The literature doesn't actually call for banning biochemistry or metabolism from medical education — it calls out rote memorization specifically as the flawed teaching/testing method. Framed that way, here are the strongest evidence-based arguments against it:

1. It creates excessive cognitive load that crowds out real understanding. Cognitive load theory distinguishes intrinsic load (inherent task complexity), extraneous load (unnecessary effort, like memorizing enzyme/intermediate names), and germane load (the effort that actually builds usable mental schemas). Spicer et al. argue that forcing students to memorize every enzyme and intermediate in a pathway consumes cognitive capacity that should instead go toward understanding regulation, integration, and disease relevance ("Medical Biochemistry Without Rote Memorization," Medical Science Educator, 2019, PMID 34457455).

2. It rewards surface learning over deep, applied learning. Multi-institution survey data (481 students across three US medical schools) found that when students were given a reference map of metabolism instead of being required to memorize it, they reported shifting from surface memorization to "deep learning and applied understanding," better organization of concepts, and reduced test anxiety (same study, PMC8360249). This suggests memorization-based testing measures recall, not clinical reasoning.

3. Memorized facts are the fastest thing forgotten and least useful at the bedside. Biochemistry has long been criticized as being "commonly perceived as focusing on recall of facts irrelevant for patient care" despite the fact that metabolic disease (diabetes, obesity, inherited metabolic disorders, lipid disorders) is a growing share of clinical practice. The mismatch between how it's taught (memorize the pathway diagram) and how it's used clinically (recognize a metabolic block from a lab pattern or phenotype) is the core objection (PMID 34457455; Ramasamy et al., J Clin Diagn Res, 2013, PMID 23634431).

4. Real-world practice is open-reference; memorization-heavy exams are not. Physicians in practice look things up constantly (UpToDate, drug references, pathway charts). The MetMap initiative was explicitly framed as "a step toward open-reference exams that reflect real-world practice" — the argument being that testing memorization trains for an artificial skill (recall under exam pressure) rather than the actual skill needed (reasoning with a reference in hand).

5. Chemical logic, not memorization, is what should transfer. Educators and biochemists (including practicing scientists commenting on the pedagogy) point out that metabolic pathways follow a consistent chemical logic — oxidation states, group transfers, regulatory feedback — and that treating them as arbitrary sequences to memorize actually obscures the transferable principles a physician would use to reason about a novel or atypical presentation, rather than just recognizing a memorized diagram.

6. It disproportionately burdens exams that already overload students. The IAMSE review of basic sciences in medical education notes biochemistry is usually front-loaded early in curricula specifically because later physiology, pharmacology, and pathology depend on its concepts — meaning excessive time sunk into pathway memorization early on has opportunity costs for building the conceptual scaffolding those later courses need.

None of these sources argue metabolism itself is unimportant or should be removed from the curriculum — they argue for replacing rote memorization with concept-based, reference-supported, clinically anchored teaching (e.g., the standardized MetMap now used at multiple US schools). "Banned" is a stronger word than the evidence supports; the actual reform movement is toward de-emphasizing memorization as the primary learning/testing method, not eliminating metabolic pathway content from medical education.

Recent evidence check: A search for meta-analyses/systematic reviews on this specific topic in the last 2 years returned no dedicated high-tier reviews (the strongest evidence remains the multi-institution MetMap study above and older curriculum-reform papers), so no contradicting recent consensus was found.