APRIL 12, 1912] 
us to gain the equivalent of a whole year 
within the time now devoted to the four 
years’ curriculum. Is not the possibility of 
such a tremendous saving well worth our 
serious consideration ? 
At the outset, it should be clearly under- 
stood that wnzform methods of teaching are 
neither necessary nor desirable. The methods 
in detail must be determined by the individual 
teacher to meet best the varying local condi- 
tions. But equally true is the important fact 
that all efficient methods of teaching must be 
based upon well-known and well-established 
principles of pedagogy. Efficient teaching re- 
quires three essential conditions: (1) Com- 
plete mastery of the subject-matter on the 
part of the teacher; (2) a clear notion of the 
aim of the teaching, and (3) well-chosen 
methods of accomplishing the aim. The first 
and most essential condition, that the teacher 
must be a master of his subject, is everywhere 
clearly recognized, and will not be discussed 
in the present paper. The second and third 
conditions are those oftenest overlooked, and 
it is therefore necessary to emphasize certain 
fundamental principles of aim and methods, 
the neglect of which is largely responsible for 
inefficient teaching. 
In the first place, let us therefore consider 
the aim of medical education. In this all will 
probably agree that the primary aim of med- 
ical education should be to train efiicient 
practitioners.. And it may furthermore be 
taken for granted that an efficient practitioner 
is one who is able to observe accurately, to 
think clearly and to act wisely in his medical 
practise. 
Keeping in view this primary aim and ulti- 
mate purpose of medical edueation, to train 
efficient practitioners, we may next consider 
the methods, the ways and means, whereby 
this aim is to be accomplished. If the end is 
to be reached most directly, if the student is 
to be trained most economically for the great- 
?Jn addition to the education of practitioners, 
the medical school has other important functions, 
such as the advancement of medical science 
through original investigation, but these are not 
within the scope of the present paper. 
SCIENCE 
567 
est efficiency, it is evident that the instruc- 
tion must be adapted to his nature and learn- 
ing capacity. How shall this be done? Let 
us see whether there is any rational prin- 
ciple to guide us in adapting our methods to 
the nature of the student. Upon this ques- 
tion an important light is thrown by the his- 
tory of education. 
A century ago, practically all teaching was 
based. upon the doctrine of authority. It was 
the function of the teacher to tell the stu- 
dent what he should know and do. It was 
the duty of the student to be a passive recip- 
ient, to follow faithfully the precepts of the 
teacher. This doctrine of authority, however, 
was found inefficient and has long since been 
abandoned in rational education. It is now 
generally recognized that all education really 
worth while is based upon self-activity. This 
principle, advanced by Froebel, is now so 
thoroughly established in education that it 
may almost be taken as self-evident. Self- 
activity is the keynote of modern pedagogy. 
And yet, while recognized in theory, this 
fundamental principle is often almost totally 
neglected in practise. In the light of this 
principle of education by self-activity let us 
review briefly certain phases of methods in 
medical teaching. 
In developing the self-activity of the stu- 
dent, it is evident that the methods first of all 
must arouse his interest and attention. In- 
terest we know to be most intense in things 
which satisfy conscious needs. Now the med- 
ical student wants above all to be a good prac- 
titioner. If he knows that a certain thing 
will help him to accomplish this, he is in- 
tensely interested, and will exert an active ef- 
fort to secure it. “The mind interprets im- 
pressions from without, not according to their 
intrinsic nature, but accordingly to their 
relation to the needs of the organism” (Bag- 
ley). Common sense and good pedagogy 
therefore agree that in teaching any subject 
in the medical curriculum, the teacher 
should make sure that the student realizes 
its bearing upon his later work. 
Some may conclude from the foregoing 
that, since time is limited, only the so-called 
