- Email: [email protected]
BIOLOGY AND THE MEDICAL CURRICULUM.
273
BIOLOGY
MEDICAL AND THE CURRICULUM. BY T. G.
LONDON,
licensing bodies wisely require a medical student to elementary test in biology (or botany and zoology), pass chemistry, and physics before permitting him to take his examination in anatomy, physiology, aud pharmacy. For very many years botany has been taught to medical students since, in the past, it has been of direct importance. Zoology was introduced later in order to provide a knowledge of the ALL
an
methods of anatomy and to form an introduction to the detailed anatomical study of the human being. The direct value of botany for the most part has disappeared at the present time, and, in view of the changes proposed in the teaching of botany to elementary students, the present is a convenient opportunity for raising certain questions regarding the instruction of medical students in
biology.
Deficiences in Organisation and Teaching. It will be generally conceded that biology has a high educative value and also is the obvious means of providing a preliminary training in the methods and technique which form so important a part in the student’s future work. At the present time instruction in botany and zoology is given in the Universities by the staffs of the two departments, so that a medical student attends lectures and practical classes in botany and zoology, the two subjects being, in the majority of cases, uncoordinated. In the larger medical schools, on the other hand, there is usually a lecturer on biology who instructs in both branches of his science ; the student at the medical school, therefore, has the advantage, but not infrequently the teacher is under the disadvantage of having fewer facilities for teaching. It is not the present intention, however, to deal with medical schools in particular ; but, from wide personal experience as a teacher under both systems, to point out some of the more outstanding deficiencies which obtain in organisation and .
’
teaching.
salary
chemistry.
speedily disappear if the right candidate were selected.
The medical student must be taught the principles of Morphology, for example, must be thoroughly understood; this does not necessitate a large selection of types, the average syllabus contains quite as much material as is requisite. Physiology is most important, and every advantage should be taken of plants simply because the main vital functions can be more easily demonstrated with plants than with animals. Further, it is all-important that the study of function should go hand-in-hand with structure. The medical man must in practice always associate function and structure, and the sooner this habit of mind is formed the better. As it is, the relegation of physiology to a week or so at the end of the course is all but valueless in training. With regard to practical work, it is to be remembered that in addition to mental education, the education of the hand and the eye is all-important. A high degree of skill in dissection and in the preparation of objects for microscopic examination should be insisted upon. A student should be absolutely at home with the microscope and should be able to use the microtome. All should be able to write a description of a preparation or other object in clear and simple language and illustrated by clear and accurate sketches. It does not always appear to be realised what parts of the subject are of direct value to the student in his subsequent studies. To take an example:much too little attention is paid to fundamental facts of the anatomy of plants. Sections of stems, roots, and leaves are all very well, but are of no value without a knowledge of the actual tissue elements. The study of macerated material, judging from examination results, would appear to be dying out. 1 remember being asked by a pathologist, a very highly qualified man, to examine some milk films, as they showed curious bodies which he had never before seen. These bodies were nothing more than lignified vegetable débris-cell walls, protoxylem rings and spirals; in brief, the milk was contaminated from an obvious source. With respect to physiology, there is reason to suspect that in many cases the apparatus is put up and the experiments performed by a demonstrator. This is quite wrong, students should themselves set up their experiments as far as is possible and should invariably perform them. Further, the reason for all negative or peculiar results should be ascertained. A few carefully selected experiments actually set up and observations made by the students themselves are worth hundreds of demonstrations performed by the teacher. In other words, the teacher should act in an advisory
biology.
HILL,
READER IN PLANT PHYSIOLOGY, UNIVERSITY OF UNIVERSITY COLLEGE.
