A Top Medical School Revamps Requirements To Lure English Majors

NEW YORK — You can鈥檛 tell by looking which med students at Mount Sinai were traditional pre-meds in college and which weren鈥檛. And that鈥檚 exactly the point.
Most of the class majored in biology or chemistry or some other 鈥渉ard鈥 science; crammed for the (the Medical College Admission Test) and did well at both.
But a growing percentage came through Icahn School of Medicine at Mount Sinai鈥檚 鈥淗u-Med鈥 program, which stands for Humanities in Medicine. They majored in things like English, history or medieval studies. And they didn鈥檛 even take the MCAT because Mount Sinai guaranteed them admission after their sophomore year of college.
Adding students to the mix who are educated in more than science is a serious philosophy at Mount Sinai.
David Muller is Mount Sinai鈥檚 Dean for Medical Education. 聽One full wall of his cluttered office is a massive whiteboard almost totally full with to-do tasks and memorable quotes. One reads: 鈥淪cience is the foundation of an excellent medical education, but a well-rounded humanist is best suited to make the most of that education.鈥

The Hu-Med program dates back to 1987, when then-Dean Nathan Kase wanted to do something about what had become known as 鈥.鈥 That鈥檚 the idea that the drive for straight As and high test scores was actually producing sub-par doctors. Students were too single-minded.
Kase 鈥渞eally had a firm belief that you couldn鈥檛 be a good doctor and a well-rounded doctor and relate to patients and communicate with them unless you really had a good grounding in the liberal arts,鈥 says Muller. 听听
So the medical school began accepting humanities majors from a handful of top-flight liberal arts schools after their second year of college. They continue to follow their non-scientific interests for the remainder of their college careers.
Mount Sinai takes care of teaching them the science they need during the summers. It鈥檚 often not the science studied in pre-med programs.
The current required pre-med sciences 鈥 including basic chemistry, physics, and calculus 鈥 date from the early 1900s, when an educator named revolutionized medical school by turning it into a truly scientific endeavor.
But those core science courses haven鈥檛 changed much since Flexner, Muller says, while science has.
鈥淭he science for 1910 is only nominally relevant today; yet that鈥檚 the filter through which everyone has to come,鈥 he said.
And it often weeds out people who could make excellent practitioners. Too frequently, he says, 鈥渋f you can鈥檛 get an A minus in organic chemistry, you鈥檙e not going to be a doctor.鈥
Such artificial barriers 鈥渆xclude people from medical school that we desperately need,鈥 he says.
Studies have shown that the Humanities in Medicine students are in med school as any other student. And they are slightly more likely to choose primary care or psychiatry as a specialty 鈥 both areas .
At a recent end-of-year party thrown by the students for professors and administrators, even the teachers had trouble remembering who was a 鈥淗u-Med鈥 and who wasn鈥檛.

Take Virginia Flatow, for instance. She鈥檚 a second-year student from New York. She majored in psychology at Bates College in Maine. Because she was also on the debate team, which meant lots of traveling to tournaments, she says she never would have been able to follow the classical pre-med track.
鈥淭here are very few courses – maybe I can think of one off the top of my head – where doing a lot of science in college helps you,鈥 she says. 鈥淭he rest of it is just a matter of how well do you study.鈥
Flatow agrees with a growing number of medical educators, for example, that organic chemistry is irrelevant for medical school. And that its difficulty discourages many students.
鈥淚 know so many people who took one semester of organic chemistry [and] dropped pre-med,鈥 she said. 鈥淢y brother was one of them.鈥
John Rhee, another second-year Hu-Med student, majored in public policy at Cornell. He was thinking about going into hotel management, but he decided to become a doctor after taking a summer job at a hospice.
鈥淭he experience was so deep for me,鈥 he said, 鈥減artnering with a patient through end-of-life care.鈥

Keith Love, a first-year Hu-Med from Colby College in Maine, said he originally gave himself a 鈥渮ero percent chance鈥 of going to medical school. He studied environmental science and anthropology in college, and still escapes Manhattan some early mornings to go birding. But, eventually, as he thought about how he wanted to make a difference with his career, he realized, 鈥渋t was medicine.鈥
These non-traditional students also serve another role 鈥 they round out what could otherwise be a class full of science wonks.
鈥淚 think the cross-fertilization of ideas that goes [on] …聽ultimately, everyone benefits from it,鈥 said Harsh Chawla, a third-year student from Danville, Calif. He did the traditional pre-med program, majoring in biology at the University of Southern California.
The effort has worked so well, in fact, that Mount Sinai is expanding it, opening it to students in any major from any college or university. Eventually half the class will be admitted from a slightly reconfigured program, which goes by the new name 鈥淔lex-med.鈥
Back in his office, Muller shows visitors his commanding view of the East River and East Harlem, 鈥渨hich is sort of the core community we serve as a medical school.鈥

And while he describes his own pre-med training as 鈥渃ookie cutter,鈥 Muller has done his own share of thinking out of the box. Among other things, he is nationally recognized for helping create the largest academic for patients in the nation.
But what would he have pursued in college had he not headed straight onto the science track?
He thinks for a moment. 鈥淟iterature, English lit,鈥 he says in a wistful kind of way. 鈥淚 read voraciously as a kid and that almost came to a complete standstill in college because there was just no time to breathe.鈥
And can pursuing different interests really make a better doctor? Of that Muller is confident.
鈥淧eople who look at the same problems through different lenses will make us better in the long run,鈥 he says. 鈥淣ow, can I prove that鈥檚 going to be the case?聽 No, but I鈥檇 like to believe that it is.鈥
This story is part of a reporting partnership between and Kaiser Health News.