Page:Carnegie Flexner Report.djvu/194

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176
MEDICAL EDUCATION

be very definitely formulated; the course worked out aims to meet them. The accepted surgeons get in this way a concentrated practice drill in bacteriology, hygiene, and military surgery. The laboratories are excellently equipped, though cramped for space. The army school enjoys the advantage of contact with the great library and museum of the surgeon-general's office. The schools, as yet in their infancy, may not improbably develop into research laboratories dealing with the specific problems that crop up in naval and military service in various quarters of the globe.

Postgraduate, like other schools, vary in character. We have spoken of the best. The others are weak concerns wearing a commercial hue. The Brooklyn Postgraduate School, for instance, entertains less than half a dozen students on the average at a time, in a wretched hospital, really a death-trap, heavily laden with debt, and without laboratory equipment enough to make an ordinary clinical examination; the Kansas City affair had, when visited, no students in its improvised hospital containing 25 ward beds, only 13 of them occupied; it ekes out its opportunities with clinics at the public hospital. Chicago, varied and picturesque in this as in all else pertaining to medical education, supports four postgraduate institutions. None of them has a satisfactory plant. All are stock companies. Only unmistakable scientific activity could dislodge the unpleasant suspicion of commercial motive thus suggested. No such activity is in any of them observable. A cynical candor admits in one place that "it pays the teachers through referred cases;" in another, "it establishes the reputation of a man to teach in a postgraduate school;" in a third, "it pays through advertising teachers." In one a youth was observed working with a microscope. Inquiry elicited the fact that he was the teacher of clinical laboratory technique, lecturing in the absence of the "professor." The following dialogue took place:

"Are you a doctor?"

"No."

"A student of medicine?"

"Yes."

"Where?"

"At the Jenner Night School."

"In what year?

"The first."

A first-year student of medicine in a night school was thus laboratory instructor and pro tempore lecturing professor in clinical microscopy in the Chicago Polyclinic. Improved medical education will undoubtedly cut the ground from under the independent postgraduate school as we know it. This is not to say that the undergraduate medical curriculum will exhaust the field. On the contrary, the undergraduate school will do only the elementary work'; but that it will do, not needing subsequent and more elementary instruction to patch it up. Graduate instruction will be advanced and intensive,—the natural prolongation of the elective courses now coming into vogue. For productive investigation mid intensive instruction, the medical school will