Practicing What You Preach

AFTER EXCORIATING two of Harvard's traditional bastions of power and elitism--the Business and Law Schools--President Bok has now trained his analytic guns on a third: the West Point of professional health care, the Harvard Medical School. Just as Bok in recent years lambasted the way this country educates its lawyers and businessmen, his annual report released recently gives a gloomy diagnosis of the current state of medical education.

While Bok's analysis and suggestions were broad-ranging, his principal message was loud and clear: med schools aren't doing a good enough a job in preparing students for the fast-changing world of professional medicine. Their faults include, according to Bok.

emphasizing basic science to the detriment of medical ethics, psychology, statistics, and other non-scientific subjects important in treating illnesses.

offering too many lectures and not enough tutorials and discussions that allow students to think analytically, rather than simply mimic rote facts.

harming undergraduate liberal arts curricula by fostering extreme competition for grades and a bias towards science courses.

While these and other criticisms are not entirely new, as Bok admits, he believes the time is unusually propitious for reform. "Many forces have combined to alter the body of medical knowledge, the way in which doctors practice their craft, and the system of delivering health care services in the country," he writes. These forces have propelled many of the very questions Bok raises to the top of the agenda in med schools and hospitals around the country.

Bok surely deserves praise for keeping the heat on. It is rare that Bok puts his Mass Hall bully pulpit to such good use in national debates, and we welcome the largely common-sense analysis and proposals with which he has confronted doctors. But as is so often the case with Bok pronouncements, his words carry a ring of irony given that it is Harvard that is one of the worst perpetrators of the ills he is trying to correct.

To his credit, Bok forthrightly brings the Harvard med School to task for shortcomings. He notes, for instance, the dearth of required courses in the behavioral sciences he sees as so necessary to a well-rounded medical education. And he offers encouraging words of support for the development of a new Med School curriculum that would place greater emphasis on emotional and psychological aspects of a doctor's training and which might lead to a rethinking of premedical requirements.

As anyone who has taken Chem 10 can attest to, Bok's condemnation of the, premed syndrome and pressure is the most welcome to undergraduates, especially those who are interested in pursuing a career in medicine. There is talk right now of revising premed requirements so as all can be completed in two full-year courses. There is concern over the quasi-dictatorial hold medical school admissions committees hold over premed course selection.

If Bok were truly concerned about the state of medical education in this country, he would step up pressure on Med School and faculty officials to continue reforms in these areas right now. That would mean more than all the pronouncements his well-meaning Mass Hall paper mills is able to churn out.