OCTODER 22. inOOl 



SCIENCE 



545 



ive system in order that medical instruc- 

 tion may have that elasticity demanded by 

 the different possible lines of work to be 

 followed by the graduate. Election within 

 the medical curriculum is at present some- 

 what limited by the requirements of the 

 state licensing boards and as almost all 

 graduates will practise medicine in some 

 form, each medical school must offer a cur- 

 riculum meeting the requirements of these 

 boards. However, such can be met and 

 still the student be allowed considerable 

 freedom of election. At Harvard there is 

 now complete freedom of election in one 

 year of the four years of medical study 

 and this has proved a satisfactory arrange- 

 ment. This question of freedom of elec- 

 tion in medical studies must be carefully 

 considered in the future. It must be 

 recognized that our present more fixed 

 curriculum has been somewhat more an 

 accidental development than a studied, 

 planned growth. New subjects of a devel- 

 oping medical science have in the past been 

 crowded into the curriculum. Now that is 

 full and new subjects can be added only as 

 the result of readjustment of the curricu- 

 lum or be left to an elective period. This 

 fact will necessitate in the future change 

 in our medical instruction and will be a 

 probable cause of extension of election in 

 medical studies. If a very free elective 

 system develops, entrance requirements 

 again will need readjustment and these are 

 problems for much thought by medical 

 pedagogians. The proper position of the 

 so-called specialties in the medical curricu- 

 lum will be another problem for future 

 consideration. A glance at the coiirse of 

 study in different medical schools will show 

 much variation in the number of hours re- 

 quired in this or that specialty, indicating 

 the action of local influences more than 

 thought as to the real needs of the students. 

 An elective system may aid in adjusting 

 the specialties but still a necessary minimal 



must be determined for the student des- 

 tined for general practise.' Up to the pres- 

 ent time the gradual growth and develop- 

 ment of special fields of medical work has 

 exerted a disintegrative influence on med- 

 ical instruction resulting in a higher devel- 

 opment of the resulting parts, but now 

 there is need for integration and balanced 

 adjustment of the parts to form a more 

 perfected whole. 



In a medical school equipped for proper 

 training of practitioners there will, of 

 course, be laboratories and men capable of 

 conducting advanced work in various 

 branches of medicine, to prepare students 

 as surgeons, eonsiiltants, specialists, teach- 

 ers, etc. This part of the medical work 

 constitutes university work in the usuall.y 

 accepted idea in contradistinction to col- 

 lege and technical-school work. Advanced 

 students and instructors will conduct inves- 

 tigations and publish, for the use of the 

 world, their results. Without this no med- 

 ical school can be regarded as a university 

 medical school. What attitude should the 

 university at large assume toward univer- 

 sity medical work? There has been a 

 marked tendency on the part of academic 

 circles to disparage the work of medical 

 departments and a lack of disposition on 

 the part of university professors to accept 

 work in medical subjects as university 

 work. Happily this attitude is disappear- 

 ing, though in rare instances Ls the medical 

 work accorded its true place in the univer- 

 sity organization. There is no essential 

 difference between the methods followed by 

 the pathologist in his investigations and 

 those followed by the zoologist in certain 

 of his fields of work; the medical chemist 

 USPS the technical procedures of the organic 

 chemist; the bacteriologist is an investi- 

 gator in a special field of botany. That, in 

 the medical departments, man and his dis- 

 eases is the iiltimate subject of study is no 

 reason for regarding these studies as less 



