The Hospital Bulletin, Vol. V, No. 3, May 15, 1909Various
History
The Hospital Bulletin, Vol. V, No. 3, May 15, 1909
Various
Medical colleges -- Alumni and alumnae -- Maryland -- Baltimore -- Periodicals; Medicine -- Periodicals
Teaching specialties to undergraduates must be carefully separated from
the same teaching to post-graduate students. The latter may be supposed
to have given such thought to their future career as to have reached the
conclusion that they wish to devote themselves to a certain line of
work. It is not these men whom I propose to discuss, save to say, in
passing, that the average six weeks' or two months' course offered by
post-graduate schools is totally inadequate. As a rule such courses
attract a large number of men who do little more than follow the
clinical work of some well-known specialist and pick up what they can.
Either prolonged hospital experience, as interne or clinical assistant,
or a special _individual course_, with a competent teacher, is needed
for a decent foundation in special work.
It seems to me that with undergraduate work the first important step is
to secure the attention of the men, and convince them that there is
something in the special course worthy of notice. There is a state of
mind, not unnatural to the undergraduate, regarding specialties. Most of
them propose to begin professional life as general practitioners. They
think they will never have use for knowledge in the so-called
specialties, and that the little they will need in order to get a
passing mark can be easily crammed at the close of the session. As a
matter of fact, it is easy to frame questions so that this “crammed”
information is of little use, and the most liberal grading hardly ever
brings such men _up_ to a passing mark. The mental attitude of these men
is unjust to themselves, their teacher and the patients who, in the near
future, will entrust to them their physical welfare. The very term
“general practitioner” implies a general knowledge of medicine. If one
lives in a city, where the services of specialists are readily obtained,
he may, if he desires, refuse certain cases, and take only such as he
wants—say such as belong to internal medicine. But in so doing he
becomes a specialist himself, and if he has neglected a properly
prepared special course for undergraduates while a student he will miss
information of great use to him as an internist. Many men, however, do
not practice where specialists _are_ easily obtained, and, perforce,
_must_ take cases which would logically come under one or other of the
recognized specialties. Here is a professional responsibility which it
is the aim and duty of a special teacher to enable his student to meet.
May I illustrate by directing attention to two troubles which it is my
own privilege to explain to our students? Iritis, in eye, and acute
otitis media, in ear diseases, are very common troubles. Both are, as a
rule, readily diagnosed, and both offer good prognosis. Yet the
responsibility for eyesight in one, and may be life in the other, may
depend on the diagnostic ability and therapeutic resources of the man
who _first_ sees the case. Men are blind and children dead because a
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