The summer 2006 edition of Stanford Medical Magazine has devoted their issue to “The evolutionary war.” Being the alumni magazine of a medical school, of course they have an article on “Darwin in medical school.” It’s a nice overview, discussing a bit of the history of “Darwinian medicine” and the pros and cons of teaching it in an already over-scheduled medical school curriculum. More after the jump…
Randolph Nesse, who I mentioned in this post and is considered one of the fathers fo “Darwinian medicine,” argues for the inclusion of evolutionary medicine in med school curricula:
…They know that deans feel beleaguered by demands to add new subjects to the already crowded schedule — nutrition, alcoholism and aging to name a few. “But still, it’s preposterous that evolution is not a part of medical education,” says Nesse. “Evolution offers a broad framework on which you can organize and understand all kinds of facts and principles. It ties together medical education instead of leaving it hanging as 50,000 discrete facts.”
Stanford’s assistant dean for medical ed largely agrees, but notes that much of the evolution discussion is integrated into the classes themselves.
“It is impossible to be a good physician without understanding the evolutionary process,” says Julie Parsonnet, MD, senior associate dean for medical education. She notes the importance of evolutionary explanations for antimicrobial resistance and the emergence of new infectious diseases, as well as more complex chronic diseases, such as the cardiovascular problems that piqued Yun’s interest years ago.
Stephen Lewis of the University of Chester in England, a proponent of evolutionary medicine, notes one reason for hesitation to include specific courses on the topic:
Add to this the fact that the field has failed so far to provide clinically useful findings and you see why medical schools lack interest, says Lewis. “There is much about explanation and understanding but little about treating and curing,” he says.
(This is along the lines of what was discussed by commenters in this previous thread).
They do, however, note that two Stanford docs take the idea seriously enough to apply evolutionary concepts to the creation of new medical devices:
Of the billion dollars under management, the firm has invested $350 million in health care, much of that in companies that produce devices that make sense from an evolutionary standpoint. In other words, stents are out; gentler procedures that don’t escalate the trauma response are in. Drug-delivery systems for treating kidney disease intravenously are out; delivering the drugs directly to the kidneys to bypass the trauma response is in.
So even if evolutionary considerations aren’t being taught up-front, at least they’re being applied.
Finally, in the sidebar to the article, they also note some other applications of Darwinian principles to medicine, with some “myths” and evolutionary insights that shed light on treatment:
Myth: Bacteria and viruses become less virulent the longer the interaction with the host species has been going on.
Myth: Aging happens because parts wear out.
Myth: Annoying responses to infection — such as fever, anemia and diarrhea — are unnecessary and should be alleviated with drugs.
I’ll leave it up to y’all to check out the article and see how they apply evolutionary biology to those claims.