Page:Carnegie Flexner Report.djvu/90

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72
MEDICAL EDUCATION

represents a reaction from the superficial methods of the practitioner professor, as well as a realization of the essential continuity of medical with biological science. The non-medical professor is not necessarily indifferent to explicit medical reference; his department need not lack sympathy with medicine merely because he has no M.D. degree; and his disinterested attitude is in any event indispensable. But the experiment is not free from danger, and its outcome will be watched with interest. Meanwhile, there is no question that these posts cannot be satisfactorily filled by active physicians. The practitioner usually lacks impartial and eager scientific spirit; he can at best give set hours to teaching, and these are not infrequently interrupted by a patient's superior claim; of course he has little or no time and rarely any zest for research. Western Reserve and the New York City department of Cornell, alone of schools of this rank, continue an active surgeon in the chair of anatomy.

Of the twenty-five institutions either now, or by the fall of 1910 to be, on the two-year college basis, or more, fourteen[1] offer the entire four-year course in one organized institution; five[2] are divided, offering the laboratory branches in one place and the clinical branches, more or less independently organized, in another, sometimes close by, at other times widely separated; six[3] are half-schools, offering only the work of the first and second years. The complete school in touch with the rest of the university represents the normal and correct form. The study of medicine must center around disease in concrete, individual forms. The ease with which the clinics and the laboratories may there illuminate each other is an incontestable advantage to both. It is difficult to imagine effective teaching of pathology, for example, under conditions where the operating-room, the medical clinic, and the autopsy do not constantly contribute specimens and propound queries to the laboratory; and assuredly the teaching of medicine and surgery cannot proceed intelligently without constant intercourse with the laboratories. Any disintegration of hospitals and laboratories is harmful to both,—and to the student, in shaping whom they must coöperate. So important is organic wholeness that the remote department, if entire, is from all points of view preferable to division. The initial difficulty—that of sharing the university ideals—may be met by liberal provision for intercourse with the academic body and by redoubled efforts to maintain creative activity, as Cornell, for example, has done at New York. Fortunately, our needs in respect to medical

  1. Johns Hopkins, Harvard, Western Reserve, Minnesota, Cornell (New York City department), Yale, Michigan, Indiana (Indianapolis department), Iowa, Pennsylvania, Syracuse, Columbia, Dartmouth, Colorado. Of these, two are not located in the same town as the university,—Cornell (New York City), Indiana (Indianapolis).
  2. Rush Medical College (of which, though both parts are in Chicago, the first two years belong to the University of Chicago, and the last two, given elsewhere in the city, are only affiliated with it), California (first and second years at Berkeley, third and fourth at San Francisco and Los Angeles), Nebraska (first and second years at Lincoln, third and fourth at Omaha), Kansas (first and second years at Lawrence, third and fourth at Rosedale), Stanford (first and second years at Palo Alto, third and fourth at San Francisco).
  3. Wisconsin, Missouri, South Dakota, North Dakota, Utah, Wake Forest. Cornell repeats the first year at Ithaca; Indiana duplicates the first and second years at Bloomington.