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Opportunities for Training in Ophthalmology
356
EDITORIALS
O P P O R T U N I T I E S FOR TRAINING IN OPHTHALMOLOGY As of October 1, 1945, the Council on Medical Education and Hospitals of the American Medical Association listed 73 hospitals where otolaryngologic residencies, 56 ophthalmologic residencies, and 43 combined ophthalmologic-otolaryngologic residencies are offered. They are not sufficient, at least in so far as ophthalmology is concerned, to take care of the overwhelming immediate demand, nor very likely to satisfy the demand when the confusion of the present subsides. The long term does not particularly concern us at the moment. The disturbing present requires our attention to see what can be done to alleviate this intolerable condition. Unquestionably, the stimulating and new Veterans' Administration program for residency training will partly solve this problem for us. It deserves careful scrutiny, and the candidate for ophthalmology should not overlook this opportunity, which may be better in many ways than some of the residencies offered by civilian institutions in so far as clinical material, training, supervised study, and research in ophthalmology are concerned. At a recent meeting of the Advisory Board for Medical Specialties, Dr. Paul Magnuson, representing the Medical Department of the Veterans' Administration, mentioned that during the next 50 years about 18 million men and women will have been taken care of by the Veterans' Administration hospitals. It is general knowledge that the Veterans' Administration is building and planning to build its hospitals as near to medical centers as possible in order to take advantage of the greatest collection of good doctors. Most of these areas are to be found adjacent to a university and medical school. Mem-
bers of medical faculties of these schools will take active part in helping to staff the hospitals and in assisting in the residency-training program. The clinical material is very great and embraces all age groups. The exservice patients deserve the best of medical care and will get it, if the wise policies of Maj. Gen. Paul R. Hawley, Surgeon General of the Veterans' Administration, are followed. The battle is uphill and difficult, for there are many politicians, professional and amateur, whose philosophy has nothing to do with the ideals of good medical care, and their opposition is a delaying one. Generals Bradley and Hawley deserve every help and great commendation. One has faith that the public, if it knows the facts, will overwhelmingly back up these plans, everywhere. To be sure, it will take a number of years to complete the building of new veterans' hospitals. However, the old ones are active, and residencies in ophthalmology in them are now available. Reorganizations of the staffs are being carried out, and new attending men and consultants are being appointed. It is good, too, to know that the problems of ophthalmology are in the capable hands of Dr. Trygve Gundersen, formerly consultant in ophthalmology, Mediterranean Theater, and to the Surgeon General of the Army, who has recently been appointed to the post of Chief Consultant in Ophthalmology to the Veterans' Administration. He is charged with the responsibility of organizing the ophthalmic services in the veterans' hospitals. These duties include matters of equipment, choice of consultants, and supervision of the residency-training program for ophthalmologists. It speaks well for the future that this able leader in ophthalmology is at the helm. The ophthalmologists who are assigned
EDITORIALS as attending men to the eye services of these hospitals have great opportunities not only for giving excellent care to the patients but also for developing to a very high degree the teaching facilities of the institution. The best places for the training of residents and internes are those that give the best professional care to the patients. Let us return for a moment to the matter of the combined eye, ear, nose, and throat residencies mentioned before. A few of these are undoubtedly excellent and offer good facilities for men and women who are planning to do combined work. It is conceded that in small communities, particularly, there is a need for the eye, ear, nose, and throat specialist. There is one advantage at any rate, such an individual is never mistaken for an optometrist by the public. However, the average combined specialist has shown himself in the Army to be poorly equipped for top-flight ophthalmic work, and since these men came from civilian life the findings would be similar for the specialty as a group. Perhaps some or many of the institutions giving a combined residency can be persuaded, during the emergency shortage of training facilities, at least, to divide their service into two, one for ophthalmology and the other for otolaryngology. This would be profitable to them in that more efficient service could be given, and a valuable boon to the neophyte ophthalmologist seeking a residency, particularly if he had had a basic course beforehand. The probable result would be a raising of the standards of ophthalmic practice among those doing part-time otolaryngology. It would mean a longer term of training for those seeking to be accomplished eye, ear, nose, and throat men; but there is no short cut without the sacrifice of training and skills.
357
Elsewhere in this issue* will be found an announcement from the American Board of Ophthalmology pertaining to preceptorships. It clearly establishes the policies of the Board in this matter, and puts it up to the student to make a wise choice of a preceptor. It recalls to mind a very attractive phase in the early history of medical education. It would have been a priceless privilege to be chosen pupil on one end of a log with Ernst Fuchs on the other, had he been available. Many a young man in the old days became a fine physician, trotting around with his preceptor on calls and in the office. A good preceptor must be very scarce. He has a reputation as a preceptor to establish and maintain, and if the pupil has to be wise in his choice, the preceptor should be most careful in his, too; for there is something very intimate and very filial in the relationship. One often judges the father by the son, and the son's manners are but a reflection of the old man's influence. A good preceptorship can be like an invaluable heritage, a poor one like a mismated marriage. It can generate affection, loyalty, and respect or it can produce evil fruits on both sides. A responsive, talented, and eager pupil brings great joy to the preceptor's heart, and in this lies his reward for a difficult task. The future career of his pupil will be followed and supported for the rest of his days. He will know that some measure of immortality at any rate will be his for a time because the preceptor comes to life again at each phrase of his pupil's speech, each turn of his pupil's hand, and each word of an old inherited patient's affectionate memory. Derrick Vail.
