The Cavalier daily :: Thursday, April 9, 1970 :: University of Virginia Library

Despite efforts in recent years
by the administration and faculty
of the University's School of
Medicine to correct and improve
the curriculum some medical students
still claim that not enough
has been done to better the
educational structure of the medical
school.

A step forward was made about
six years ago when the medical
school and the fourth year of study
completely elective. This allowed
what is called "voting with your
feet," which means that students
showed which courses they thought
were better by choosing to take
them, and did not take courses they
thought were irrelevant or poorly
taught. This year the third year was
made elective also.

In September of 1968 the
two-year basis science curriculum,
which all students are required to
take, was compressed into a year
and a half. But according to Steven
Leichter, a fourth-year medical
student, the basic problems of the
curriculum have not been solved.

Mr. Leichter, who is the chairman
of the Student Curriculum
Committee of the Medical School,
complained that the basic problems
are caused by "the political structure
of each department in the
medical school." He explained that
each department teaches its course,
such as gross anatomy, without
relating it to other courses or
aspects, especially the clinical aspect.

"Each department is run like a
feudal principality," said Mr. Leichter,
"and any attempt to change the
structure would require tremendous
upheaval."

The change two years ago to
delete the basic science requirement
was, according to Mr. Leichter,
"theoretically good on paper but
not in practice." Whereas the
change was expected to do away
with irrelevant course material, "All
material was simply compressed so
that you learned the same amount
in less time," he said.

Another area that Mr. Leichter
feels should be corrected is testing
and grading. "Instead of being
tested on general concepts, a
student is asked to regurgitate trivia
given in lectures," he said. "Learning
a lot of trivial facts is fine if you
are going to be a biochemist or
research man, but not a doctor," he
added.

Since the basic science program
was compressed the number of
students flunking out or failing
courses has "skyrocketed." Mr.
Leichter claimed that out of an
average class of 86 between five and
seven students flunk out, the same
number drop out, and about one
third of the class had a "D" or
lower grade in a course. The
previous figures he said were one or
two flunking and the same number
dropping out.

What Mr. Leichter proposes in
order to solve the curriculum
problem is to have the basic
sciences taught by interdisciplinary
committees instead of having individual
basic science departments.
This change, he feels, would do
away with irrelevant material and
make the material more relevant to
a medical education.

"But a change of this sort would
require overthrowing the existing
departmental political structures,"
he added.

Beginning in the middle of a
student's second year, he studies
clinical practices. A second year
student is required to make clinical
rotations in neurology, psychology,
internal medicine, surgery, and
pedantries. Mr. Leichter said this
part of a medical student's curriculum
can be "routine, pointless, and
of little educational value."

On clinical rotation a student
works with a professor, known as
an "intending," an intern, a resident,
and the house staff. "The
question of how much value this
experience is depends upon how
much interest the intending takes
with the student," explains Mr.
Leichter.

Students are graded in clinical
rotations by subjective reports
made by the resident and the
intending under whom the student
has worked. Mr. Leichter said that
occasionally comments are written
about the student which are completely
unjustified and are based on
personality clashes between the
student and the resident or intending,
not the student's performance
on the wards.

"A student is never allowed to
see the report and consequently can
not defend himself," said Mr.
Leichter, "Also any constructive
criticism in the report is not given
to the student so you never know
when you are doing something right
or not or how to correct it."

This procedure "puts a tremendous
repressive atmosphere on
students in the wards," he added.
Mr. Liechter proposed that the
subjective reports be opened to the
students so they can see how they
have done or defend themselves
against unjust criticism.

On the whole, Mr. Leichter, the
Chairman of the Student Curriculum
Committee, thinks that the
basic problems in the medical
school are the lack of coordination
between departments and the lack
of feedback to students. Why these
problems have not been resolved is
the subject of a following article on
student-faculty relations in the
medical school.