Medical Education in France.

1828

Although this may seem an ideal solution, the time is hardly ripe for it yet, but it is owners of factories and workshops tends to encourage emover-ripe for the extension to home workers of the sanitary ployers to resort to home work in order to avoid these obliga- advantages secured to factory and workshop hands. tions and the visits of inspectors. The committee’s investiga- Advantages would accrue not only to the workers but tion of the existing law with regard to home work retells an to the purchasers of their produce, for the present A very important suggestion made by the committee is that the imposition by law of obligations upon

the work. "’

which

we

review in another column.

old story, that local authorities do not make sufficient use system which allows of clothes and other articles intended of the imperfect sanitary powers which they possess already. for sale to be heaped up on the beds and tables of These powers fall under the general public health law con- a den used for both eating and sleeping by the wretched cerning dwellings and certain special provisions of the toiler who calls it "home," must surely lead to the Factory and Workshop Act of 1901, the chief of which dissemination of disease when the goods are distributed prohibits any person to give out work to be done in premises to the public. On this point the committee might well

which

to the health of the persons employed Persons giving out work are obliged to supply

are

therein.

injurious

sought more direct evidence. asking the Government to give the

have

It

strengthens

us

in

recommendations of the authority early and thorough whom they employ. These lists are usually incomplete and consideration. In the mean time health officers should urge incorrect. Other Acts, such as the Truck Act of 1896, made by all means in their power on their local authorities the for the protection of workers’ wages, are often frustrated in enforcement of such powers as the committee has reminded their application to home workers and the committee is them that they possess. The trade interests involved in satisfied that the existing law has failed to produce any certain districts doubtless clash with the sanitary interests of amelioration in their condition and that legislation of a far- the community in this as in many other matters, and it

twice

a

year to the local

a

list of the outworkers

reaching character is required. The

report then summarises

other countries for the

tI

Select Committee

affords some

of home proceeds to make its recommendations which record with little comment. These include the

protection

we

Home Work its

additional argument for

that the of tenure of medical officers of health should cease

an

existing in security workers and to be dependent

of the laws

on

on

demanding

private interest and caprice.

must

following Medical Education in France. suggestions :WE have received the annual Numero des Et1ldiants et des (2.) That legislation should at first be tentative and experiPratitiens published by the French weekly medical journal mental, and be limited in its scope to home workers engaged in the tailoring, shirtmaking, underclothing, and baby linen Le Progrès -iV6dical. It is on the same general lines as the trades, and in the finishing processes of machine-made lace. The Home Secretary should be empowered after inquiry Students’ Number of THE LANCET and it supplies a very made, to establish Wages Boards for any other trades. interesting and complete summary of the educational (3.) That Wages Boards representing both workers and facilities afforded to the student and the practitioner of employers should be established in selected trades to fix minimum time and piece rates of payment for home workers medicine in France. In addition it supplies valuable inin those trades. formation regarding the regulations for the various examina(4.) That it should be an offence to pay or offer lower rates tions in the different universities and general advice to the of payment to home workers in those trades than the minimum rates which had been fixed for that district by the practitioner regarding the laws governing medical education Wages Board. and practice, and is in effect a very complete presentation of (6.) That all home workers who are employed by other all that concerns the official aspect of the medical curriculum persons in producing or preparing articles for sale should be required to register their name, address, and class of work and the profession of medicine. It opens with an address to at, and receive a certificate of such registration from, the the student in which he is advised to avail himself of the offices of the local authority, and that the keeping of accurate outworkers’ lists by employers should be strictly courses of instruction provided by the Faculty of Medicine of enforced. his university, and to seek to acquire the habit of observa(7.) That it should be an offence for any person to tion. The necessity for practical work is strongly emphasised employ any home worker to produce or prepare any articles for sale by another person unless the worker produce and the student is enjoined to go to the hospital daily a certificate of registration. from the time that he commences the study of medicine, and (8.) That the provisions of Section 9 of the Public Health to endeavour to form his own opinions in regard to cases. Act, 1875, with regard to factories and workshops which areI not kept clean or are ill-ventilated or overcrowded should be I The importance of a due perspective in regard to his extended to rooms in which home work is done, and power work is also most strongly insisted on. should be given to sanitary and factory inspectors to inspect The actual subject matter of this special number is them and secure the enforcement of the law. (9.) That the full protection of the Truck Act should be divided into four parts, the first of which is devoted to a secured to home workers. general account of the universities and schools of medicine Recommendation (6) was apparently the outcome of Dr. and to the general arrangements for medical students and DUDFIELD’S evidence given in 1907, and together with (7) practitioners. There are 15 universities in France and one and (8) it will probably receive the support of many medical in Algiers, but only seven of these-viz., Bordeaux, Lille, officers of health. It will be seen that no suggestion is made Lyons, Montpellier, Nancy, Paris, and Toulouse-possess a of abolishing home work by establishing communal work- Faculty of Medicine. There are, however, in addition 17 schools of medicine, divided into two classes-schools for rooms and creches, which will occur to many as a possible ,

and radical method of reform and which is advocated in Mr. " J. SAMUELSON’8 little bookThe Lament of the Sweated"

the

complete curriculum, comprising Marseilles, Nantes, Rennes, and Algiers, and preparatory schools at AmieRs.