in a medical school should be paid a much lesser (Hi biology than the lecturer in Other difficulties would
Since medical science is a branch of biology the importof general biology-not botany and zoology as such, but a general introduction to the knowledge and study of life and an education in the methods of biological work-in the preliminary medical sciences cannot be over-estimated. The exact amount of actual knowledge gained by the student is immaterial provided he thoroughly understands what he knows and is able to apply the principles learned. In a capacity. It is not infrequently stated that no reform can be made phrase, education rather than mere information. This is, of to the examination system ; if this be so, the sooner owing course, realised ; vividly by some, dimly by others, and efforts have been made to bring the more ideal state of the system be reformed the better. Examiners are to asceraffairs into being. For example, in the first examination for tain what a candidate knows and what he can do. and medical degrees in the University of London, which replaced whether he has a sufficient equipment to proceed with his the older Preliminary Medical Examination, the syllabus has studies. If examiners gave more credit for the practical been much cut down and, instead of separate examinations in examinations and less for the theoretical a great improvequickly result, especially in a subject like botany and zoology, papers are set in general biology. The ment would very where the number of possible questions for biology, general success of these experiments has not been conspicuous, nor the written papers, as judged by the published papers, will be until certain reforms are carried out, appears to be limited. ance
Suggested Reforms.
The first reform is that the medical students must have a special course of instruction, not a bowdlerised edition of PARIS. the instruction given to students in the Faculty of Science. OUR OWN (FROM CORRESPONDENT.) This course must be general biology treated as one subject; it should not be resolved into its components botany and Proposal for a Central Health Department. zoology. Clearly this is not possible unless the instruction THE Commission of Hygiene of the Chamber has adopted be given by a professor or a lecturer, with an adequate staff, who must be held entirely responsible. In other words, he a report drawn up by Dr. Navarre in favour of the formamust be independent of other departments of biology ; he tion of a Ministry of Public Health, under the direction of should be of the Faculty of Medicine rather than of the which would be placed all the health services, both civil and military, of relief and public hygiene. The idea is Faculty of Science. It may be argued that it will prove a very difficult matter not a new one. having been advanctd by a number of to find teachers of any standing to undertake the work and deputies more or less suspect of coveting the post of that, nowadays, no biologist has the time to keep abreast of executive officer. Possible occupants of the post are, the details of botanical and zoological research, and so on. indeed, numerous. The present medical staff is not These are but minor difficulties. When it is understood that unfavourable to the idea in view of the fact that the various there is a high and worthy object in view, the proper people services of hygiene are distribnted among all the Ministries, will be forthcoming, provided the terms of appointment are each occupying a subordinate position without right of attractive; it is, for example, an anomaly that the lecturer initiative or liberty of action. At the Ministry of the
BIOLOGY
MEDICAL AND THE CURRICULUM. BY T. G.
LONDON,
licensing bodies wisely require a medical student to elementary test in biology (or botany and zoology), pass chemistry, and physics before permitting him to take his examination in anatomy, physiology, aud pharmacy. For very many years botany has been taught to medical students since, in the past, it has been of direct importance. Zoology was introduced later in order to provide a knowledge of the ALL
an
methods of anatomy and to form an introduction to the detailed anatomical study of the human being. The direct value of botany for the most part has disappeared at the present time, and, in view of the changes proposed in the teaching of botany to elementary students, the present is a convenient opportunity for raising certain questions regarding the instruction of medical students in
biology.
Deficiences in Organisation and Teaching. It will be generally conceded that biology has a high educative value and also is the obvious means of providing a preliminary training in the methods and technique which form so important a part in the student’s future work. At the present time instruction in botany and zoology is given in the Universities by the staffs of the two departments, so that a medical student attends lectures and practical classes in botany and zoology, the two subjects being, in the majority of cases, uncoordinated. In the larger medical schools, on the other hand, there is usually a lecturer on biology who instructs in both branches of his science ; the student at the medical school, therefore, has the advantage, but not infrequently the teacher is under the disadvantage of having fewer facilities for teaching. It is not the present intention, however, to deal with medical schools in particular ; but, from wide personal experience as a teacher under both systems, to point out some of the more outstanding deficiencies which obtain in organisation and .
’
teaching.
salary
chemistry.
speedily disappear if the right candidate were selected.
