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In Reply: None of the writers defend the need for calculus. And none dissent from the need to substitute genetics, molecular biology, biochemistry, ethics, psychology, and statistics as premed requirements. Disagreement seems limited to the value of organic chemistry and physics.

Dr Kramer believes that organic chemistry is the most important premed requirement, not because it is intrinsically interesting or enlightening, but because it helps instill rigorous thinking, and helps future physicians develop "an organized, systematic, and creative approach" to problems. Biochemistry, genetics, and especially statistics can instill the same rigorous and systematic thinking. These courses have the added advantage of being more relevant to actual medical practice than organic chemistry.

Drs Higgins and Reed contend that basic concepts in organic chemistry and physics are useful to medical students. However, a year-long biochemistry course would certainly have a few weeks devoted to basic organic structures and synthesis reactions. Such a . . . [Full Text of this Article]

Ezekiel J. Emanuel, MD, PhD
eemanuel@cc.nih.gov
Department of Clinical Bioethics
National Institutes of Health
Bethesda, Md

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