OCTOBEE 10, 1913] 



SCIENCE 



495 



The conditions in the United States have 

 only recently so begun to improve that 

 there begins to be a distinct incentive for 

 a young clinician to definitely formulate a 

 career as a medical teacher. Three years 

 ago, in New York City, there was no hos- 

 pital which could offer a continuous serv- 

 ice. If any one were interested in scientific 

 research, he might work for three months 

 in his wards, at the end of which time he 

 was turned out by a successor who might 

 care nothing for research. The admirable 

 example of the close affiliation between the 

 hospital and medical school at the Johns 

 Hopkins was long ignored. The whole 

 situation was most unsatisfactory from an 

 educational standpoint. 



At the present time Columbia has 

 formed an affiliation with the Presbyterian 

 Hospital, the Cornell Medical School one 

 with the New York Hospital, similar al- 

 liances exist in Cleveland, St. Louis and in 

 other localities and, in Boston, the Harvard 

 Medical School controls the appointments 

 to the Peter Brent Brigham Hospital. The 

 arrangements are, for the most part, tem- 

 porary and experimental. The last-named 

 union has enabled the new Brigham Hos- 

 pital and the Harvard Medical School to 

 attract from different parts of the country 

 some of the best minds in the United 

 States. It is of happy augury that men 

 who, often at the expense of poverty and 

 mental anxiety, of illiberal criticism and 

 even of personal abuse, have labored to at- 

 tain high professional rank through scien- 

 tific endeavor, should be given the oppor- 

 tunity to achieve a better condition of 

 medical scholarship. There is here embod- 

 ied the true spirit of the possibility of con- 

 quest of the material by the intellectual. 

 The appointments at Harvard were made 

 for merit and were not due to local celeb- 

 rity or to the desire to satisfy relatives or 

 personal associates. Of aU the traditions 



inherited from the days of the proprietory 

 school, the faculty perquisite of the ap- 

 pointment of local mediocrity to important 

 clinical positions dies the hardest. It is 

 still too easy to appoint to a professorship 

 a man without scientific or educational in- 

 terests. Yet such misuse of power is grad- 

 ually becoming less and less possible. 



There has been much discussion of late 

 years regarding the duties of a university 

 professor of a clinical subject. Effort has 

 been made to have him renounce all private 

 practise. This ideal state has not yet been 

 put to the test but arrangements are now 

 in progress for its introduction into one of 

 the best schools. President Vincent, of the 

 University of Minnesota, presents the un- 

 solved problem of the clinical teacher in 

 the following words: 



Tou realize how difficult it is to persuade a 

 man who is making $25,000 a year from his prac- 

 tise on the outside to accept a position of $3,000 

 on the inside. If you can get hold of the un- 

 sophisticated medical man before he owns an auto- 

 mobile, much may be accomplished, but after he 

 once yields to the insidious motor car, nothing can 

 be done in the way of regeneration. 



The best class of university professors 

 accept only a strictly consultation practise 

 and do not receive patients for treatment 

 except in their own hospitals. The pro- 

 fessor of medicine at Columbia has devoted 

 five hours daily to his work in the school 

 and the affiliated Presbyterian Hospital, 

 and his associate does not practise. Herein 

 lies the kernel of reformation. The uni- 

 versity should emphatically require that 

 the welfare of its affiliated hospital, the pa- 

 tients therein and the throng of young 

 physicians who are being educated, should 

 be considered as of at least equal im- 

 portance to the maintenance of regular 

 office hours by the physicians in charge. 

 Progress in the right direction is now being 

 accomplished. The increasing spirit of 



