Evolution in Health and Disease: The Role of Evolutionary Biology in the Medical Curriculum

Abstract

Recent work has emphasised the relevance of evolutionary processes to medical thinking and practice. However, medical curricular revisions, in reducing basic science content, have often excluded evolution. This study establishes the extent of inclusion of evolution in UK medical courses, reports on the level of medical student rejection of evolution, and on student reactions to a special study module (SSM) approach to evolution’s relevance to medicine.A questionnaire survey was sent to course directors of all UK medical schools on evolution in the curriculum. First year medical students completed a questionnaire on their acceptance or rejection of evolution. Students completing an SSM on Evolution in Health and Disease evaluated the course by questionnaire.Only 37% of responding medical schools included evolution in the curriculum. 10% of medical students surveyed did not accept long-term evolution, though most rejectors accepted that natural selection works within species. Rejection of evolution was firmly linked to a religious belief in a creation account, not to any consideration of the evidence. Rejection influenced attitudes to the intergenerational equity issue of drug resistance evolution. Students taking the SSM on Evolution strongly appreciated its relevance to medicine.It is recommended that evolutionary biologists should urgently work with medical schools to develop courses in evolutionary medicine that will help clinicians in training to appreciate the importance of evolutionary processes in medical practice.

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