388 



SCIENCE 



[N. S. Vol. XLI. No. 1054 



Hospital Medical School), chemistry; Mr. J. 

 H. Morgan (University College and the Lon- 

 don School of Economics), constitutional law; 

 Dr. W. J. E. Simpson (King's College), hy- 

 giene and public health; Mr. J. H. Thomas 

 (University College), sculpture; and Mr. G. 

 Wallas (London School of Economics), polit- 

 ical science. 



DISCUSSION AND COSBESPONDENCE 



HEADSHIP AND ORGANIZATION OP CLINICAL DEPART- 

 MENTS OF FIRST-CLASS MEDICAL SCHOOLS 



To THE Editor of Science: In the October 

 30, 1914, number of Science there is a very 

 interesting and timely article by Dr. Meltzer, 

 of the Rockefeller Institute, on the reorgani- 

 zation of clinical teaching in this country, 

 " Headship and Organization of Clinical De- 

 partments of First-class Medical Schools." 

 The subject is a very important one and I feel 

 sure that it will interest the many medical men 

 who have the opportunity of reading your 

 journal. Dr. Meltzer refers in his letter, which 

 is written to a university president, to the 

 report of the Council on Medical Education of 

 the American Medical Association made to the 

 House of Delegates of the A. M. A. in June 

 of last year. He takes occasion to criticize in 

 his letter several statements made in this re- 

 port, and especially the statement "that the 

 medical school very properly demands that its 

 clinical teachers be men who are recognized 

 as authorities in their special fields, both by the 

 profession and the community," and he fur- 

 ther objects to the use of the term " grotesque " 

 as referred to a plan in which it is proposed 

 that clinical teachers may do private practise, 

 but that fees from such practise are to be 

 turned into the university treasury. He also 

 questions in advance the value of a report on 

 the reorganization of clinical teaching that is 

 to be made by a committee of the well-knovm 

 clinical teachers to whom this subject has been 

 referred by the Council on Medical Education. 



As chairman of the Council on Medical 

 Education I am very glad that this important 

 subject is being discussed in the columns of 

 such an influential journal as Science and 

 by such an able physician and research worker 



as Dr. Meltzer. I feel, however, that the 

 readers of Science and college presidents and 

 trustees could not form an accurate view of 

 the position taken by the American Medical 

 Association from Dr. Meltzer's letter alone, 

 and without reading the portion of the report 

 of the Council on Medical Education referring 

 to this subject, and therefore am enclosing 

 this special part of our report from page 15 

 to page 17. 



In the reorganization of our medical schools 

 one of the most pressing needs is that of 

 placing the clinical departments on a more 

 satisfactory basis. Little has as yet been done 

 in this country with this problem, and the 

 time has arrived when the medical profession 

 and the medical schools must take up this 

 matter vigorously and formulate a general 

 plan of organization of our clinical depart- 

 ments and urge its adoption. With this in 

 view the Council on Medical Education has 

 appointed a strong committee of ten clinicians, 

 who have had great experience in teaching and 

 who are regarded as authorities in their spe- 

 cial departments and in medical education, to 

 study this subject and report to the conference 

 on medical education. 



The organization of a clinical department is 

 a more complex subject than that of a depart- 

 ment like anatomy, or physiology, where teach- 

 ing and research are the functions demanded. 



In clinical work the head of the department 

 and his associates must be three things; first, 

 great physicians in their special field; second, 

 trained teachers; and third, research workers. 

 The medical school very properly demands that 

 their clinical teachers be men who are recog- 

 nized as authorities in their special fields, both 

 by the profession and by the community. In the 

 organization of a clinical department this fact 

 must not be lost sight of and whatever plan 

 is adopted must make it possible for the clinical 

 teachers to remain the great authorities in 

 their special fields both in the eyes of the pro- 

 fession and of the public. 



The plan adopted by the German univer- 

 sities has been on the whole most satisfactory. 

 There a professor in a clinical department is 

 in every sense a university professor just as 



