776 



SCIENCE 



[N. S. Vol. XLII. No. 1092 



laboratory or clinical diagnosis, are taught 

 in the department of medicine or in other 

 clinical departments. As nearly as can be 

 estimated the time allotted to pathologic 

 topics ranges from 210 hours in one school 

 to a maximum of 504 hours in the Univer- 

 sity of Ohio. 



One of the most conclusive evidences that 

 up to 8 or 10 years ago the principles of ped- 

 agogy were little understood or regarded by 

 medical faculties, was the great diversity in 

 the number of hours assigned to the sev- 

 eral medical branches. You will recall the 

 rather startling findings of the investiga- 

 tions made as to this matter a decade ago 

 by the secretary of the Michigan State 

 Board of Medical Examiners, the president 

 of the Illinois State Board of Health, and 

 by the Council on Medical Education of the 

 American Medical Association. It was 

 found that the number of scheduled hours 

 assigned to some of the important medical 

 subjects varied by as much as three or four 

 hundred per cent., and that some of the 

 minor subjects, for example, orthopedic 

 surgery, occupied as much of the student's 

 time in some colleges as a major branch 

 like medicine or general surgery. 



It is obvious that these curricula were 

 not prepared with any logical considera- 

 tion of the relative values of the medical 

 branches. Each instructor, impressed with 

 the magnitude of his own subject, clamored 

 for more and more time, insisting that he 

 could not ' ' cover the ground ' ' of his branch 

 of medicine in any number of hours that 

 could in reason be given over to it in a four- 

 year course of study. The construction of a 

 medical curriculum from the point of view 

 of the average student's working capacity 

 and the logical division of his total work- 

 ing hours between the several branches in 

 ratio to their relative importance to the 

 medical practitioner seems not to have been 

 attempted until a very recent period. 



When the problem is approached from 

 this standpoint it becomes at once evident 

 that by no possible scheme can such a num- 

 ber of scheduled hours be allotted to any 

 branch as will make it possible for the in- 

 structors to completely "cover the ground" 

 of that branch. The task of each depart- 

 ment is to make such use of the number of 

 hours assigned to it, by faculty vote, as will 

 secure to each student the largest possible 

 educational result for the expenditure of 

 that time in the given topic. With a cur- 

 riculum blocked out on such a basis, pathol- 

 ogy can not logically demand more than 

 8 or 9 per cent. — together with bacteriology 

 not to exceed 12 per cent. — of the total 

 number of scheduled hours in the four 

 years' course of study; as this total in the 

 average medical school is approximately 

 4,400 hours, the time assigned to pathology 

 should not exceed 350 or 400 hours. 



I find that the average allotment to the 

 courses in pathology in the curricula of the 

 forty colleges which I have examined is 

 about 350 hours, although there are a few 

 marked exceptions. The time allotted to 

 bacteriology ranges from about 100 to 200 

 hours, with an average of 150, thus making 

 a total for the two subjects fairly propor- 

 tionate to their importance in relation to 

 the other branches of the medical curric- 

 ulum. 



The logical sequence of the medical sub- 

 jects is determined by certain fundamental 

 pedagogic principles. 



The study of structure logically precedes 

 the study of function; knowledge of the 

 normal is essential to an understanding of 

 the abnormal, although the study of the 

 latter often yields valuable information 

 about the normal; a broad knowledge of 

 the principles, facts and methods of any 

 growing science to specific problems, as 

 those of medicine, is an indispensable pre- 

 requisite if the student is to be so grounded 



