Intellect, Memorization, and Medicine

To the Editor:

The courageous effort by Emanuel to outline a new pre-medical and medical curriculum has one contradiction and two omissions.

First, after advocating a year of biochemistry in the pre-medical curriculum, he rightly states that knowledge of the Krebs cycle generally has no practical use at the bedside. This contradiction suggests that devoting a year to biochemistry is excessive.

Second, there is a fundamental, yet unspoken truth about medicine: as an intellectual endeavor, it is extremely easy. While the hard sciences require detailed understanding and nuanced application of difficult quantitative principles, medical textbooks simply demand memorization on a massive scale. One could argue that mnemonic training is the greatest omission in medical teaching and that, of all pre-medical requirements, organic chemistry is the greatest developer of memorization skills.

Finally, I wish there were some way to teach humility more effectively and more permanently. Any physician not cowed by their own ignorance should be drummed out of the profession.