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THE CURRICULUM
905
seeing the effects of compulsory health insurance depicted in a roseate hue," and has quoted at length a passage from our own columns2 describing the hardship arising from the 10 per cent. cut on the 9s. capitation fee-a hardship now fortunately in process of
mitigation. THE CURRICULUM
AT its Dublin meeting the representative body of the British Medical Association received and discussed a report from a special committee on medical education. The report was an interim one ; the meeting was not asked formally to approve it but rather to indicate whether there was any fundamental objection to the main suggestions contained in it. That report was gratefully received by the meeting, and during the winter the same committee has continued its deliberations and has now presented 3 a report to the council of the B.M.A. which is to be submitted to the Bournemouth meeting in July for its approval, with the intention then of sending copies to the General Medical Council and other bodies interested in medical education. The interim report has been embodied in the report now presented. No alteration has been made in its main points ; it has been rounded off and amplified. Sir HENRY BBAOEBNBUBY summarised the report at the Dublin meeting. The committee, he said, had defined medical study as properly beginning at the point at which a student starts work upon human anatomy and physiology, and they had had to decide what stage he should have reached before he began those studies. All agreed that the course should not be lengthened, but it was generally felt that the education of the student should have reached a certain standard before he entered on the study of anatomy and physiology, and the first main change proposed by the committee was that the student should give evidences of a heightened educational standard and of being well grounded in the fundamental principles of chemistry, physics, and biology in their application to medicine. Conflicting views have been expressed as to the nature of the instruction in the basic sciences necessary for medical education. There are those who emphasise the acquirement in physics, chemistry, and biology of a certain knowledge of facts which are of direct value to the medical student and practitioner, but the view has prevailed in the committee that the essential purpose of these studies is the training of the student in scientific method and discipline rather than the acquirement of a smattering of technical knowledge. If, as is suggested, two years or thereabouts are given to the study of these sciences along with cther subjects of general education-usually English language and literature, a foreign language, and perhaps history-an intellectual equipment and scientific outlook will have been acquired which will enable the student readily to apply these sciences to his own particular field. After registration, which the committee would wish to see made a statutory obligation, it is felt 2 THE LANCET, March 17th, p. 600. 3 Brit. Med. Jour., April 21st Suppl., p. 192.
that too great demands are made on the student’s time in the courses of anatomy and physiology as at present taught. These should be taught as interrelated subjects, their main aim being the study of the living rather than the dead body, and it will be generally admitted that it cannot be necessary for the student to dissect every part of the dead body. At this period it is suggested that the student should become familiar with the methods of manual examination and be taught the use of the clinical thermometer and the various " scopes " along with the estimation of blood pressure, the examination of blood, and the analysis of secretions ; but not more than five terms should be occupied with this part of the curriculum, and in its present report the committee shows how desirable it is for the inclusion of three special subjects, attention to which has been woefully inadequate. These are genetics, growth, and
mental function-and although from the systematic side they could probably be dealt with in a few lectures the committee evidently doubts whether these should be given by the appointed teachers of anatomy and physiology. The most interesting suggestion for the clinical years is that a period of two years and six months on the lines of the present curriculum, but with less specialisation, should close with the final written and oral examination, but that the student should not be eligible to obtain his legal qualification without a further period of nine months of practical experience to be gained in one of five ways : (1) in a resident appointment in a teaching hospital ; (2) as clinical assistant in a hospital or clinic ; (3) as pupil assistant to an approved general prac-
titioner ; (4) as pupil to an approved M.O.H. ; (5) in regular attendance at hospital practice in a medical school. It was at this point that the committee was not unanimous, for one of its members felt that it was a bad thing for students to spend their last year hanging about the hospital out-patient department. The report as it stands is a very interesting and stimulating contribution to the revision of the medical curriculum which does at long last seem likely to be taken seriously. THE council of the British Medical Association has. recommended that Sir Richard Stawell, consulting physician to the Melbourne Hospital and Children’s Hospital, should be elected president of the Association for 1935-36. The annual meeting is to be held at Melbourne next year in the week beginning Sept. 9th, and at Oxford in 1936. The report ot the council issued last week states that the Sir Charles Hastings clinical prize for 1934 has been awarded to Dr. Helen Lukis, of New Maiden, for her study of the problems of anaesthesia in general practice. The Katherine Bishop Harman prize given every second year for the encouragement of study and research in avoiding the risks of childbearing has been awarded to Dr. J. M. Munro Kerr, regius professor of midwifery in the University of Glasgow. A certificate of honourable mention was given to Dr. Dora Colebrook.
