Page:Carnegie Flexner Report.djvu/89

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CHAPTER V

THE COURSE OF STUDY: THE LABORATORY BRANCHES

(b) First and Second Years (continued)

With the preceding characterization, the schools included in our first division[1] on the whole agree. They are all organic parts of full-fledged universities; their medical courses are as a rule constructed upon the basis of adequate pre-medical scientific training. In general, the laboratories of institutions upon a college basis reflect university ideals in equipment, management, and appearance.[2] As a rule these institutions have at least four separate laboratories, for anatomy, physiology and bio-chemistry, pharmacology, pathology and bacteriology. As their resources have grown, the departments have tended to increase by subdivision: histology, physiological chemistry, clinical pathology, bacteriology, attain departmental stature. Hygiene is especially prominent at the state universities, where effective departments of public health bring the laboratories of pathology and bacteriology into fruitful relation with local authorities and the local profession throughout the state; and endowed schools are making determined efforts to develop departments of preventive medicine. In some cases abundant, in several others increasing, facilities are offered in all branches for both teaching and research; and teaching and research permeate each other. The various departments, in intimate communication with each other and with the general science work of the institution, are officered each by its own full-time professor, in most instances with a more or less satisfactory corps of paid assistants. Within these active hives of scientific interest a thoroughly charming relation prevails: a vigorous, stimulating, and appreciative chief, on the one hand, enjoying the cooperation of enthusiastic young disciples on the other. It is difficult to realize that so substantial an organization is so recent,—hardly more than a half-century old in Germany, less than twenty years old in America. In this brief period the earlier subordinates have themselves become departmental heads in their own schools, or have gone forth to found or to reconstruct distant institutions. Laboratories have increased in number so rapidly that the rewards of early promise or of early performance have been alike great and prompt. It is unlikely that this pace will permanently keep up.

In anatomy and physiology it occasionally occurs that the departmental head is not himself a graduate in medicine.[3] This innovation arises out of a dual motive: it

  1. i.e., those requiring for entrance two or more years of college work; a list of them is given on page 28.
  2. A few of these, formerly on a lower basis, have elevated their entrance requirements, while leaving facilities as they were. Several schools are pledged to higher entrance requirements, though quite unable to improve their facilities. Indeed, as higher standards mean fewer students and reduced income, their facilities may suffer deterioration.
  3. Occasionally the dean of a medical school is a non-medical man. In such cases it is extremely important that he be in close sympathy with the clinical side and well acquainted with modern developments in clinical teaching. Even more dangerous is the expedient of making a professor in the academic department dean of the medical department.