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To compare with the foregoing full courses the course of lectures at two The course of lectures of the medical depart
Introductory: Chemical and histological composition of the
Physical properties; heat. Alimentary canal..... Normal histology:
histology of tumors.
Functions of the
spinal cord and
Proximate principles Veins; lymphatics... Functions of the of the human body.
a One lecture per week will be devoted to the subject of hygiene.
All teachings illustrated clinically in the amphitheater of the Charity Hospital and at the bedside in the wards of the same institution.
schools still retaining the nongraded system are given.
ment of The Tulane University of Louisiana.
c Diseases and injuries of genito-urin ary organs, syphilis, and many other affections, not mentioned above, are demonstrated in the amphitheater and wards of the Charity Hospital. d Surgical diseases of women are taught in the wards and amphitheater of the Charity Hospital.
Schedule of didactic and clinical lectures given in the Long Island College Hospital and the Hoagland Laboratory during the regular term.
8 a. m.
Tuesday. Wednesday. Thursday.
histolog y and pathological anatomy, Professor Van Cott, Hoagland Laboratory. Practice of medicine, Professor McCorkle.
Practical histology and pathological anatomy, Prof. Van Cott, Hoagland Laboratory. Practice of medicine, Prof. McCorkle.
11 a. m.
Clinical teaching in the wards of the hospital and maternity, general clinics in the
chemistry,2 to 3.30 p.m., chemical laboratory.
Practical anatomy.in dissecting room.every evening (except Sunday) from 8 to 10 p. m., Dr. Wm. W. Browning, demonstra
SUGGESTIONS AS TO HOW THE STATUS OF THE MEDICAL PROFESSION MAY BE ADVANCED.
In response to an inquiry for opinions as to the manner in which the status of the medical profession might be advanced, as far as it is influenced by the instruction in a medical school, about fifty replies were made, all, with three or four exceptions, from "regular" schools. These are grouped under four heads: Suggestions that all candidates be examined and licensed (a) by State boards, (b) by national boards, (c) that the course be extended two or three years, and (d) suggestions not falling in a, b, or c.
The drift of the suggestions in regard to the establishment of a State board is that it should examine the student as to his competency to practice medicine after he has obtained a certificate or diploma from a medical school or college, the State examination to be independent of the college. The dean of the Yale medical school puts the matter thus: "(1) No practice without registration; (2) no registration without diploma or examination; (3) an impartial board to determine what diplomas could be registered (desirable for effect on schools and as best meeting the conditions in the different States); (4) registration only by examination, but not until conditions are more uniform in different States."
In eight cases a national board (or boards) of examination is suggested. In two of these the matter is expressed by saying that it would be of great advantage if the laws relating to medical education were uniform throughout the country.
A third of the deans think that the course should be lengthened to three years of lectures or graded course, and in some cases four years of study. As this is what is being very rapidly done, no comment is required.
In the miscellaneous category are suggested a preliminary examination, more laboratory work, and compulsory graduation from a medical college. From lowa it is answered: "A change in the law that now requires a student to study practical anatomy and then makes him a criminal for obtaining the material would materially advance the status of the profession." Another correspondent says: "The first law in Tennessee was passed by the legislature of 1888 and 1889. Having gained this one great step I think it unwise to attempt more too soon lest reaction result and we lose all."
Reply from the faculty of the medical department of the University of the State of Missouri.
Dr. WILLIAM T. HARRIS,
Commissioner of Education, Washington, D. C.:
DEAR SIR: Dr. A. W. McAlester asks me to reply to the request made on the back of the circular sent out by your Bureau for the purpose of obtaining statistical information of the medical schools of the country. I do so with some diffidence, and beg to call your attention to two things in this connection:
The first is, that length of course should, in my judgment, be measured by something else or additional than mere length of time; system, manner, and kind of instruction are of more importance in laying the foundation of a good medical education than time. The knowledge and mental discipline which the average medical student brings to the school or college of medicine is limited and deficient; to what extent this is the case no one connected with any medical school likes to tell. Such as he is, the medical student, hears five or six or even seven lectures a day; no one, I presume, will affirm that he masters them; and when the process is repeated another term, and may be a third, any general discernment has been sacrificed for the possession of disjointed and loose parts. The more a student at the beginning of his career is encouraged to attend to clinics and hospital practice, the more certain is this result attained; a certain handiness has effectually taken the place of knowledge. There are three things to counteract and overcome these tendencies:
1. A graded course, strictly adhered to and guarded well at the entrance; students should be made to take a narrow path rather than to spread themselves over the whole subject.
2. Lecture and text-book instruction not merely descriptive, but to stand in organic relation to the whole, and to be in themselves logical treatises of the subject they deal with.
3. Lectures to alternate with recitations; no quizz classes, where the aim is to rote and cram, but proper lectures and wise questions to strengthen as well as to test the intelligence, understanding, and progress of the students.
The other point is, that a difference should be made between a college of medicine and a medical school; the former teaches medicine as a science, the latter mainly as an art; the former attempts to make scientific physicians, the latter practitioners. A State university has no more business to make practitioners in medicine or advocates in law than it has to make carpenters or shoemakers. If the State desires to do so, it could establish technical or trade schools, of which the so-called agricultural and mechanical colleges are types. They stand in my judgment coequal with the university, each called into life by the foresight of the General Government, and each for a distinct purpose, their connection being, I take it, somewhat like this:
I. State university:
a. Academic college.
b. College of medicine. c. College of law.
II. Agricultural and mechanical college:
b. Mining school.
This dissociation between the schools and colleges could of course be carried farther, but as I have already spoken at some length, I will only add that I believe it to be rash to set up the claim that a medical graduate is, in virtue of his graduation, a skillful and experienced physician; he should, after graduation, receive one or two years hospital practice, which in no case is rendered unnecessary on account of clinical attendance while a student.
Reply from William M. Thornton, chairman of the faculty of the University of Vir
The following are recognized as the reforms most urgently needed in medical education:
1. The separation of the teaching and licensing bodies already carried out in Virginia should be adopted in all the States. This reform was advocated by the late Prof. James L. Cabell, of this State and University, in 1847, in an address before the American Medical Association; was persistently urged by him, and was finally carried into effect in 1885 in Virginia.
2. The grading of the course of medical studies and the inclusion of biology and comparative anatomy, as follows:
First year course: Chemistry, physics, biology, and comparative anatomy, with laboratory practice in each case.
Second year course: Human anatomy, physiology, histology, with laboratory practice in each case.
Third year course: Pathology (with laboratory practice), obstetrics, gynæcology, surgery (with laboratory practice), practice of medicine, materia medica, medical jurisprudence, clinical surgery.
3. The extension of the term of study to nine months in the year. The step indicated in 3 has been approved by the faculty, but the visitors consider it one for which the public is not prepared.
WILLIAM M. THORNTON,
Reply from H. D. Didama, M. D., LL. D., dean of the College of Medicine of Syracuse University.
"If you had asked for opinions instead of information I might have answered: "Observation proves that higher matriculation requirements and better systems of education do not originate with the great schools in the State of New York, but are forced upon them by the profession through the legislature,
"The schools did not adopt a matriculation examination of any value. Some had no examination whatever. Most of them had been content with the old unnatural two six-months' courses, both exactly alike, so that if the student had a good memory one course would have been all sufficient.
The profession should demand enactments requiring fitness at the entrance, a thorough graded course of three years of eight months each, and a rigid examination at the termination of the three courses, if not at the end of each year. But you asked only for information, and I forbear." • "H. D. DIDAMA,