Medical Department
UNITED STATES NAVY. See NAVY, UNITED STATES.
MEDICAL EDUCATION. In ancient times almost all medical teaching was given by masters to their pupils without the use of formal schools. But the names of Hippocrates and Galen, who were in classical days in great repute, show that the teachers of medicine were held in honor. Almost all the surgeons and physicians were slaves, and Greek and Latin comedy is full of jests aimed at the doctor. In the Middle Ages and the Renaissance much of medical education was formal and traditional. With the emergence of the great European universities in the twelfth and succeeding centuries, medical education gradually obtained a distinct place. Thomas Linacre (c. 1460-1524) is popularly regarded as having been the first to give the study of medicine a university status at Oxford. In Scotland a medical school was founded at St.
Andrews in 1411, and at the University of Edinburgh in 1582.
In the United States the earliest medical schools took their origin from occasional lecture courses. At the opening of the Revolution it is estimated that there were in the thirteen colonies 3,500 practitioners, of whom about 400 had medical degrees. In our early history many doctors were educated at Edinburgh, but more obtained their training by serving as apprentices under well known physicians. In 1750 Dr. Thomas Cadwallader was lecturing in anatomy in Philadelphia, where in 1765 the medical department of the College of Philadelphia, later the University of Pennsylvania, was founded. In 1767 the medical department of Kings College, later Columbia University, was opened, followed in 1782 by the foundation of the medical department of Harvard and in 1798 and 1820, respectively, of Dartmouth and Bowdoin. In the middle of the nineteenth century many proprietory schools of medicine had been established, in which the teachers divided all fees and conducted the administration on purely commercial lines.
During the past thirty years American medical schools have been vastly improved. For example, at one time the degree of M.D. was granted to the students who had attended for one year a course of lectures; later the period was extended to two years, then to three, and now universally to four and in some cases to five. At the same time the quality of men entering medical schools has been improved until now some MEDICAL EDUCATION But schools require for admission the baccalaureate degree, and all schools of reputation, at least the equivalent of two years in college. This has meant a diminution both in the number of schools and students, but a very marked gain in quality. For example, in 1906 the United States had 162 medical schools, or over half the world's supply. In 1920, through the elimination of poor schools and consolidation, this number has been reduced to 86. In 1904 there were 28,142 medical students; in 1920, only 13,554. But higher enrolments are in prospect, and medical schools of a high grade can satisfactorily teach 17,000 or 18,000 students, which number will in all probability supply the demand for some years to come. For statistics show that in August, 1919, the United States had one physician to every 720 people, as compared with one to 1,500 in Great Britain. There is, therefore, no scarcity of physicians in the United States, but a very imperfect distribution of the supply.
There are to-day medical schools in 37 of the 48 States and in the District of Columbia. The States that have no schools-Rhode Island, New Jersey, Delaware, Florida, New Mexico, Arizona, Idaho, Montana, Nevada, Wyoming and Washington-have medical schools in close proximity or are sparsely settled.
From the standpoint of abundant clinical facilities and large hospitals and dispensaries, the centers of population have obvious advantages as sites for medica! schools, and the tendency is very clearly in that direction.
Medical education, thus, has fairly kept pace with the great advance in medical science and art which has been achieved in the past forty years. Medicine can now be regarded as a science. Knowledge in its domain is obtained by following the methods of science, and the application of this knowledge has been of incalculable value to mankind. Formerly medicine was concerned merely with the treatment of the sick individual, and the measures directed toward this were empirical and traditional. The fact that most diseases were self-limited and tended to recovery was not appreciated, and treatment, though not usually harmful, had little or no effect on the disease. With the new knowledge, the prevention and medical care of disease has been placed on a rational basis and a new conception of the relation of medical service to society has arisen. Modern medicine seeks, first, to prevent disease, this being made possible by knowledge of the causes of disease and the mode of action of these causes; second, the recog nition of disease in its early stages when MEDICAL EDUCATION cure can most easily be effected; third, ment of these aims medical education is the past thirty years, and although all methods and ideals as has medicine in has experienced such advance both in directed. No department of education tion of suffering and the prolongation of life in incurable disease. To the attainment of these aims medical education is directed. No department of education are now among the best in the world. ica. Medical schools in the United States has been particularly marked in Amermethods and ideals as has medicine in the past thirty years, and although all countries have shared in this advance, it has been particularly marked in America. Medical schools in the United States are now among the best in the world.
Changes affecting a few of the best tion of all the medical schools of the the great advance began in 1902, when the American formed a Council of Medical Education. possessed. All facts ascertained were Medical Association tion of all the medical schools of the country and graded them according to the facilities for education which each possessed. All facts ascertained were published and the primary effect was the At about the same time the different schools and the combination of others. At about the same time the different States demanded a license for the practice of medicine, which was granted after examination of the candidate by a board studied, were published. Education was examinations, with the names of the schools at which the candidates had studied, were published. Education was further improved by the formation of medical faculties in the various universities, thus giving medicine the advantage of association with other departments of science and participation in university ideals, and scientific research in medicine, to which formerly but little attention was given, has become a dominant ideal.
MEDICI and French or German have been taken The medical course is four years of nine months each, and the instruction is more or less divided into that of the sciences clinical instruction in medicine, surgery given in the first two years, and the physiology, pathology, etc., which are underlying medicine, such as anatomy, physiology, pathology, etc., which are given in the first two years, and the clinical instruction in medicine, surgery and obstetrics, which occupy the last two. The lecture system, though not entirely given up, holds a subordinate place in instruction, most of the time of the student being spent in laboratory work or in the hospitals, where he studies the products of disease and the physical and chemical methods used in diagnosis.
After graduation the student serves annot necessarily connected with a school, where he has the care of the patients other year as an interne in a hospital, under direction. through such a course is fitted for general service in medicine, but should he through such a course is fitted for gen- under direction. A student passing cialties of medicine, further training is necessary. The strongest criticism which cialties of medicine, further training is elect to enter into any of the main spe- A student passing can be made against the present system of medical education is that the student can be made against the present system elect to enter into any of the main speis too old when he graduates. The medical course is rarely begun before the age of twenty-one, which brings graduation and the hospital year to the age of twenty-six. This defect, if it be such, can best be met not by shortening the medical course, but by improving the character of the preparatory education, so that the student can acquire at the character of the preparatory education, twenty-one. branch of state medicine which is concerned with the administration of justice.