Basic neurological sciences in the medical curriculum.

Abstract

T HE past decade has witnessed dramatic developments in educational theory, methods of instruction, and student evaluation procedures at all levels from primary through graduate education. Medical schools have not been sheltered from this turbulence in education. Curriculum reform is everywhere the order of the day in theory, if not in practice. And many a curriculum committee must face up to the Herculean task of defining the basic core curriculum, and the mechanisms by which the individual student's career objectives may be attained while at the same time preserving some degree of faculty-student harmony. Evidently, in considering the role of the neurological sciences in the basic medical curriculum, it is appropriate to examine the possible consequences of curriculum reform, for these will surely have a most profound effect on the future development of neurology and neurosurgery. It is likely that in the near future neuroanatomy and neurophysiology will no longer command significant independent segments of the medical curriculum. And the same may hold true for required lecture and clerkship courses in neurology and neurosurgery usually given in the second and third years. Combined programs in the neurosciences will be developed in most core curricula, and I would hasten to add that for the most part these combined courses will probably be planned without extensive discussion between basic science faculties and neurologists and neurosurgeons. During the past year we have been intimately involved in implementing a new curriculum at the Albert Einstein College of Medicine. When I assumed the responsibility as Chairman of this Curriculum Committee, I saw as one of the important objectives of curriculum reform the development of a sequence of neuroscience courses extending from the core program through elective or supplementary courses. It was anticipated that this sequence could provide extensive training in the neurological sciences for those students seeking a career in neurology or neurological surgery. It will come as no surprise to learn that I have been accused by some of my colleagues of placing undue emphasis on a strong neurobiology course in the core curriculum at the expense of gross anatomy dissection, biochemistry labs, or other more traditional activities of medical students. Some of these protestations are not without justification, for I have long considered an interdepartmental course in neurobiology a most important feature of the core curriculum. The moral of this story is self evident --beware of the power of your curriculum committee! It may be on the side of the angels. It is also conceivable that a curriculum committee could formulate a curriculum that might virtually eliminate the basic neurosciences in the core program. In point of fact I learned recently that at one prominent medical school in Philadelphia neurophysiology was dropped from the core curriculum as a result of some unfortunate planning. In view of this, perhaps one can understand why that renaissance philosopher W. C. Fields had inscribed on his tombstone the final epitaph, 'l'd Almost Rather Be In Philadelphia. Having stated my prejudices in respect to the role of neurobiology in the core curriculum, it is pertinent to detail some of the objectives envisaged for this course. Planning for the core curriculum course in neurobiology at Albert Einstein has been delegated to an interdepartmental committee consisting of neurophysiologists, neuroanatomists, neurochemists, neuropharmacologists, and behavioral scientists in the medical school complex. Representatives