valuable, so, it is urged, a formal training in the inductive handling of ascertained data may be of use to students whose logical habit has been none too strictly formed. "Let us assume such and such data: what do they mean? What would you do?" This is the essence of the case method, -a method, by the way, excellently adapted to class use, calculated there to develop the friction, competition, and interest which are powerful pedagogical stimulants. It is, moreover, economical, for it brings considerable numbers in touch with fertile teachers, at a minimum expenditure of time and energy.
The class in medicine has another use: it may be made the means of training students to use the "literature;" once more, of course, only by way of amplifying an actual sense-experience. One's own experience always falls short; yet without a very vivid realization of just what one's own experience is and means, one is in no position to use a vicarious experience intelligently. The careful taking and keeping of records is in the first instance the means of clarifying the student's own experience; the instructor's comments raise the questions which he may profitably investigate in the literature. The case record in full and an abstract of important publications on the same subject may well fill a regularly appointed hour given to informal conference and discussion. The student will thus get into the way of reading substantial journals and "running down" literature in the course of his actual practice.
It is a nice question as to how the student's time in the third and fourth year is to be apportioned between patient work, ward work, demonstrative and class exercises, and didactic lectures. The number of hours is itself necessarily elastic: for if the hospital is a laboratory, it is open at all hours, and, subject to the limitations fixed in each case by the condition of the patient, the wards may be used by students, even though no teaching is going on. The principle upon which division may be made has been, however, very clearly stated by Cabot and Locke. “Learning medicine is not fundamentally different from learning anything else. If one had one hundred hours in which to learn to ride a horse or to speak in public, one might profitably spend perhaps an hour (in divided doses) in being told how to do it, four hours in watching a teacher do it, and the remaining ninety-five hours in practice, at first with close supervision, later under general oversight."[1]
In what relation is the medical school to stand to its hospital if the methods above described are to be instituted? Exactly the relation which it occupies to its laboratories generally. One sort of laboratory may as well be borrowed as another. The university professor of physics can teach his subject in borrowed quarters quite as well as the university professor of clinical medicine. Courtesy and comity will go as far in one case as in the other: in both it keeps teaching to the demonstrative basis,—or worse, according to the limitations prescribed. The student can never be part of the organization in a hospital in which he is present on sufferance. A
- ↑ "The Organization of a Department of Clinical Medicine," by 'Richard C. Cabot and Edwin A. Locke, p. 9. (Reprinted from Boston Med. and Surg. Journal, Oct. 19, 1905.)