1829 Arras, Angers, Besanoon, Caen, Clermont, Dijon, Grenoble, detailed and the prizes offered by it, amounting to nearly Limoges, Poitiers, Reims, Rouen, and Tours. In the former 60, are enumerated. The third part is concerned chiefly with the provincial students can study for the whole 16 terms of the curriculum, in the latter only for the 12 early terms, and in both cases the final examination must be taken before a faculty. There

universities and schools, and gives the various courses of lectures and practical work afforded in them. An interesting is a dean (doyen) at the head of each faculty who is appointed appendix to it gives brief details of foreign universities in by the Minister of Public Instruction for a period of which the French language is employed, including the three years, and is chosen from the titular professors. The Belgian universities of Brussels, Ghent, Liege, and

professoriate and agrégés.

is divided into two classes-titular

professors Louvain, the Universities of Geneva, Lausanne, Bucharest, appointed periods, and Jassy, and the Faculties of Medicine of the Laval usually nine years, but the period can be extended University in Quebec and Montreal. The fourth and by the Minister. They assist in the examinations, replace concluding part is specially addressed to the practitioner, the professors when they are absent, and give courses It opens with some general advice to those newly qualisupplementary to those of the professors. There are two fied concerning registration, starting in practice, provarieties of the diploma of Doctor of Medicine in France fessional secrecy, the signing of certificates, responsibility, The and the many difficult problems with which the professional -that of a university and that of the State. university diploma is open to foreigners; it is purely man may be called upon to deal. The various laws, rules, academic and is only of value as a scientific qualification. and regulations concerning medical practice are then It does not confer the right to practise or any other of the summarised, including special laws dealing with the pracprivileges of the State diploma. Certain regulations must tice of pharmacy and the supply of therapeutic serums and The various societies for professional be conformed to, certain examinations taken, and fees paid similar products. amounting to 1400 francs in order to obtain this diploma. assistance and protection are next described, with their For the State diploma the curriculum is four years, divided objects and aims. The concluding section is devoted to the into 16 terms. Various examinations have to be passed, a thermal stations and mineral springs of France and gives thesis written on some subject, and fees of 1390 francs paid. useful accounts of the chief features of these waters and the This part also contains information regarding the military, indications for their use. Le Progres Medical is to be connaval, and colonial medical services and the various associa- gratulated upon this very useful production ; it should be of tions of students both in Paris and elsewhere. great value to all people in this country who are interested The second part is devoted to the University of Paris, to in medical education in France and to those who propose the hospitals and institutions in that city, and to the various to pursue post-graduate or vacation courses of study in Paris medical societies. The Faculty of Medicine of the University or at any other of the great medical centres in France. The latter

for stated

are

founded in 1808 in succession to the Ecole de was itself the successor of the old Faculty of Sant6, Medicine suppressed in 1793 at the same time as the College of Surgery. Full information is given of the various courses of lectures to be given during the academic year 1908-09 and of the special courses to be held during the vacations. The various hospitals of Paris are described, the staff of each is given, and the courses of instruction and the clinical facilities afforded by each are set forth. A special chapter is devoted to the Pasteur Institute and Hospital. The institute is described and the nature of the work carried on there is briefly outlined. It is of interest to learn that since 1889 more than 1000 persons have attended the lectures and practical courses of microbiological technique, while nearly an equal number have attended the lectures only, showing what an important part the institute has played as an educational body as well as a home of research. A special chapter is devoted to the consideration of the preliminary scientific education of the medical student who has to produce a certificate of having passed the P. C. N. of Paris

was

which

(i.e., physics, chemistry,

and natural

liminary year is under the control of

history). the Faculty

This preof Science.

The four dental schools in Paris are next described. The dental course extends over three years and the examinations are carried out by the Faculty of Medicine. The fees vary from 1000 to 1500 francs and the examination fees amount to 250 francs. The second part is brought to a close by an

interesting

account of the various medical societies.

The

constitution of the well-known Academy of Medicine is

Annotations. "one quid nimis."

NATIONAL HEALTH. ON Dec. llth the third annual meeting of the National League for Physical Education and Improvement was held in the Jerusalem Chamber adjoining the south side of Westminster Abbey under the presidency of the Bishop of Ripon. His lordship, in moving the adoption of the and the accounts, said that the object of the league report to make was people as physically "I fit" as possible. It had lately been realised that the mind could not be properly educated unless the body was so too. By means of proper care and forethought much infantile mortality might be prevented. The Lord Mayor, who seconded the motion, said that unless they began with the child they would never teach the alphabet of regeneration. A pure milk supply was of the most vital importance. He was going to do all he could to make his year of office a children’s year. The report and accounts were adopted, the former containing a recommendation that Poor-law authorities should be granted powers to acquire farms in Canada and other suitable site? in the empire. The Archbishop of Canterbury said that they could not separate man into two parts. Both the physical and the spiritual sides must be dealt with. It was often asked why the legislature did not do something, but the legislature had done its part, it was owing to the apathy of the public that so little had been done. The meeting then terminated. For our part we think that the problems which the league has set itself to solve are among the most