J. M. D. Olmsted 469 



University, the others being science, law, theology and, as a concession, arts. 

 Article 12 of this decree states that "the existing five schools of medicine* 

 shall form five faculties of the same name. They shall preserve the organization 

 determined by the law of 19 ventose an XI" (March 10, 1803). The die of 

 French medical schools had, therefore, already been cast in 1803, and with the 

 awarding of the doctorate as the certificate of the attainment of a superior 

 medical education beyond that of an officer of health, the modern scheme 

 of organization of medical instruction had already been entered upon. The 

 later decree merely brought the medical schools into the same system as other 

 departments of public instruction, and the title of doctor of medicine or doctor 

 of surgery was now conferred under the authority of the University. 



A study of the 1938-1939 announcement of courses given by the Faculty of 

 Medicine at the Sorbonne (the last to come to the Library of the University 

 of California) shows that there is still a close parallel between its provisions 

 and the scheme outlined in 1803, Vv'hich was, after all, merely an extension of 

 the plan proposed by Chaussier in 1794. Mornings for all students of medicine 

 are to be spent in the hospitals. For the M.D. degree there are five sets of exami- 

 nations in theoretical subjects, three clinical examinations, and a thesis. The 

 five examinations in theoretical subjects come at the end of the different years 

 in the following order: (1) mainly anatomy with some histology, physiology, 

 medical physics, and medical chemistry; (2) mainly physiology with some 

 anatomy, histology, medical physics, and chemistry; (3) pathology, experi- 

 mental medicine, parasitology, and bacteriology; (4) obstetrics, medical and 

 surgical pathology; (5) general pathology, hygiene, legal medicine, therapeu- 

 tics, and pharmacology. Aside from the inclusion of those sciences which were 

 developed chiefly by the aid of the microscope in the nineteenth century, such 

 as histolfjgy and bacteriology, the scheme is essentially the same as the original 

 one, although naturally the content of the various courses has kept pace with 

 advance in the medical sciences. 



The idea is to produce practitioners, hence the emphasis on hospital train- 

 ing from the first day the student enters medical school to his last. The bad 

 features of the system have been emphasized in the report (1932) of the Com- 

 mission on Medical Education under the chairmanship of A. Lawrence Lowell. 

 A single quoted sentence will convey the main objection: "The students are 

 preoccupied and quite overwhelmed with clinical problems, for the under- 

 standing of which they have had no preparation." In spite of this overatten- 

 tion to the clinic, the Commission claimed that because of the competitive 

 appointments of externs and interns, "50 per cent of medical students in 

 France do not receive adequate clinical experience before graduation. About 

 40 per cent (those who have succeeded in becoming externs) obtain a good 

 preliminary experience . . . while about 10 per cent (the interns) receive what 

 is probably the largest and most varied clinical experience provided for med- 

 ical students anywhere in the world." 



* Paris, Montpellier. Strasbourg, ruriii. and Mainz. 



