Scientific Foundations for Future Physicians, a 2009 report of the Association of American Medical Colleges (AAMC) and the Howard Hughes Medical Institute (HHMI), proposes eight core competencies that pre-medical students should fulfill in their undergraduate education, as an alternative to the traditional required courses in the pre-medical curriculum. More recently, changes have been proposed for the MCAT to reflect this shift to core competencies. Despite the positive change toward core competencies, the proposed competencies largely ignore the importance of evolutionary biology, biodiversity, ecology, and environmental science in the pre-medical and medical curriculum.
In the AAMC-HHMI report, evolutionary biology is included to a limited degree in the pre-medical core competencies (Competency E8). In addition, the report includes ecological principles in the competencies for the medical curriculum (Competency M6), such as:
- "Apply the principles of host–pathogen and pathogen–population interactions and knowledge of pathogen structure, genomics, life-cycle, transmission, natural history, and pathogenesis to the prevention, diagnosis, and treatment of infectious disease."
- "Apply the principles of symbiosis (commensalisms, mutualism, and parasitism) to the maintenance of health and disease."
However, these ecological principles are not reflected in the pre-medical competencies.
Proposed Core Competency on Ecological Principles and Biodiversity for The Pre-Medical Curriculum
Competency: Demonstrate an understanding of taxonomic diversity and fundamental ecological processes and how they relate to human health.
- Discuss the features of the major phyla of plants, animals and microbes.
- Explain how bacteria differ from viruses and protozoans.
- Discuss the features that are common to parasitic worms, and distinguish them from free-living taxa.
- Provide an example of a pharmacologically active secondary metabolite that is unique to a single plant family.
- Discuss concepts of population growth and regulation.
- Explain how the population dynamics of a vector will influence disease transmission in a vector-borne disease.
- Explain the concept of carrying capacity and whether it is applicable to all species.
- Discuss the outcomes of species interactions.
- Define biodiversity and know how it relates to the prevalence of diseases like Lyme disease.
- Explain how host-parasite dynamics differ from other species interactions.
- Demonstrate an understanding of the impacts that humans have had on ecosystem processes and the importance of those processes.
- Explain what is meant by global climate change and how its consequences can impact human health.
- Explain the concept of ecological services from the standpoint of improving water and air quality.
- Compare the ecological correlates of disease transmission for people living in urban, suburban, and rural locations.
Scientific Foundations for Future Physicians, "Report of the AAMC-HHMI Committee" (AAMC, Washington, DC, 2009); www.hhmi.org/grants/pdf/08-209_AAMC-HHMI_report.pdf.
AAMC, "5th Comprehensive Review of the Medical College Admission Test® (MCAT)" (www.aamc.org/download/182662/data/mr5_preliminary_recommendations.pdf).
A Response from ESA's Education and Human Resources Committee (EHRC) in 2012
"Add Ecology to the Pre-Medical Curriculum," a letter initiated by members of EHRC and led by Dr. Chris Beck of Emory University in response to MCAT changes.
Dr. Chris Beck, et al. 2012. Add Ecology to the Pre-Medical Curriculum. Science: 1301. Science: 1301. doi: http://dx.doi.org/10.1126/science.335.6074.1301-a.
Frontiers in Ecology and the Environment
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One Health Initiative – an initiative to examine the relationship between animal and human health (http://www.onehealthinitiative.com/)
EcoHealth – the International Association for Ecology and Health (http://www.ecohealth.net/)