seeing the effects of compulsory health insurance depicted in a roseate hue," and has quoted at length a passage from our own columns2 describing the hardship arising from the 10 per cent. cut on the 9s. capitation fee-a hardship now fortunately in process of
mitigation. THE CURRICULUM
AT its Dublin meeting the representative body of the British Medical Association received and discussed a report from a special committee on medical education. The report was an interim one ; the meeting was not asked formally to approve it but rather to indicate whether there was any fundamental objection to the main suggestions contained in it. That report was gratefully received by the meeting, and during the winter the same committee has continued its deliberations and has now presented 3 a report to the council of the B.M.A. which is to be submitted to the Bournemouth meeting in July for its approval, with the intention then of sending copies to the General Medical Council and other bodies interested in medical education. The interim report has been embodied in the report now presented. No alteration has been made in its main points ; it has been rounded off and amplified. Sir HENRY BBAOEBNBUBY summarised the report at the Dublin meeting. The committee, he said, had defined medical study as properly beginning at the point at which a student starts work upon human anatomy and physiology, and they had had to decide what stage he should have reached before he began those studies. All agreed that the course should not be lengthened, but it was generally felt that the education of the student should have reached a certain standard before he entered on the study of anatomy and physiology, and the first main change proposed by the committee was that the student should give evidences of a heightened educational standard and of being well grounded in the fundamental principles of chemistry, physics, and biology in their application to medicine. Conflicting views have been expressed as to the nature of the instruction in the basic sciences necessary for medical education. There are those who emphasise the acquirement in physics, chemistry, and biology of a certain knowledge of facts which are of direct value to the medical student and practitioner, but the view has prevailed in the committee that the essential purpose of these studies is the training of the student in scientific method and discipline rather than the acquirement of a smattering of technical knowledge. If, as is suggested, two years or thereabouts are given to the study of these sciences along with cther subjects of general education-usually English language and literature, a foreign language, and perhaps history-an intellectual equipment and scientific outlook will have been acquired which will enable the student readily to apply these sciences to his own particular field. After registration, which the committee would wish to see made a statutory obligation, it is felt 2 THE LANCET, March 17th, p. 600. 3 Brit. Med. Jour., April 21st Suppl., p. 192.
that too great demands are made on the student’s time in the courses of anatomy and physiology as at present taught. These should be taught as interrelated subjects, their main aim being the study of the living rather than the dead body, and it will be generally admitted that it cannot be necessary for the student to dissect every part of the dead body. At this period it is suggested that the student should become familiar with the methods of manual examination and be taught the use of the clinical thermometer and the various " scopes " along with the estimation of blood pressure, the examination of blood, and the analysis of secretions ; but not more than five terms should be occupied with this part of the curriculum, and in its present report the committee shows how desirable it is for the inclusion of three special subjects, attention to which has been woefully inadequate. These are genetics, growth, and
mental function-and although from the systematic side they could probably be dealt with in a few lectures the committee evidently doubts whether these should be given by the appointed teachers of anatomy and physiology. The most interesting suggestion for the clinical years is that a period of two years and six months on the lines of the present curriculum, but with less specialisation, should close with the final written and oral examination, but that the student should not be eligible to obtain his legal qualification without a further period of nine months of practical experience to be gained in one of five ways : (1) in a resident appointment in a teaching hospital ; (2) as clinical assistant in a hospital or clinic ; (3) as pupil assistant to an approved general prac-
titioner ; (4) as pupil to an approved M.O.H. ; (5) in regular attendance at hospital practice in a medical school. It was at this point that the committee was not unanimous, for one of its members felt that it was a bad thing for students to spend their last year hanging about the hospital out-patient department. The report as it stands is a very interesting and stimulating contribution to the revision of the medical curriculum which does at long last seem likely to be taken seriously. THE council of the British Medical Association has. recommended that Sir Richard Stawell, consulting physician to the Melbourne Hospital and Children’s Hospital, should be elected president of the Association for 1935-36. The annual meeting is to be held at Melbourne next year in the week beginning Sept. 9th, and at Oxford in 1936. The report ot the council issued last week states that the Sir Charles Hastings clinical prize for 1934 has been awarded to Dr. Helen Lukis, of New Maiden, for her study of the problems of anaesthesia in general practice. The Katherine Bishop Harman prize given every second year for the encouragement of study and research in avoiding the risks of childbearing has been awarded to Dr. J. M. Munro Kerr, regius professor of midwifery in the University of Glasgow. A certificate of honourable mention was given to Dr. Dora Colebrook.