The Mail

To the Editors of The Crimson:

The only flaw in an otherwise perceptive, well-written editorial entitled "Defeating Doctors" (Feb. 21) is the paragraph down-grading the importance of organic chemistry and other introductory science courses in producing competent practising physicians. From my brief experience in medical school, I must admit that Harvard's notorious organic chemistry course helped me understand some of the mechanisms and basic principles of biochemistry. Biochemistry, in turn, is important because medical science is exploring with increasing success the processes of life and of disease on a molecular level. To know what lab tests to order, how to interpret their results, and to be able to understand the relevant literature in clinical medicine, an elementary knowledge of biochemistry is important.

Chem 20, Harvard's organic chemistry course, nevertheless has serious flaws. The professors have failed to make the course relevant to many of their premedical students. Although the second semester becomes more interesting because organic mechanisms are applied to biochemistry, the first semester neglects the medically relevant side of organic chemistry. It seems that the professors teach organic chemistry for the benefit of the few students scattered through the lecture hall who may pursue a career in pure organic chemistry research, rather than for the benefit of the hundreds of students who hope to go to medical school.

The course has another serious defect because it presents the relevant chemical reactions in the lectures, but then tests the students on a much more sophisticated level of problem-solving, without teaching the students how to solve these problems. Premeds are forced to bridge the lecture/exam gap for themselves, or else face disastrous consequences. The 11 per cent of the class who received D's or E's this year reflects the lack of being taught how to solve the problems on the exams, as much as it indicates any disinclination for hard work or for science. When a professor flunks a student, particularly in a subject like organic which requires a certain art in addition to brute memorization, it is an indictment of the quality of teaching.

The grading policy in Chem 20 also has serious faults. When the Harvard median is a B minus, half the Harvard premeds are automatically in serious trouble. The professors refuse to realize that any grade below a B minus virtually insures rejection from medical school (everyone is quick to think of the exceptions, but that just shows how rare they are). The professors are neglecting the national aspect of medical school admissions. Although this is Harvard University, most medical schools across the country do not give special consideration to this fact. They do not have the time to investigate the particular difficulty and rigorousness of Harvard's organic chemistry course. Beseiged by applications, these schools feed the grades of applicants into a computer to screen out most of the candidates. This is particularly true of the state schools, which have more than half the medical school seats available. In other words, Yale University Medical School may give an understanding nod to the exceptional candidate with a C plus in organic. But Ohio State, with a more rigid, less individualized admissions policy, will probably send out a rejection letter to any candidate with a C plus, exceptional or not. When I mentioned the medical school admissions issue to the organic chemistry professors last year, they replied to the effect that "What the medical schools do with the grade is their business. We're just teaching the course." This attitude is less than optimal.


The danger of Chem 20, with its median that is inevitably set at a B or B minus, despite anything the professors may tell the class, (such as, "We are prepared to give all of you A's if you master the material.") is that it creates an atmosphere where students are reluctant to help each other, afraid that they will give their classmates a crucial margin of understanding. The environment of students fighting each other in subtle and unsubtle ways is detrimental to academia. The biggest danger from excessive competition in Chem 20 is that it may create a student who is unlikely to become a humane and considerate physician.

I shall make two suggestions to improve the current unsatisfactory situation. First, another course in introductory organic chemistry should be set up for those students not interested in medicine. The remainder, which would be most of the current class, would be taught organic chemistry in a way which emphasizes its applications to biochemistry and to medicine, thus making the relevance of the material more evident and hopefully giving students some motivation to study the subject besides fear of a non-honors grade.

The second suggestion, perhaps more controversial, is for the professors to decide at the beginning of the year precisely what material must be mastered for an introductory course in organic chemistry. All students who fail to reach this crucial, basic level would be given an E. All other students would be considered equipped to handle biochemistry and the pursuit of medicine. They would be given grades ranging from an A to a B minus. Under this system, competing against course material rather than classmates would no longer be a myth. And medical school admissions computers across the country might spew out less rejections for Harvard premeds. Many courses in this and other colleges are considered honors courses. Chem 20 should be one of them. Samuel Z. Goldhaber '72   [Harvard Medical School '76]