen more often. Poverty leads to a life on welfare using up social services or in prison. Much better to get them into the middle class. Education is one of the best opportunities.

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#14

And yet many medical schools, including some of the best and most productive don’t require organic chemistry at all. Not as an undergraduate, not in medical school, not ever.

One must wonder and the philosophy that says “we must have this really difficult course, which we acknowledge students don’t need, to help weed out those “non highly motivated and contentious” students from the rest of them. Heck, why not require them to calculate artillery ballistic trajectories to 9 digits, or learn Sanskrit. I’m sure that would weed out the laggards too.

Phooey. If you’re on a career track to be a doctor, offer courses that are necessary to be a doctor. If you are in one of the narrow specialties that require some background in organic chemistry, then require organic chemistry.

Anything else is nonsense, on a par with hazing rituals to join a fraternity.

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#15

The hazing continues after med school, with newly minted MDs forced to work 80-100 hours a week for terrible wages during their residency. The only explanation I’ve ever heard is that “I had to go through it, so they need to as well.”

How many mistakes are these exhausted young doctors making? I’m sure most of them are caught by their attending, but does it make any sense at all to put people through these meaningless rituals? Residency is certainly a necessary part of medical education, but the long hours and low pay are not.

And before someone starts talking about the benefit of watching the patient’s progress over time, that can certainly be done just as well with something more civilized, such as 4 or 5 10-hour days in a row. You don’t need to personally watch a patient 24/7 to learn how they are progressing. The attending isn’t doing that. They learn how their patients are doing by getting reports from their residents and the nursing staff.

–Peter

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#16

I think you will find that the great majority (>90%) of U.S. medical schools require at least one semester of organic chemistry. Even in the few that don’t have any organic requirement I strongly suspect that they will give an advantage to the applicant that did well in organic versus one that tried to avoid the topic.

One big reason why organic has the reputation it does is because it is typically the first advanced chemistry/biology course taken by premeds. Upper level preMed courses like Genetics, Cell Biology, Organismic physiology, etc are typically as challenging as organic. Having taught genetics I can say that those student who have taken organic generally have an easier time with the course. Much easier to understand the structure and properties of DNA and RNA with an organic chemistry background. The relevance of organic chemistry to biochemistry, physiology, and pharmacology seems even more obvious.

There is a medical career track with a much more streamlined curriculum of the type you suggested. It’s called physician assistant, or PA, where one can skip a lot of the courses you believe are unnecessary.

Given a choice would you rather be treated by a PA or an MD?

That has changed. 80 hours/week is the max limit. Should point out that physicians on average work 50+ hours/week with 20% working 60-80 hours/week.

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#17

Most of the time, I’d rather have 20 minutes of a PA’s or NP’s time than 10 minutes of an MD’s time. I don’t really need an MD to tell me I have sinusitis or a sprained ankle and prescribe the appropriate treatments. Or to suture a small laceration. Or advise me on birth control. (Well, probably not me, but my wife or girlfriend - although as a man I should be there both to learn and support.) If a PA or NP can do these basic diagnoses, that works out just fine.

When things get complicated, that’s when the additional training, knowledge, and experience of an MD comes in. And I think any good PA or NP will know when to call in the cavalry. That’s one of the skills they need.

Good to know. Only 10 hours a day, 8 days a week. :wink: More realistically, 13 hours a day, 6 days a week, with the remaining 11 hours a day equally divided between sleep, meals, and off the clock charting. That leaves one day off a week to handle the rest of life. Useless little things like family and friends and writing checks for your huge student loans. And catching up on sleep. :grinning:

–Peter

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#18

One of the worst doctors I ever heard of billed twice what his peers in the group did. He worked from 4 AM till 11 PM with no time off. He was well off and his wife was rich. He just had too many personal problems. He died upon his retirement at age 65. He was disease ridden by then.

Dad worked 50 hours per week. He did two internship, Dublin and here in the states. The US would not accept his Irish internship.

#19

I’m sure they do. Whether that is a good idea is an entirely different thing. If it is not germane to the regular practice of most doctors, if it is nothing but a “weeding mechanism”, if it doesn’t help them diagnose, there what’s the point, except “we’ve always done it this way”?

Maybe it is with some disciplines, as you note. Then how about moving it further down the line, so people interested in those disciplines get it but those for whom it holds little/no practical value don’t?