The medical student must be taught the principles of Morphology, for example, must be thoroughly understood; this does not necessitate a large selection of types, the average syllabus contains quite as much material as is requisite. Physiology is most important, and every advantage should be taken of plants simply because the main vital functions can be more easily demonstrated with plants than with animals. Further, it is all-important that the study of function should go hand-in-hand with structure. The medical man must in practice always associate function and structure, and the sooner this habit of mind is formed the better. As it is, the relegation of physiology to a week or so at the end of the course is all but valueless in training. With regard to practical work, it is to be remembered that in addition to mental education, the education of the hand and the eye is all-important. A high degree of skill in dissection and in the preparation of objects for microscopic examination should be insisted upon. A student should be absolutely at home with the microscope and should be able to use the microtome. All should be able to write a description of a preparation or other object in clear and simple language and illustrated by clear and accurate sketches. It does not always appear to be realised what parts of the subject are of direct value to the student in his subsequent studies. To take an example:much too little attention is paid to fundamental facts of the anatomy of plants. Sections of stems, roots, and leaves are all very well, but are of no value without a knowledge of the actual tissue elements. The study of macerated material, judging from examination results, would appear to be dying out. 1 remember being asked by a pathologist, a very highly qualified man, to examine some milk films, as they showed curious bodies which he had never before seen. These bodies were nothing more than lignified vegetable débris-cell walls, protoxylem rings and spirals; in brief, the milk was contaminated from an obvious source. With respect to physiology, there is reason to suspect that in many cases the apparatus is put up and the experiments performed by a demonstrator. This is quite wrong, students should themselves set up their experiments as far as is possible and should invariably perform them. Further, the reason for all negative or peculiar results should be ascertained. A few carefully selected experiments actually set up and observations made by the students themselves are worth hundreds of demonstrations performed by the teacher. In other words, the teacher should act in an advisory
biology.
HILL,
READER IN PLANT PHYSIOLOGY, UNIVERSITY OF UNIVERSITY COLLEGE.
in a medical school should be paid a much lesser (Hi biology than the lecturer in Other difficulties would
Since medical science is a branch of biology the importof general biology-not botany and zoology as such, but a general introduction to the knowledge and study of life and an education in the methods of biological work-in the preliminary medical sciences cannot be over-estimated. The exact amount of actual knowledge gained by the student is immaterial provided he thoroughly understands what he knows and is able to apply the principles learned. In a capacity. It is not infrequently stated that no reform can be made phrase, education rather than mere information. This is, of to the examination system ; if this be so, the sooner owing course, realised ; vividly by some, dimly by others, and efforts have been made to bring the more ideal state of the system be reformed the better. Examiners are to asceraffairs into being. For example, in the first examination for tain what a candidate knows and what he can do. and medical degrees in the University of London, which replaced whether he has a sufficient equipment to proceed with his the older Preliminary Medical Examination, the syllabus has studies. If examiners gave more credit for the practical been much cut down and, instead of separate examinations in examinations and less for the theoretical a great improvequickly result, especially in a subject like botany and zoology, papers are set in general biology. The ment would very where the number of possible questions for biology, general success of these experiments has not been conspicuous, nor the written papers, as judged by the published papers, will be until certain reforms are carried out, appears to be limited. ance
Suggested Reforms.
The first reform is that the medical students must have a special course of instruction, not a bowdlerised edition of PARIS. the instruction given to students in the Faculty of Science. OUR OWN (FROM CORRESPONDENT.) This course must be general biology treated as one subject; it should not be resolved into its components botany and Proposal for a Central Health Department. zoology. Clearly this is not possible unless the instruction THE Commission of Hygiene of the Chamber has adopted be given by a professor or a lecturer, with an adequate staff, who must be held entirely responsible. In other words, he a report drawn up by Dr. Navarre in favour of the formamust be independent of other departments of biology ; he tion of a Ministry of Public Health, under the direction of should be of the Faculty of Medicine rather than of the which would be placed all the health services, both civil and military, of relief and public hygiene. The idea is Faculty of Science. It may be argued that it will prove a very difficult matter not a new one. having been advanctd by a number of to find teachers of any standing to undertake the work and deputies more or less suspect of coveting the post of that, nowadays, no biologist has the time to keep abreast of executive officer. Possible occupants of the post are, the details of botanical and zoological research, and so on. indeed, numerous. The present medical staff is not These are but minor difficulties. When it is understood that unfavourable to the idea in view of the fact that the various there is a high and worthy object in view, the proper people services of hygiene are distribnted among all the Ministries, will be forthcoming, provided the terms of appointment are each occupying a subordinate position without right of attractive; it is, for example, an anomaly that the lecturer initiative or liberty of action. At the Ministry of the