The essential role of basic science in medical education: the perspective from psychology.

Probably ever since the Flexner report endowed basic scientists with a central role in the education of doctors, the same basic scientists have been engaged in active, but circular, debates about why basic science really is essential to medical education. The arguments are generally at the theological level and can easily be dismissed by critics as self-serving. There is little evidence in the medical education literature to inform the issue; indeed, some studies, which I will review in more detail, suggest that clinicians rarely use basic science concepts. Of course, this does not imply that basic science might not have other roles in the educational process or that clinicians never use basic science concepts. It would not be easy to bring direct evidence to bear on the situation. The definitive randomized trial, in which the experimental group’s undergraduate preclinical education omits any contact with basic science, will likely never be done (although some might maintain that problem-based learning [PBL] is a close approximation). Consequently, if we are to bring evidence to bear on the question, the evidence must, of necessity, be indirect. That is the purpose of this paper — to review the evidence from education and psychology that might indicate whether there is an identifiable role for learning basic science in the education of physicians, and what form this learning might take. I shall begin by briefly describing 3 possible roles for basic science in the armamentarium of a practising physician.