944 



SCIENCE 



[N. S. Vol. XXXII. No. 835 



state — practical examinations already car- 

 ried oiit in some branches and to be ex- 

 tended to all branches very shortly accord- 

 ing to their statements. Furthermore, 

 that board has notified other state boards 

 that full reciprocity relations would be 

 held only with such state boards where 

 similar methods of examination were in 

 vogue. "When I heard this announcement 

 made I thought that the millennium was 

 certainly approaching, for I too, like some 

 others among teachers, have fondly and 

 hopefully talked and thought of the correc- 

 tion of perverted view-points and other 

 existing evils which such methods of test- 

 ing your efficiency would bring about. 



To some of my colleagues my reluctance 

 to teach didactically may seem a derelic- 

 tion of duty, but this remissness apparently 

 is not productive of such lamentable re- 

 sults as at first glance one might suppose 

 would be the case. The facts needed by 

 our students to pass examinations in pa- 

 thology are obtained in some way and ac- 

 quired very well to judge by the reports. 

 In one of the western states where it is be- 

 lieved the medical board has always 

 favored graduates from institutions in that 

 state, one of our graduates took the exami- 

 nation for a license to practise not long ago 

 and subsequently told me that one of the 

 medical examiners in complimenting him 

 upon his success referred to the high grade 

 secured in pathology by graduates from 

 this school. Evidence is at hand from 

 other sources that students here do in some 

 way obtain the necessary information in 

 pathology for such ordeals notwithstand- 

 ing this lack of didactic instruction. 



There is another phase of this subject 

 which I am disposed to treat frankly with 

 you. I know you already have strong 

 suspicions of the existence of a difference 

 of opinion among many of your teachers 

 here in regard to the work of the so-called 



hospital class,- the advisability of its con- 

 tinuance and of faculty recognition for it. 

 It does not seem to me imprudent to tell 

 you that the consideration of this matter at 

 faculty meetings has developed sharp dif- 

 ferences of opinion. It is altogether com- 

 plimentary to your faculty that questions 

 of teaching methods and their merits 

 can excite such— to state it mildly — en- 

 thusiasm. I am also disposed to discuss 

 this subject because I have occupied places 

 in both camps. One of the reasons of my 

 desertion to the camp of those who are 

 strongly opposed to this method of teach- 

 ing may seem a strange one to you. It is 

 the well-founded conviction I possess that 

 teaching in medicine which has for its 

 chief and final aim, the diagnosis of the 

 disease, is pernicious because it tends to 

 generate a sense of contentment and 

 triumph over the arrival at a diagnosis, be- 

 cause it appoints as the journey's end what 

 should be but a breathing place, because 

 there goes with this emphasis of investiga- 

 tion to predicate a diagnosis, the implica- 

 tion, at least, that with the diagnosis made, 

 investigation can cease and treatment be- 

 gin; and I have been convinced that the 

 work of the so-called hospital class — and 

 you will please remember that I labored 

 faithfully in this kind of teaching a num- 

 ber of years — is of such a character as to 

 cultivate in the minds of the students the 

 notion that accurate diagnosis represents 

 the Ultima Thule of their inquiries, the 

 finality of medical education. This con- 

 viction is partly the result of watching the 

 careers of students who have industriously 

 followed the hospital class work, practised 



^A class prepared by written and oral so-called 

 " quizzes " for hospital examinations, particularly 

 for the written examinations conducted under the 

 civil service regulations which govern the securing 

 of places as residents in Cook County Hospital, 

 the large charity hospital of Chicago. The system 

 of preparation is essentially one of " cramming." 



