May 8, 1914] 



SCIENCE 



663: 



consequence all the colleges, I believe, have 

 had to limit the freedom of election in a 

 marked degree. The group system by 

 which the student is compelled to do a con- 

 siderable part of his work in one depart- 

 ment or group of allied departments has 

 been widely adopted. The principle is "A 

 thorough training in a definite direction." 

 Of course the curriculum of a profes- 

 sional school is a group curriculum by the 

 nature of things. The question is whether 

 it shall be fixed and inflexible or variable 

 and elastic. 



GENERAL PURPOSES 



Now it is evident that if we are to make 

 any serious effort to find guidance in our 

 own experiments in curriculum-building, 

 we should begin by determining as weU as 

 possible what we are trying to do. It is 

 easy to say that our first business is to make 

 doctors — to make good doctors. But a 

 "good doctor" is hard to know and harder 

 still to define. I have discussed this mat- 

 ter before- and will only recapitulate my 

 conclusions here. 



A good doctor is a keen observer. We 

 must train the powers of observation in 

 our students. We may say that there is a 

 technique of observing, and that we must 

 teach this technique. 



A good doctor is a trained experimenter. 

 That is, he combines control of conditions 

 with observation. We must train our stu- 

 dents in experimental methods in the lab- 

 oratory and at the bedside. This is tech- 

 nical training. 



A good doctor is a skilled technician also 

 in another and narrower sense of the word. 

 He knows how to do certain things con- 

 nected with the practise of his profession, 

 things requiring accuracy of hand, ear 



2 American Medical Association Bulletin, Jan- 

 uary 15, 1911; also "Medical Eeseaxeh and Edu- 

 cation," Science Press (1913), p. 375. 



and eye. He has attained a skilful adjust- 

 ment of certain senso-motor reactions not 

 provided by nor required in the ordinary 

 experiences of life, but essential in medi- 

 cal practise. Such adjustment is attained 

 only by repetition under direction ; that is, 

 by development of habit. We must train 

 our students in the technique of their pro- 

 fession. 



A good doctor is a man of judgment. He 

 must be able to draw correct conclusions 

 from observations and experiments. He 

 must be able to synthetize isolated ele- 

 mental facts into a unified compound. We 

 express this idea when we say he must be 

 able to think. And here is the greatest 

 stumbling block. No one has discovered a 

 royal road to thought. It almost seems as 

 if it is in a man or it isn 't. And yet think- 

 ing is really a kind of technique. It con- 

 sists in making valuable associations. If 

 you have on hand the proper thought-stuff 

 and can make the right combinations of it 

 — why, you think. Given a particular sen- 

 sory stimulus, the resulting impulses pre- 

 sumably go bounding from part to part of 

 the cerebral cortex instead of coming out 

 immediately to the muscles. How these 

 impulses travel depends on how the cere- 

 brum is constructed and which paths have 

 been made easy. Thought in this sense is 

 involuntary response; it is reflex, it is 

 habit. 



A large part of our teaching is devoted 

 to giving students what we consider valu- 

 able thought-stuff — facts, we call it. We 

 also give them numerous examples of think- 

 ing — ready-made combinations of facts, or 

 so-called conclusions. This is well. It 

 ought to help them in the same way that 

 seeing a blacksmith forge out a tool should 

 help one to make that tool, or in the same 

 way that seeing a surgical operation should 

 help the student to do it. But when it 

 comes to making new thoughts, the only 



