Physiology's Role in the Future of Medical Education

Dear editor (in response to “The Inevitable Reimagining of Medical Education,” published February 27, 2020):

As president of the American Physiological Society, I speak on behalf of a community of nearly 9,000 researchers working in the biomedical sciences. Many of us conduct basic research—foundational science upon which health and medicine are based. So, after reading Zeke Emmanuel’s recent editorial in the Journal of the American Medical Association, I was both intrigued and concerned.

I agree with Dr. Emmanuel that the evolution of education is well underway, accelerated by the coronavirus. But today, in the midst of a global pandemic, never has the importance of basic science been more clear. Scientists are working in partnership with clinicians to understand the mechanisms that drive the virus’ behavior, how it spreads and how patients recover.

It is times like this—when faced with a new disease that reacts differently than anything we’ve ever seen before—that the vital nature of a robust and thorough scientific foundation for clinicians is evident. We’re learning in real time how critical it is that medical doctors, physician assistants, nurses and pharmacists be well-equipped with a foundation of physiological knowledge that can be immediately applied.

In recent years, we have seen significant growth in students enrolling in physiology as an undergraduate major. That is a very good thing. But the study of disciplines such as physiology doesn’t and shouldn’t end early on in clinical education. Basic science is the basis of all clinical work, providing structure and context for all that comes after it.

In addition to highlighting the need for interdisciplinary collaboration and understanding, the virus has also shown us that working in a traditional classroom setting is no longer a given. Distance learning, with its benefits and limitations, is the new normal for now, and this moment in history very well has the potential to permanently change the way science and medicine are taught, learned and practiced. But this change should not include a narrowing of thought, experience or insight. This could easily become a consequence of a system relying on a just handful of experts to be the primary educators of the next generation of medical doctors.

The depth of understanding that students gain through close study with experienced, working scientists cannot be underestimated or replaced by canned lectures from a handful of researchers—no matter how esteemed they are. The specialization that has been cultivated at the many research centers in the U.S. and around the globe is beneficial to students and prepares them for the diverse array of health and medical challenges that we’ll need to face today and in the future.

The medical school experience, like so many other things in life, is not—nor should it be—one size fits all. I hope that we can embrace solutions that provide for an expedient path for young clinicians to move into practice. But we should also aspire to a system that provides our young people with exposure to the wide variety of important, fundamental medical and biomedical careers.

I believe that together, researchers, doctors and educators can find a way to provide a diverse basic science education that turns out smarter clinicians well-prepared to understand, diagnose and treat disease.

Linda Samuelson, PhD, FAPS
President, American Physiological Society