April 28, 1922] 



SCIENCE 



441 



and will doubtless become extinct in time for the 

 simple reason that teaching must be accompa- 

 nied by thinking; teaching and research are 

 inseparable. The great teacher has always pos- 

 sessed the investigative spirit but may not have 

 been a great investigator. We must, at present 

 make provision for those who wish to prepare 

 for teaching in its broadest sense. 



These three types have been designated as 

 they exist to-day. They are generic rather 

 than specific. They possess many attributes in 

 common and may sometimes form a trinity. 



The materials to be converted by one method 

 or another into the products set forth are stu- 

 dents who enter the medical school with a high 

 school and at least two years of college train- 

 ing. There are no two who have followed the 

 same course of study with the same degree of 

 interest or who have reached the same results. 

 In the high school the student feels his way 

 through a large range of group eleetives, and 

 often before entering college he has decided 

 that he will major in agriculture, engineering, 

 law, theology, or medicine. In his college 

 work, eleetives have enabled him to accentuate 

 his choice or j^erchance to find that his deci- 

 sion was wrong. In both high school and col- 

 lege the student may have inclined toward sub- 

 jects involving manual training and thereby 

 have acquired keenness of touch and dexterity, 

 or toward music, cultivating the sense of hear- 

 ing. He may have elected biologic sciences, 

 accentuating observation. He may have turned 

 toward mathematics, physics and chemistry, 

 emphasizing precision in deduction and ex- 

 perimentation. He may have laid special 

 stress on history or languages thus acquiring 

 an excellent memory and facility of expres- 

 sion; or perchance on philosophy thus devel- 

 oping the power of abstract thought. Those 

 of us who come in contact with these men as 

 they enter upon the study of medicine ai'e 

 impressed by their differences in concept, habit 

 and training. He who comes from the land of 

 mighty oceans, forests, and mountains, thinks 

 in larger terms than he who comes from the 

 truck farm. The boy brought up in the coun- 

 try better understands the thought and action 

 of the country folk than the boy brought up in 

 the city. The boy who is reared in the highly 



commercialized districts of a great city regards 

 an education in quite a different light from the 

 one who is reared in a college or university 

 town. One student is always on time, another 

 is always behind time; one works quickly, an- 

 other slowly; one is deft, another clumsy; one 

 student retains best what he sees — his memory 

 is visual; another retains best what he hears — 

 his memory is auditory; still another remem- 

 bers best what he reads — his memory depends 

 on word association. One mind stores up 

 isolated impressions and facts— it is analytic; 

 another arranges impressions and facts in 

 gi'oups — it is synthetic. WUl the student who 

 is slow and clumsy ever make as efficient a 

 surgeon as the one who is quick and deft? Will 

 the one whose memory is auditory, or depends 

 on word association, ever succeed in surgery 

 as well as another who is able to visualize the 

 positions and relations of organs in the body? 

 WUl the student who has an untrained ear 

 ever make as efficient an internist as the one 

 whose keenness in sound perception and dis- 

 crimination enables him to differentiate be- 

 tween normal and abnormal sounds in the lung 

 or heart? Is the one which an analytic mind 

 as capable of interpreting a syndrome as an- 

 other whose mind is synthetic? It is beyond 

 question that the men who enter the medical 

 school at the age of 22 or 23 years are quite 

 unlike in their mental equipment and this fact 

 must be taken into account in the medical cur- 

 riculum. 



The method of the medical school is the cur- 

 riculvun; around it centers, to a large extent, 

 the resources of the school, and through it are 

 expressed the principles and concept of medical 

 education. The curriculum of half a century 

 ago was probably the best that could be devised 

 to meet the needs of the profession and schools 

 of that day. Trom an economic point of view, 

 it was highly advantageous; one teacher could 

 lecture to a large number of students and was 

 entirely relieved of the time consuming instruc- 

 tion to small groups and individuals. It was 

 an excellent mechanism for turning out one 

 type of general practitioner. While it served 

 in part as an intellectual pathway, it also 

 functioned as a "straight jacket." It kept the 

 students so busy that they could not destroy 



