704 



SCIENCE 



[N. S. Vol. XLIII. No. 1116 



whose living interest is in his clinic, it 

 matters little. For in either instance, 

 through the character of the men that he 

 associates with him, he will see that his de- 

 partment does its best work. 



The objection so often raised that there 

 is danger that a professor of medicine or 

 surgery who abstains from outside consult- 

 ing practise may be removed from touch 

 with the profession, is comprehensible but 

 not, I think, serious. If the director of 

 the department be one who does a consid- 

 erable amount of clinical work, he will still 

 keep in active touch with the medical pro- 

 fession even though his consultations be 

 held only at the hospital. In any event, 

 the work of the department itself, set forth 

 by him and by his associates and assistants 

 in public clinics, in medical societies, and 

 in journals, should keep him well before 

 the eyes of the medical world. 



The tendencies of the hour would seem to 

 indicate that a very large nucleus of the 

 staff of the medical or surgical clinic will 

 in the future consist of salaried men who 

 are giving the greater part of their time to 

 the activities of the department ; and it is 

 very interesting that not only in hospitals 

 affiliated with university schools of medi- 

 cine, but in other independent institutions, 

 this idea has already taken root. The ex- 

 periment of a generously salaried staff of 

 physicians and surgeons who are expected 

 to give the greater part of their time, if 

 not their entire time to the institution, is 

 already being made in various hospitals. 



One of the most important functions of 

 a modern medical or surgical clinic is that 

 it should afford opportunities for the am- 

 bitious student with scientific aspirations 

 to pursue that course of study and acquire 

 that experience which will fit him for a 

 university career. Every year there grad- 

 uate from our schools of medicine men 

 with the ideals, aspirations and abilities of 

 the true student, who, because of financial 



disability, are obliged to enter directly into 

 active practise. A certain number of these 

 men preserve their enthusiasm, make the 

 most of their opportunities, and return 

 later to the pursuit of those studies which 

 have always been the object of their am- 

 bitions. Some find unexpected intellectual 

 satisfaction in the varied opportunities 

 offered by the life of a practitioner. 

 Others, dazzled by the financial rewards of 

 success, lose their early ideals. Many, 

 however, are obliged to sacrifice their am- 

 bitions. With the organization of the mod- 

 ern medical clinic, there should be a con- 

 siderable number of assistantships com- 

 manding salaries which should make it 

 possible for many of the really good men to 

 pursue their chosen career. And it is 

 highly desirable that such salaries should 

 be sufficient and so graded that these men 

 may continue their work through long 

 years should they prove themselves of suit- 

 able character and ability. 



But — and this is a question very often 

 raised — what about the opportunities for 

 the development of practitioners or con- 

 sultants if every medical or surgical clinic 

 become a training school for professors of 

 medicine? The answer is simple. The 

 training which best fits a man for a pro- 

 fessorship differs in no way from that 

 which best qualifies him for the career of a 

 practitioner or consultant. Some of the 

 men who start upon their career in a mod- 

 ern department of medicine will remain 

 connected with the service in one capacity 

 or another for ten or fifteen years or even 

 more, until the offer of a position as assist- 

 ant or professor or director in anothel 

 large clinic comes to them. Many, after 

 eight or ten years' experience, will find 

 themselves well fitted to enter into the 

 practise of medicine or surgery as con- 

 sultants. Others after spending a shorter 

 period of time will doubtless take up gen- 

 eral or special practise. That to which we 



