August 11, 1922] 



SCIENCE 



155 



finally that they have a clear view of the merits 

 of preventive as compared with palliative med- 

 icine. The public would always pay more to 

 have a given case cured than to have all cases 

 of a given disease prevented, but leaders of 

 universities must not fall into this error. Uni- 

 versities should rather lead than follow public 

 opinion. In great contrast to public opinion, 

 it is interesting to note that the most con- 

 spicuously successful and hard-headed Ijusiness 

 man of our time has judged it wise to make 

 his total contribution toward the study of dis- 

 ease. The condition of discrimination against 

 the fundamental sciences is also a menace to 

 universities unless they wish to lose the abler 

 men in the pre-clinical branches who have 

 proved themselves fundamental on two scores, 

 on miaking progress, and on training workers 

 in the methods of research. I do not believe 

 that increased salaries of those engaged in edu- 

 cational work will come through any organiza- 

 tion of teachers. The associations of teachers 

 have always been based on the principle of 

 improving their professional standards instead 

 of seeking for personal gain. The profession 

 of teaching is concerned in a very fundamental 

 way with the ideals of giving and helping, 

 rather than receiving. But there are signs 

 that the community as a whole is beginning to 

 think of the value of education. Progress 

 through the light of reason may no't be rapid, 

 but there lurks in the minds of all of us a 

 memory of the poison gases of the late war 

 and a consciousness that no antidotes are to 

 be found against them except through trained 

 minds. It is only with regret that one appeals 

 to the educational force of war, but it can not 

 be escaped. It is probable that the contact of 

 the univei-sity with the increased earning ca- 

 pacity of modern medicine and with the need 

 in commercial life for men trained in science 

 ^vill work out to the advantage of education in 

 two ways, first, in the bringing of more ade- 

 quate funds to education, and second, in the 

 drawing of abler people into universities, thus 

 raising the standards of teaching. 



I have claimed that the idea at the root of 

 the full-time scheme is better teaching and 

 more research. In the practical working out 

 of the plan it has not always been clear that 



the balance of high ideals of teaching lies with 

 the full-time scheme. If this were made clear 

 the plan would readily win the support of the 

 entire body of students. By the time a student 

 has reached the third and fourth years of the 

 medical course, he has no longer the idea that 

 teaching does not matter; he really wants help 

 and guidance. Marked ability to teach is not 

 common; exceptional ability is as rare in 

 teaching as it is in any other profession. A 

 man who is practicing medicine may easily 

 have as much ability to teach as a man who is 

 doing research, and indeed, in many of the 

 medical schools, there are practicing physicians 

 who are doing excellent work in teaching. The 

 universities have asked these men to teach, 

 giving them either no salaries or salaries that 

 are merely nominal, and have expected them 

 to gain compensation in experience as an asset 

 to the practice of medicine. The full-time 

 scheme must not be considered as an attack 

 on these men but merely as the next step in 

 the progress of medical education which de- 

 mands that educational institutions shall now 

 select, and draw into their teaching force, a 

 group of men who shall devote their entire 

 energy to teaching and research. If this can 

 be done, one can hardly question but that the 

 advances of the past thirty years of profes- 

 sional teaching of the pre-elinical side will be 

 duplicated on the clinical side. 



It is clear that two factors have given us a 

 very much larger staff of teachers on the clin- 

 ical than on the pre-clinical side. The fii-st is 

 the legitimate factor of the development of the 

 great number of specialties. The second is 

 the fact that many clinical teachers have put 

 only a small part of their time into teaching 

 and the fact that the custom of the medical 

 school of paying them practically nothing has 

 made it easy to increase their numbers. With 

 the change of emphasis on teaching and re- 

 search, it is obviously impossible to put all of 

 this large group on the full-time basis with 

 adequate salaries. The change can be made 

 rapidly in the organization of new institutions 

 but must be made gradually in the older ones, 

 where only a few of the teachers in the main 

 branches of medicine and surgery, together 

 ■with representatives of some of the specialties, 



