If the general ward is the backbone of the clinic, then the head of the clinic must be close to it; indeed, it ought to be directly under him. The importance of the general ward and what it stands for as representing the general practice of medicine can be impressed on the younger members of the staff and on the students only if the relation of the chief to the ward is real and not fictitious. The whole atmosphere of the general ward, and thus the attitude of the future practitioners to the profession of medicine, is here set by the chief of the clinic, for it must always be remembered that standards of thought, as well as of action, are set from above. If the chief has any conviction as to the relation of doctors to their patients, to scientific research, or to any other aspect of his profession, this is his opportunity to bring it out, and in so doing he will determine the character of the clinic. The growing tendency for the chief to delegate ward authority and responsibility to his assistants, and to “spare himself” from making ward-rounds and doing ward-teaching, seems to me extremely unfortunate. The wards may be run as well or better, but the dignity of the general ward becomes impaired in the eyes of staff and students just as soon as the chief separates himself from it. This is one of the reasons that I have not adopted the usual plan of having a resident staff over the intern staff in the general wards. I want the interns to learn to assume responsibility for the patients and then to come directly to the chief with their problems, rather than feel that they can take things up only with subordinates. This arrangement leads directly to a consideration of the status of the interns. On this point I feel very strongly. They should be regarded as advanced students, and as perhaps the most important group of advanced students that we have. They come with minds, characters and personalities in the most pliable and receptive states, and can be affected in an extraordinary degree even by the atmosphere of the clinic. Their very manner of dress and parting their hair changes. Social ease, and manners that will play a large and legitimate part in medical practice, develop. At the same time intellectual changes of a far deeper character are going on, and the chief has an opportunity to set his seal on them. Provided the chief has anything in himself to offer, here is his chance to turn out every year a group of selected men who shall represent his ideas and his clinic all over the country, and it is to be hoped that they will gradually affect the type of medicine in many remote communities. Again, this cannot be done as successfully through subordinates as it is if the chief undertakes to keep himself close to the interns. It takes time, but it seems to me that the results are well worth striving for.