Evolution course for medical students at the Universidad de Chile

A brief overview of the development of an Evolution course for medical students at the Universidad de Chile

By Angel E. Spotorno O., PhD

Programa de Genética Humana, ICBM,

Facultad de Medicina, UNIVERSIDAD DE CHILE

In the last nine years, about 200 premedical students per year are taking a basic course of Evolution specially designed for the medical curriculum in our Facultad de Medicina at Santiago, Chile. I will begin describing how such a course was included in the curriculum, then the content and main features of the first version and how it was received by the students, as well as its principal modifications through time.

The first version was designed in the context of a medical curriculum reorganization in 1998. The Commission in charge, which included the Head of the Medical School whose husband was a senior anthropologist, thought that a short course in Evolution might integrate the large group of new basic courses called Scientific Fundaments of Medicine. Therefore three local Faculty professors, two geneticists and one anatomist, were requested to design it. We proposed a 46 hr course to be given by the end of the fifth university year.

The general goal was that, by the end of the course, the student should be able to evaluate the biological nature of the human species in the context of its origins, evolution and Pleistocene/present ecology, and to analyze the adaptations of the human body and its biomedical implications from Evolutionary Medicine. The first chapter on Hominid Evolution included six lectures: Evolutionary theories and the Table of 4 Areas (Spotorno 2005), natural selection, hominid fossils and their ecology, molecular phylogenies, hominid ontogenies, and biological/cultural evolution. We also designed seven Lab-Seminars for small groups on Biometry of hominid footprints (use of Excel program), Selection in newborns (Spotorno 1998), Geometric biometry of skulls (TPS program), and molecular (MEGA software) and chromosomal phylogenies of hominids.

The second chapter on Evolutionary Medicine included five lectures on Natural drive, the new paradigm of Evolutionary Medicine, species and subspecies, human biodiversity and Amerindian peoples, and co-evolution. The Lab-Seminars were focused on Viral phylogenies, lactose intolerance, and the initial presentation and discussion of an individual Project entitled “Evolutionary Medicine of …” (a disease, a symptom or a trait to be chosen by each student). The final Project was given a 20% of the final grade.

From the beginnings in 2002, and during the first four versions of this course, we introduced several resources for student support, inspired by similar or related courses at the University of Michigan, Universidad de La República (Uruguay), or ENSI activities. Every student received copies of all handouts, some chapters previously published in Spanish (Spotorno 1991; Spotorno 1993), or translations like Nesse and Williams general paper (Nesse & Williams 1999). The book of the latter authors was required reading (Nesse & Williams 2000).We also designed a particular WEB site (http://docencia.med.uchile.cl/evolucion) with links to relevant sites, as well as additional surveys for students. Many of them declared their enthusiasm for the course, particularly the individual Project, but about a third strongly disagreed. A student even proposed its replacement by a course on Surgical sutures; the Head of the Medical School replied that “you soon will be tired of sutures”. Another frequent criticism stated that it was a basic course, and that the Cell and Genetics course were too far away. Therefore, the course was moved to the fourth semester, after a new Genetics course.

The 2005 version grew to 70 hr, and included Population Genetics, taken from the required Genetics course. The 2010 version now displays three Units: Principles of Population Genetics and theories of organic evolution, Main landmarks during the evolution of the hominid lineage, and Basic principles of Evolutionary Medicine. Its general objectives are that the student should be able to apply such principles to past and present human populations, recognizing the main aspects of evolutionary processes and theories, to describe and identify Homo sapiens as a polymorphic, neotenic and vulnerable biological species in the context of its origins and changing ecological niche, and to explain the inheritance, variation, and evolution of some diseases and unique human traits.

Some Lab-Seminars were added or modified. They included two PBS videos with observation guides, “The case of AIDS: construction of hypothesis and phylogenetic inference”, “Changes in Hardy-Weinberg equilibrium. Effects of natural selection” (use of Populus software), “Panmixia and sociocultural factors in Chilean populations” (mother-child AB0 blood groups in two contrasting hospitals), “The color of human skin: drift or adaptation?” (use of ImageJ software to measure face brightness in pictures of different peoples, including the student one, and its correlation with correspondant geographic sites in a global UV map), “Hominid skull morphometry and neoteny”, “Paleo-pathology of extant and extinct Andean populations”, and “Diseases of civilization: evolutionary approaches” (construction of Tables of 4 areas for obesity and mammary cancer). New resources were an Evolutionary Medicine review in Spanish (Spotorno 2005), as well as CDs with guides for homework, relevant materials, raw data, links and papers in English and Spanish. This second version was positively evaluated by nearly 80% of the students year after year, although a very few remain skeptics.

The medical and biomedical curricula for eight professional careers in our Faculty are now facing a new process of innovative reorganization and integration. Evolution, as the most inclusive and powerful explanatory body of biological knowledge, might provide an efficient and integrative core for the vast amount of mechanistic and dispersed knowledge now required by our biomedical students.

Angel E. Spotorno O., PhD

Programa de Genética Humana, ICBM,

Facultad de Medicina, UNIVERSIDAD DE CHILE

Santiago 7-CHILE

e-mail: [email protected]

REFERENCES

Nesse, R.M. & Williams, G.C. (1999) Evolución y orígenes de la enfermedad. Investigación y Ciencia, 1-12.

Nesse, R.M. & Williams, G.C. (2000) ¿Por qué enfermamos? (Trans. ed. Vol.). Barcelona, España: Grijalbo Mondadori, pp. 344.

Spotorno, A. (1991) Origen y evolución de la especie humana (Trans. ed. Vol.). Santiago, Chile: Centro de Extensión Biomédica Fac. de Medicina, Pages pp. 48.

Spotorno, A. (1998) Evolución. In: L.E.g. Walker, A. Spotorno (Editor Asesor). (Eds.), Problemas de Genética. Editorial Universitaria, Santiago, Chile, pp. 339-358.

Spotorno, A.E. (1993) Teorías de la evolución. In: A.E.S.y.G.H. (eds.) (Eds.), Elementos de Biología Celular y Genética. Facultad de Medicina, U. de Chile, Santiago, Chile, pp. 340-353.

Spotorno, A.E. (2005) Medicina Evolucionaria: una ciencia básica emergente. Revista Médica de Chile, 132, 231-240. (available at http://www.scielo.cl/pdf/rmc/v133n2/art13.pdf)