Word. I’d rather have more medical personnel trained to do 95% of what is needed than many fewer trained to do something esoteric that’s not.

As for the “24 hours” thing, I was a recipient of that. After my bike accident (me: bike, him: Oldsmobile) my attending in the ER was in hour 23 of a 24 hour shift. How unsurprising that he misdiagnosed my concussion. How lucky for me that my sister ran a department at that hospital and caught the issue after-the-fact.

I have attempted to engage more than one doctor over whether this rigorous “hazing” is a good idea, but they never want to talk about it. I think it’s “I had to do it, so they should too”, but it could be that they think I’m trying to set up a malpractice suit, I suppose. I’m not. It’s 40 years later!

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#20

I also maintained myself in peak physical performance…

Somewhat off-topic but, in this context, do you use a performance related “wearable”. One that gives you, say, an estimated VO2MAX or some proxy for it?

I’m on a few of the support boards that accompany my Peloton and this topic came up on a board for those of us who’re Chronologically Enriched…and, with most who’re wearing one, the numbers are pretty low in spite of the exercise they claim to be doing. Tried explaining how part of the reason is that they’re late bloomers in the exercise arena and as great as that is, what they’re doing might not be adequate to compensate for being a Sedentarian for the previous 4 or 5 decades. I’m surmising that yours would be right up there too.

Rekindled a new interest here what with my recent surprise diagnosis of coronary artery disease with absolutely no symptoms or reduced capacity for exercise …or to my VO2MAX.

We just took another trip back to the UK for a medical meeting (Dublin then on to England). After a couple of days back down at sea level, thought I’d eyeball the feature on my Garmin and it alleged that my VO2MAX had risen to a level that pegged me at the fitness age of a 20 year old. Back at ~6200ft, I’ve aged another 15 years🤣

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#21

Even if Organic Chem was solely a weeding class, what you suggest would be a terrible thing to do for everyone concerned.

What a lot of people apparently don’t know is that what limits the number of physicians trained per year is the number of Residency positions, the great majority of which are funded by the federal government. This means there is a limited number of residencies available in any given year. This number dictates the number of students Medical Schools can accept every year. Since Med School admission rates are already on average only 7%, it is in everyone’s best interests to reduce the number of preMeds as early as possible in their undergrad years to those who have a plausible chance of getting accepted.

This schedule is pretty common during the “apprentice-years” for a number of careers, particularly those with high status, income, power, and/or responsibility. It is how much interns work who want to get into finance or big-time law firms, not to mention entrepreneurs who start businesses. Ask a grad student trying to get a Ph.D. in the sciences how much time in the lab they are spending and how much they are getting paid.

On the flip side one should also be more accepting of the times when these lesser trained happen to miss something serious. Easy to do in the abstract, but more difficult when it becomes personal.

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#22

Goofy,

The generalizations of “most of the time” are an opening for most people here to get badly blindsided when a problem comes into play. There is no most of the time. There is quality care which is hard to find.

#23

Briefly: two things, either one of which I could expand into an essay.

First: trainee workload. DS2 - very much a MiniMe, the poor man - is currently doing his internal medicine residency thirty-five years after I did mine.

Much of it is the same, but what is most instructive to me are the differences.

First is the sensible work hour restrictions. The formula is complex (how many days in a row; how many hours per day; some other stuff wrt purely instructional hours e.g. practice board tests). Those are unequivocally better than my era, when no restrictions existed. Internship for me averaged 110 hours/week over the 52 weeks, easing only slightly in the ensuing two years. My personal most-ridiculous schedule: 24 hours on/24 hours off for a full month, working (with culpably little supervision) the emergency room of an inner city university hospital of a major metropolitan era. At only 84 hours/week (on paper, in reality more like 90+), it seemed great for the first few days…but then the physiologic reality of being up all night, every other night started to kick in. I did five months of this in three years.

Yes, it was dumb. And dangerous. And it was the era that brought the Libby Zion case, where an overwhelmed intern and his supervising resident caused the unnecessary death of a young woman in a major NYC teaching hospital. Once again, medicine couldn’t/wouldn’t police itself, so the justice system and multimillion-dollar lawsuits were needed to get the policy-makers’ attention.

