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This book raises fundamental questions about the propriety of continuing to use a premedical curriculum developed more than a century ago to select students for training as future physicians for the twenty-first century. In it, Dr. Donald A. Barr examines the historical origins, evolution, and current state of premedical education in the United States. One hundred years ago, Abraham Flexner's report on Medical Education in the United States and Canada helped establish the modern paradigm of premedical and medical education. Barr’s research finds the system of premedical education that evolved to be a poor predictor of subsequent clinical competency and professional excellence, while simultaneously discouraging many students from underrepresented minority groups or economically disadvantaged backgrounds from pursuing a career as a physician. Analyzing more than fifty years of research, Barr shows that many of the best prospects are not being admitted to medical schools, with long-term adverse consequences for the U.S. medical profession. The root of the problem, Barr argues, is the premedical curriculum—which overemphasizes biology, chemistry, and physics by teaching them as separate, discrete subjects. In proposing a fundamental restructuring of premedical education, Barr makes the case for parallel tracks of undergraduate science education: one that would largely retain the current system; and a second that would integrate the life sciences in a problem-based, collaborative learning pedagogy. Barr argues that the new, integrated curriculum will encourage greater educational and social diversity among premedical candidates without weakening the quality of the education. He includes an evaluative research framework to judge the outcome of such a restructured system.This historical and cultural analysis of premedical education in the United States is the crucial first step in questioning the appropriateness of continuing a hundred-year-old, empirically dubious pedagogical model for the twenty-first century.

This book will be of profound interest both to those responsible for carrying out national health care policy and to those who study health policy from an academic perspective.

At the outset these four works were obviously not intended as adolescent classics. All were published between 1950 and 1960 as ordinary trade books for adults. All were first novels. All were wel-comed - some of them quite rapturously - by reviewers as ''profound,'' ''daring,'' ''searing,'' ''of strong contemporary national significance,'' and so on. All sold well to adults. Three of them, perhaps even ''A Separate Peace,'' became ''in'' books among college students. Then each in turn moved down through the schools, two as far down as seventh grade, two actually to sixth. ''A Separate Peace'' has begun to fade a little, but ''To Kill a Mockingbird'' has been sold by the millions of copies to children and adolescents. All four still jostle ''Romeo and Juliet'' in middle school and high school reading lists. THE college students chose these books themselves; but high school students -even college-bound high school students - do not, by and large, choose their own reading. There are exceptions: sword-and-sorcery purveyors like Piers Anthony, for instance, seem to have a voluntary, word-of-mouth following, often considered flaky by the other students. But in general, the American adolescent is given books to read, and less often by his parents than his teachers. It is important to note that. It may explain a lot, for as we come to consider what else these four books have in common, there is a lot that needs explanation. Now there is nothing new about giving children books that were written for adults. ''Robinson Crusoe'' and ''Gulliver's Travels'' have been given to young children (though usually in edited-down versions) for a hundred years or more, ''Macbeth'' and ''Julius Caesar'' for much longer. But that is an entirely different matter. ''Macbeth'' and ''Julius Caesar'' are about the adult world. Presumably they served school children as cautionary tales, as preparatory literature. ''Robinson Crusoe'' and ''Gulliver's Travels'' are about adults who are forced to confront special worlds, fabulous worlds, just the way children have to learn to confront the adult world. So far we are dealing with novels altogether different from the older books about childhood and adolescence written for adults and then wisely or unwisely given to children and adolescents to read. ''David Copperfield,'' '' Oliver Twist'' and ''Great Expectations'' are stories about growing up and the difficulties of growing up. ''Catcher'' and ''Lord,'' as stories, are about not growing up; and to the reader who has not grown up enough to discern their moral structure, they may even provide half-seductive images of alienation. After all, there is a glamour about being Misunderstood, Screwed Up, On the Ragged Edge, Dangerous. By comparison, maturity is a drag. Somehow one feels that Holden Caulfield, whose symbolic dream was to be the protector of children, would not have given children ''The Catcher in the Rye'' to read. One feels that the impulse to give children ''Lord of the Flies'' to read would itself have been an apt subject for [William Golding].