No, not a tasty, Swiftian type of proposal—this one is about medical education, evidence-based medicine, and woo. There has been much in the blogosphere lately about the infiltration of various forms of quackery into American medical schools. Medical training has been slowly changing over the decades, with more emphasis on the “human” in “human medicine”; students are seeing patients earlier in their training, and explicitly learning to listen and communicate. Unfortunately, this has served as a foot-in-the-door for alternative medicine.

Medicine has become a more difficult field of study over the years—there is more you need to know, and a different skill set than that used by physicians 40 years ago. Memorizing biochemical pathways are less relevant to the practice of medicine than genetics, statistics, and pharmacology.  Doctors must now be adept with evidence-based medicine in order to know how to properly evaluate and use all the wonderful new tests, machines, and medicines we’ve developed.  Medical students get a taste of medical statistics, but it usually takes a back seat to the more traditional medical sciences.  It’s time to put it up front.

I propose that EBM be an early requirement in medical schools, and that some of the “traditional” classes make way for it.  Or, in lieu of that, EBM should be incorporated into pathology, pharmacology, and other clinical courses.

There.  That’s it.  Modest, no?