I’m less than fully enthusiastic about the work limits now set on even senior trainees, because that’s not how the world works. Barring the few fields where there are few truly urgent cases (think: dermatology), in cardiology, oncology, nephrology, ob/gyn, emergency, critical care, etc etc etc there are just going to be random days where the load is two standard deviations above average. While a third-year medical student just starting on the wards is best capped at 2-3 patients at a time, and newly minted interns probably shouldn’t have more than, oh, 5-6 existing patients plus 2-3 admissions per shift - the senior trainees should have real-life exposure to those full moons when the wheels fall off, the cavalry isn’t coming, and triaging, time efficiency and a sleepless night are critical to getting the job done.

But overall: DS2 experience much more appropriate in 2022 than was mine during the Reagan administration.

My second thesis: I actually have a pretty good idea what in a perfect world, driven by logic, should supplant organic chemistry as the default undergraduate weed-out.

(Parenthetically: I did a brief internet search and it looks like around fifty US medical schools no longer require O-chem, or around 25%. I mean, if you’re an undergrad and make the decision to get in the high-stakes poker game where everyone else is playing from a 52-card deck while yours has 39, then God be with you. Complicating this is that many of these are state schools which just don’t take out-of-state applicants. If you’re a resident of the great state of WX, and the Univ of WX Med school requires O-chem, then)

OK, out of time. Very briefly: my O-chem replacement concept. The necessity is that of a complex, highly technical set of closely interrelated subjects which lends itself to testable hypotheses…but is necessary for the intelligent practice of 21st century medicine, which O-chem is not (and truly ever was. Biochem should have supplanted O-chem as a premed weeding course around 1980).

And I’m not in favor of eliminating organic chemistry entirely. As I wrote somewhere above, ten instructional hours or so should be plenty for an MD

My proposed replacement thesis statement: “The Wacky World That Nucleic Acids Have Wrought”, or (more sophisticated): “A Comprehensive Survey of Information Transfer in Biologic Systems”

You start with Mendelian genetics and Punnett squares. That takes a day. Then you quickly move on to translation, transcription; up- and -down-regulation; gene transfer. A moderate survey of different organisms (viruses, fungi, prions, even intuitively common things like corn) are instructive as to what is essential to life, and why different trees ‘chose’ differing strategies.

You move on to the modeling of 3D protein structures (which in the final analysis are dictated by physical chemistry meeting a certain nucleic acid sequence) and implications for drug design - necessarily including some pathologic variants (e.g., oncogenes)

Yes, it’s hard science - and the computer modeling is just beginning. It may not lend itself to a lab section as O-chem, but, uh, so?

The course has room for enormous breadth, and could be as complex as the university chose to make it. But the graduate would be facile with, well, Life.

My hypothetical course finishes with memes - the original Dawkins variety, where the whole purpose of life becomes the transmission of information across generations.

I’d rather my doc - or any well-educated biologic scientist - be capable of handling and be well-versed in the methods, vagaries, adaptations, errors than in Kekule’s snake or the Grignard reaction.

/rant

  • sutton
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#24

While I understand where you are coming from, I think it would be a mistake to require courses specialized for PreMeds. The premed concentration is a popular choice of incoming freshmen who like STEM but are otherwise uncertain of their major. A large percentage of freshman premeds end up in a different career path by their junior year, though most typically stay in the sciences. The last thing you want is for these students to have to stay an extra year or two because their specialized premed courses are not adequate for other majors.

The standard recommended premed curriculum during the first two years include general chemistry, organic chemistry, general biology, physics, and calculus. These courses also happen to count for most other majors in the life sciences and chemistry, which is relevant since most premeds are biology majors. This means that one-time premeds who found medicine not to be their calling are still on track to graduate on time with a science degree.

I think much of the disagreement here stems from whether one perceives physicians to be technicians or scientists. I get the feeling that the general public tends to see the practice of medicine as a trade where the physician only needs to know techniques. This is analogous to an auto mechanic where only practical knowledge of the car is needed. Academics tend to see MDs as scientists who have a role not just in practicing medicine but also in developing medicine. This is akin to an automotive engineer who not only needs to understand the car, but also have knowledge in physics and math.

If MDs are scientists, then one can see the rationale for med schools requiring education in the fundamental fields of the life sciences.

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#25

Physicians do need some background in chemistry. They can’t regard chemical names as a foreign language. They need to know something about metabolism and biochemistry.