* See page 385.
EDITORIALS
O P P O R T U N I T I E S FOR TRAINING IN OPHTHALMOLOGY As of October 1, 1945, the Council on Medical Education and Hospitals of the American Medical Association listed 73 hospitals where otolaryngologic residencies, 56 ophthalmologic residencies, and 43 combined ophthalmologic-otolaryngologic residencies are offered. They are not sufficient, at least in so far as ophthalmology is concerned, to take care of the overwhelming immediate demand, nor very likely to satisfy the demand when the confusion of the present subsides. The long term does not particularly concern us at the moment. The disturbing present requires our attention to see what can be done to alleviate this intolerable condition. Unquestionably, the stimulating and new Veterans' Administration program for residency training will partly solve this problem for us. It deserves careful scrutiny, and the candidate for ophthalmology should not overlook this opportunity, which may be better in many ways than some of the residencies offered by civilian institutions in so far as clinical material, training, supervised study, and research in ophthalmology are concerned. At a recent meeting of the Advisory Board for Medical Specialties, Dr. Paul Magnuson, representing the Medical Department of the Veterans' Administration, mentioned that during the next 50 years about 18 million men and women will have been taken care of by the Veterans' Administration hospitals. It is general knowledge that the Veterans' Administration is building and planning to build its hospitals as near to medical centers as possible in order to take advantage of the greatest collection of good doctors. Most of these areas are to be found adjacent to a university and medical school. Mem-
bers of medical faculties of these schools will take active part in helping to staff the hospitals and in assisting in the residency-training program. The clinical material is very great and embraces all age groups. The exservice patients deserve the best of medical care and will get it, if the wise policies of Maj. Gen. Paul R. Hawley, Surgeon General of the Veterans' Administration, are followed. The battle is uphill and difficult, for there are many politicians, professional and amateur, whose philosophy has nothing to do with the ideals of good medical care, and their opposition is a delaying one. Generals Bradley and Hawley deserve every help and great commendation. One has faith that the public, if it knows the facts, will overwhelmingly back up these plans, everywhere. To be sure, it will take a number of years to complete the building of new veterans' hospitals. However, the old ones are active, and residencies in ophthalmology in them are now available. Reorganizations of the staffs are being carried out, and new attending men and consultants are being appointed. It is good, too, to know that the problems of ophthalmology are in the capable hands of Dr. Trygve Gundersen, formerly consultant in ophthalmology, Mediterranean Theater, and to the Surgeon General of the Army, who has recently been appointed to the post of Chief Consultant in Ophthalmology to the Veterans' Administration. He is charged with the responsibility of organizing the ophthalmic services in the veterans' hospitals. These duties include matters of equipment, choice of consultants, and supervision of the residency-training program for ophthalmologists. It speaks well for the future that this able leader in ophthalmology is at the helm. The ophthalmologists who are assigned
EDITORIALS as attending men to the eye services of these hospitals have great opportunities not only for giving excellent care to the patients but also for developing to a very high degree the teaching facilities of the institution. The best places for the training of residents and internes are those that give the best professional care to the patients. Let us return for a moment to the matter of the combined eye, ear, nose, and throat residencies mentioned before. A few of these are undoubtedly excellent and offer good facilities for men and women who are planning to do combined work. It is conceded that in small communities, particularly, there is a need for the eye, ear, nose, and throat specialist. There is one advantage at any rate, such an individual is never mistaken for an optometrist by the public. However, the average combined specialist has shown himself in the Army to be poorly equipped for top-flight ophthalmic work, and since these men came from civilian life the findings would be similar for the specialty as a group. Perhaps some or many of the institutions giving a combined residency can be persuaded, during the emergency shortage of training facilities, at least, to divide their service into two, one for ophthalmology and the other for otolaryngology. This would be profitable to them in that more efficient service could be given, and a valuable boon to the neophyte ophthalmologist seeking a residency, particularly if he had had a basic course beforehand. The probable result would be a raising of the standards of ophthalmic practice among those doing part-time otolaryngology. It would mean a longer term of training for those seeking to be accomplished eye, ear, nose, and throat men; but there is no short cut without the sacrifice of training and skills.
357
Elsewhere in this issue* will be found an announcement from the American Board of Ophthalmology pertaining to preceptorships. It clearly establishes the policies of the Board in this matter, and puts it up to the student to make a wise choice of a preceptor. It recalls to mind a very attractive phase in the early history of medical education. It would have been a priceless privilege to be chosen pupil on one end of a log with Ernst Fuchs on the other, had he been available. Many a young man in the old days became a fine physician, trotting around with his preceptor on calls and in the office. A good preceptor must be very scarce. He has a reputation as a preceptor to establish and maintain, and if the pupil has to be wise in his choice, the preceptor should be most careful in his, too; for there is something very intimate and very filial in the relationship. One often judges the father by the son, and the son's manners are but a reflection of the old man's influence. A good preceptorship can be like an invaluable heritage, a poor one like a mismated marriage. It can generate affection, loyalty, and respect or it can produce evil fruits on both sides. A responsive, talented, and eager pupil brings great joy to the preceptor's heart, and in this lies his reward for a difficult task. The future career of his pupil will be followed and supported for the rest of his days. He will know that some measure of immortality at any rate will be his for a time because the preceptor comes to life again at each phrase of his pupil's speech, each turn of his pupil's hand, and each word of an old inherited patient's affectionate memory. Derrick Vail.
* See page 385.