This does not mean that all the subordinate members of the staff, including (with rare exceptions) those whose time is largely devoted to research, should not undertake direct responsibilities for the ward routine. I believe, indeed, that such responsibilities form a very valuable part of their training--so much so that the men must be made to assume them even if they are reluctant and prefer to stick to their research. This can usually be arranged for in the vacations and at such times as their research is not at a critical point. It is very easy for a man to get absorbed in his own little problem, or in the somewhat larger field of which this is a corner, and to neglect the opportunity to get a training in internal medicine. At the present time there are many men who have been associated with American clinics for several years and who have had only the narrowest contact with medicine as a whole. Few of the men who become members of our departments of medicine will become stimulating teachers and still fewer will ever do important research work, but almost all can be made into first class clinicians. This is in itself a very important contribution, for the majority of the staff are eventually going to practice medicine, and the chief should do his best to see to it that every one who has been attached to his staff for three or four years has at least made a good start at becoming a high grade internist, as well as being an expert in some narrow field of medicine. The necessary training is, of course, best attained by assuming actual responsibility in general wards, and very often the men have to be driven, almost by force, from their own laboratories to take up what is sometimes spoken of a little casually or even cynically as “ward routine.” Here, again, the example of the chief is vital.