664 



SCIENCE 



[N. S. Vol. XXXIX. No. 1010 



way is by practise and repetition and habit. 

 We can help another man's thinking 

 chiefly in the same way that we can help 

 his drawing or his chemical analysis or his 

 physical examination, by stimulating his 

 interest, by showing him where he fails and 

 by teaching him to criticize his own work, 

 as he would any other technical achieve- 

 ment. 



Finally, the good doctor is a man of char- 

 acter, which means again, I suspect, only 

 that he has on hand certain kinds of brain- 

 stuff, makes certain kinds of associations of 

 it and reacts in certain ways to these as- 

 sociations. Here again example and criti- 

 cism are the basis of teaching. A good doc- 

 tor is skilled in the technique of right be- 

 havior. He makes mistakes in ethics no 

 more than in counting blood corpuscles. 



You will all see that I have used the word 

 "technique" in a broad way. Probably I 

 have stretched it too far. But for to-day 

 we will let it stand and will ask ourselves 

 what principles should guide us in attempt- 

 ing to make this kind of technicians out of 

 the young men who come to us as students. 



Putting the matter in another way, oiir 

 purpose is to train scientific physicians. By 

 a scientific physician I mean one who is im- 

 bued with the principles of science and 

 trained in particular scientific methods. I 

 do not mean that he should necessarily be 

 an original investigator. I do mean that he 

 should approach his work in the spirit of 

 an investigator. 



Our commonest stumbling block in con- 

 sidering a problem in curriculum making 

 or in teaching is the unfortunate belief that 

 we must turn out our graduates as fully 

 trained doctors. "There is so much that 

 they need to know," we say. This idea 

 leads us to overcrowd the curriculum and 

 deprive it of elasticity and virility. Our 

 aim should be not to turn out a finished 

 doctor, but a man who will continue to 



work and learn as long as he lives — a man 

 who will consider that his student life has 

 just begun on the day when he takes his 

 diploma. Our aim should be not to pro- 

 duce a walking encyclopedia, but to incul- 

 cate the scientific spirit. What principles 

 are likely to be of service in this work ? 



ENTRANCE REQUIREMENTS 



Of course the first principle is that we 

 start with good material. We depend upon 

 certain "entrance requirements" to supply 

 this material. We can not stop to consider 

 these requirements to-day, except to remark 

 their mechanical character. A sieve is a 

 good instrument for separating different 

 sizes of coal. It is a bad instrument for 

 separating pebbles from diamonds. The 

 best formulated entrance requirements will 

 supply good material only when supple- 

 mented by personal consideration of the 

 individual case. Often you can only tell 

 the diamond by seeing whether it will 

 scratch glass. My sentiment is that it is 

 better to try out ten pebbles which will fail 

 rather than risk throwing one diamond 

 into the dump. 



PRINCIPLE OP INDIVIDUAL DIPPERENCES 



Having selected our students, we must 

 recognize the inequality among them. No 

 two freshmen are alike. No two seniors are 

 alike. No two graduates are alike. No 

 two old doctors are alike. We are all 

 "bom short" in one place, "born long" 

 in another, to use William Hawley Smith 's* 



3 "All the Children of AU the People," Mae- 

 millan, 1912. Mr. Smith discusses also the simi- 

 larities of children. Of course the principle of 

 similarities is basic in any system of education. 

 The trouble in medical education is that we have 

 assumed not only similarity but even equality 

 among students. This address is a protest against 

 the prevailing rigid curricula and emphasizes 

 therefore the differences of students, to the pres- 

 ent disregard of their similarities. The latter 