Eliminating chemistry from the curriculum is a bad idea. But how much time they should spend in chemistry courses is a reasonable debate.

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#26

What a bunch of curmudgeons. :slight_smile:

Of course young adults are different than us old schoolers. They grew up with the world’s knowledge in their palm.

And they’ll complain about the young whippersnappers because they’ll have chips implanted in them so they won’t have to even have to pull a phone out of their pockets or use their digits! 1,367 x 55,042? Easy peasy. 75,242,414 (at least that’s what my phone tells me).

Drive a car? How quaint. Want to quote a Shakespeare sonnet? No prob.

Of course, the successful people will require more than just having facts at their finger tips, as it has always been.

It’s not the smarts, it’s the intelligence. And more importantly, how you utilize your intelligence.

Things are accelerating at an exponential rate. Exciting times we live in, and scary.

Sometimes the light’s all shinin’ on me.
Other times, I can barely see.

Not to worry, though. If the UAP don’t get you then the AAI will. Or the thunder. I forget which.

AW

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#27

Yes, true.

One of the interesting things about this story was the context: I agree with much of Wendy’s opinions in her OP. In this specific case, though, NYU fired the ‘semi-retired’ (many of us now) professor in reaction to a student petition, which itself did not call for his firing. I heard an NPR story on this last week that brought up the fact that this particular professor was condescending and dismissive to his students and didn’t bother to clarify much in the class. The reporter asked why students even took the class and, of course, the answer was that it was a pre-med requirement (that we’ve talked about here a lot) and they didn’t have any options. Why, then, did these students not take OC with another professor? Because they were already booked up! This is the thing: NYU had a few other professors teaching an OC section that very few students had problems with, but those classes filled up and they were stuck with Prof. Jones.

I’m not sure “just get over it” is the right response to these students and saying they are overly coddled just because they had trouble with one out of many, many professors at NYU. Sure, many of them are coddled, but I’m not sure this is the best story to show that.

But it all makes for good memes.

Pete

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#28

This story reminds me of an amusing incident when I was working on my Ph.D. There was a visiting professor, most recently from Oxford teaching a seminar on The Reconstruction of Fossil Hominid Behavior. It was quite large for a seminar, maybe 25 students. One’s grade depended entirely on a paper which one wrote. At the time, a Harvard grad student expected to get an A or B, maybe a C if they had really slacked off, and a D was a invitation to quit and go elsewhere. This professor was used to a different standard and handed out a couple of Fs, a few Ds, a bunch of Cs, something like 5 Bs, and 2 As. The students were outraged and went to the department head to get the grades changed … he just didn’t understand how things were done here. But, said head, pointed out that two people got As, so it was quite possible to do well, so nothing was changed.

Yes, I was one of the As and I had worked extraordinarily hard on the paper. It had more citations than any prior or subsequent paper I have done. And, it really greased my relationship with my dissertation advisor.

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#29

[quote=“tamhas, post:28, topic:77352”]
But, said head, pointed out that two people got As, so it was quite possible to do well[/quote]

Said Head is a bamboozler. It does not say that. That’s just skillful word usage meant to tell people to STFU and go away. It could be an indication that the fix is always in and this is just the cover story. That’s what it might be saying.

#30

The head of the Biological Anthropology section was W.W. Howells, one of the most distinguished men in the field. I am sure that his reaction had a lot to do with the students overreacting to the grade. One’s grades were simply not that important in the context of the Ph.D. program unless a pattern of bad work indicated that one was just not cut out for the scholarship the place required. What mattered was the dissertation itself.

As it happens, I got a D in another course. It was an odd course addressed at both senior undergrads and graduate students. The grad students had to do a research paper in addition to their other work. It turned out that the project on which I was going to do my paper became infeasible late in the term and so I took an Incomplete until I could come up with something else. In the fall term, I was taking a seminar in multivariate analysis, so I went to the professor and asked if he had a data set that he would like me to slice and dice using all the tools we were going to cover in the seminar. He was tickled and I set of with this data set of blood and physical measurement data from a three village tribe in the Solomon Islands. At the end, I wrote him a paper which concluded that basically there was nothing interesting going on in that data … might be something comparing to other data, but not in that specific group. He didn’t like me much, so he gave me a D, even though my class work was at a high level. Other professors knew the story and laughed, so the grade was never an issue.

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