OCTOBEE 30, 1914] 



SCIENCE 



621 



discussion, because they come from tte most 

 important educational bodies in medical mat- 

 ters in this country and because they throw 

 light upon the acuteness and the present 

 status of our problem. (1) The Johns Hop- 

 kins University has recently appointed full- 

 time professors of medicine, surgery and pedi- 

 atries. There under the term " full-time pro- 

 fessorship " two obligations are included. In 

 the first place the head of a clinical depart- 

 ment must give as much of his time to his 

 department as other full-time university pro- 

 fessors give of their time, for instance, as the 

 professors of physiology and pathology give 

 to their departments. In the second place, the 

 head of a clinical department can not give 

 any of his spare time to any clinical venture 

 which may bring him material gain. It is in- 

 teresting and instructive to find that this plan 

 was advocated twelve years ago by Dr. L. F. 

 Barker, while he was professor of anatomy at 

 the University of Chicago. Here is what he 

 said then:^ 



They (the full-time professors of clinical sub- 

 jects) should be well paid by the universities. 

 They should not engage in private practise even 

 if the university has to pay them double the ordi- 

 nary salary now paid a university professor to 

 retain them wholly in university work. If any 

 patients at all outside the hospital were seen in 

 consultation, and there is some force in the argu- 

 ment that the well-to-do public should, at least in 

 some rare and difficult cases, be permitted to 

 profit by the opinion and advice of the university 

 professor, the fees received from them may be 

 contributed to the budgets of the hospital them- 

 selves, in order \to remove all temptation from the 

 staff. ^ 



2. The second manifestation is contained 

 in the official Report of the Council of Med- 

 ical Education made at the last meeting of 

 the American Medical Association.^ This re- 

 port speaks of the Johns Hopkins plan, ac- 



" Second: How important do you believe full- 

 time positions in the clinical subjects are for a 

 satisfactory connection between the school and 

 hospital?" 



^Amer. Medicine, 1902, Vol. 4, p. 146. 



3 The Journal of the American Medical As- 

 sociation, LXIII., 1914, 86. 



cording to which the full-time professors 

 " may do private practise, but that fees from 

 that practise are to be turned into the univer- 

 sity treasury and not into their own pockets," 

 as grotesque. The report lays stress upon the 

 fact that this plan was proposed by non-med- 

 ical men (that is, the General Education 

 Board) who " do not have the medical point 

 of view and do not understand the complex 

 functions demanded of the clinical teacher." 

 It may be said here in parenthesis that the 

 term " non-medical men " is in this case not 

 entirely correct, as the plan was surely sug- 

 gested, advocated and accepted by important 

 members of the Medical School, for instance 

 the professors of pathology, physiology, anat- 

 omy, etc. However, this designation remains 

 true to the extent that some of the medical men 

 who advocated these radical changes in the de- 

 partment of medicine have practical knowl- 

 edge only in the sciences closely associated 

 with medicine, but not in the domains of 

 clinical medicine itself. The report, however, 

 acknowledges the fact that at present the 

 placing of the clinical departments in the 

 medical school on a satisfactory basis is one 

 of the most pressing needs. 



With this in view the council of Medical Edu- 

 cation has appointed a strong committee of ten 

 clinicians, who have had great experience in. 

 teaching and who are regarded as authorities in 

 their special department and in medical educa- 

 tion, to study this subject and to report to the 

 next conference on medical education. . . . The 

 medical school very properly demands that their 

 clinical teachers be men who are recognized as 

 authorities in their special fields both by the pro- 

 fession and by the community . . . 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 profession 

 and in the eyes of the public. 



The report of the council does not state di- 

 rectly that the present status of teaching in 

 the clinical departments in the medical 

 schools of this country is very unsatisfactory. 

 It admits it, however, tentatively, when it 

 states that the placing of this teaching on a 

 very satisfactory basis is one of the most 

 pressing needs. We have seen that the Johns 



