HHMI: ULTIMATELY, WON'T THIS COME DOWN TO A SPECIFIC SET OF COURSES OR SOME OTHER WELL-DEFINED REQUIREMENTS A STUDENT WILL NEED TO PREPARE FOR THE MCAT [MEDICAL COLLEGE ADMISSION TEST]?

RJA: The appearance of this report couldn't have been better timed because another committee is reviewing the MCAT. To be frank, the MCAT will define specifics of the competencies to be tested. Changes to the test will drive changes in the curriculum—they need to change together to bring about reform. The critical element will be changing the MCAT and giving colleges enough lead time to rewrite courses to prepare students for the changed test.

HHMI: CHANGING UNDERGRADUATE AND MEDICAL SCHOOL CURRICULA WON'T BE EASY, WILL IT?

RJA: We thought there'd be enormous resistance to the proposed changes, but every medical school dean we surveyed was wildly enthusiastic. The same is true for most undergraduate faculty. The students I have spoken with have all said, ‘Can't you do it faster?’ Resource-rich schools are not waiting; they're making changes already. With the help of HHMI and other organizations, we want to make sure less wealthy colleges have the resources they need to make the changes. Underrepresented minorities come disproportionately from those schools, and we don't want to cut off that pipeline of future doctors and researchers.

Realistically, it will take at least five years and some say ten to have every student arrive at medical school with the competencies we'd like. It's not going to happen overnight, but when it does, I think it will represent a major transformation in medical education.

A physician-scientist, Robert Alpern focuses his research on the regulation of kidney transport proteins. The AAMC-HHMI report, published in June, is available at www.hhmi.org/grants/sffp.html.

Interview by Marc Wortman

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