Basic Science Departments Research Articles

The teaching of surgery to undergraduate and graduate students

I T WOULD SEEM proper to make a statement of credentials, which will afford a base from which readers may form an opinion about remarks upon the teaching of surgery to undergraduate and graduate students. I Graduation from a voluntarily supported University’s medical school, an internship in a large county hospital, and the practice of medicine and surgery for fourteen months in an Illinois city of 22,000 inhabitants stimulated a desire for more education and training in surgery. There were no formal residency education and training programs in surgery in Chicago in 1920. However, progressive education and training in surgery was completed under the auspices of one surgeon. This program consisted of a year in a laboratory plus a small number of diagnostic preoperative duties; a year of general surgical diagnostic and preoperative responsibility, plus teaching duties in two basic science departments; a third year of surgical operative and postoperative work, which included studies of the gross and microscopic pathologic specimens, and a fourth year devoted to diagnostic and operative work in the special field of neurologic surgery. In 1920, it was unusual in the Midwest for a graduate to pursue medical education beyond commencement day, or a year of internship. Until 1919, it was possible to graduate, pass the state board examination, and practice in Illinois without having the experience of an internship. The colonial pattern of the practice of medicine prevailed generally. Physicians learned to perform surgical operations by cutting upon patients willing to mount a table and exercise the degree of patience and confidence necessary under the conditions imposed. These operators wielded their knives indiscriminately within the abdomen, pelvis, and about the periphery. It is not difficult to trace the origin of the terms, “general surgeon,” and “he does his own surgery.” In one instance in the early years of the twentieth century, a deep laceration upon the dorsum of the hand, which included a branch of the radial artery, was treated with an application of turpentine before the doctor arrived. The anesthetic consisted of a sprinkling of iodoform, which was described by the bearded doctor as he removed his highly starched detachable cuffs, as a miraculous yellow substance which prevented all pain. The operating theater was the sitting room, the table was the mother’s lap; the curved needle was picked from the bottom of the black bag and threaded with a strand of large catgut untangled from among a number of items which would do credit to the contents of the present day purses of ladies. A continuous, engaging conversation was not interrupted by the passage and tying of the suture and skillful application of a bandage. Another example was the reduction of a dislocated head of the humerus by the physician grasping the hand of the extended arm, as he sat upon the football field with the heel of his stockinged foot thrust f%-mly into the axilla. The surgical course in one medical school in 1914 to 1918 was taught to undergraduate medical students with the goal of preparing them to practice surgery, within the bounds of their own conscience and belief in the Golden Rule. A course in surgical anatomy was given in the senior year by which time it was hopefully assumed that the cadaver dissection of the freshman year, and the combined experiences of the intervening years, had prepared the student for a valuable review of the intricacies of blood vessels, nerves, and viscera. The emphasis was

Biochemical Aspects of Hormone Action.

This volume constitutes a report of the proceedings of a symposium entitled Biochemical Aspects of Hormone Action, held in the latter part of 1962 at the Jewish Hospital of St. Louis. Among the 21 contributing authors were ten from basic science departments of medical schools, five from clinical departments, and six from research laboratories or research institutes. There were 10 PhD's and 11 MD's, and one had both degrees. The book has ten chapters with a recorded discussion after each chapter. This practice is controversial; in such discussions one often gets lost in the snowstorm of trivia which makes up the greater part of the exchange among participants. Either the editor is superb or all the contributors write excellent scientific English—for the book is unusually well written and there is no criticism in regard to English usage. Credit is deserved all around for an unusually well-written book in happy contrast

Library and basic science departments at Indian Institute Continue Growth

Library and basic science departments at Indian Institute Continue Growth

The underlying cause of unrest in university medicine.

• Medical science has been increasing rapidly in scope and complexity. Medical research has to enlist the services of the whole range of knowledge from surgery to mathematics, and medical practice depends on techniques ranging from physics to psychiatry. As a result, the duration and expense of medical education have increased greatly. The eventual solution of the basic problem must include some shortening of the course for selected medical students, some reduction of the now almost prohibitive cost of medical education, closer collaboration between liberal arts and medical science, and strengthening of the basic science departments of medical schools.

Research knowledge and attitudes reflected in medical education.

• Teachers who are also competent as investigators are no longer confined to the basic science departments of medical schools but are found in the clinical departments as well. Students can obtain desirable research experience by various informal and formal arrangements, which include programs of summer research or even a year of full-time research in a laboratory of the student's choice after he has finished his preclinical courses. The financial problems can be solved. Grants to institutions that wish to further student research training are available through federal agencies and private foundations. These permit the universities to pay students enough for time spent on research to compensate them when they forego higher-paying work of other kinds.

Study of Physical Medicine

ACCORDING to the Journal of the American Medical Association of December 25, the first centre for the scientific study and development of physical medicine as a branch of medical practice has been established by the National Foundation for Infantile Paralysis in the Graduate School of Medicine of the University of Pennsylvania. The centre will include a department for development of physical medicine as a scientific part of the practice of medicine, a training centre for medical leaders and teachers in this branch of medicine, and a school for training technical workers. The departments of anatomy, physiology pathology and other basic sciences of the University of Pennsylvania will co-operate in this proposed programme.