Medical Education

MEDICAL EDUCATION. A sound general education is necessary for the medical as for all other learned professions.

In Great Britain before admission to a course of training a boy or girl is required to show in an examination of matriculation, character and standard that he or she has acquired a respectable knowledge of English, a language other than English, mathematics and some other school subjects of the candidate's own selection. Latin is no longer exacted by the General Medical Council (G.M.C.) although in certain universities it is compulsory for students who desire to obtain a medical degree.

The General Council of Medical Education and Registration does not determine directly the requirements of the various licensing bodies, but exercises a measure of control over the doc tor's training by deciding the conditions precedent to registration, first as a medical student and finally as a qualified practitioner. Since 1922 the G.M.C. has required an examination in physics and chemistry be passed by him before registration. The gain is two-fold. His school work more efficiently prepares the boy for his profession, and more time is made available in the brief five years, which is the most that can be exacted as a minimum between registration as a student and registration as a qualified practitioner. The council also allows the student to pass the examination in biology immediately after registration. The cur riculum recognized as medical carries the student through a suc cession of stages which merge insensibly one into the other, until his accumulated knowledge and steadily increasing skill justify the conferring upon him of a degree or diploma which admits him to all the responsibilities of medical practice. It is impossible to over-emphasize the statement that the several steps "merge." They are not stepping stones. No subject is left behind when the passing of an examination qualifies a student to approach the next. The examination tests his fitness to approach subject B whilst still carrying forward subject A.

Stages of the Education.

These stages may be defined as (I) The study of the structure of the body and of its behaviour in health, anatomy (q.v.) and physiology (q.v.), to which two years are assigned. (2) The study of the behaviour of the body when perturbed by abnormal conditions, by malformations, by injury (see PATHOLOGY), by the invasion of parasites (see PARA SITOLOGY) ranging from ultra-microscopic "germs" (see FILTER PASSING VIRUSES) to intestir al worms, an extension of physi ology into the domain of disease. (3) The study of physiological changes which result from the administration of various chemical substances, "drugs," already anticipated by the study of the "drugs" which, in health, various organs pour into the circulation, internal secretions (see ENDOCRINOLOGY). (4) The study of the

possibilities of modifying the behaviour of the body, when dis eased, in a beneficial way by administration of drugs. (5) The proper management of the body in health, preventive medicine. (6) The care of the sick and of women in childbirth.

The Object of Medical Training.

With the exception of the changes already referred to, developments in medical educa tion are rather in the manner of presenting knowledge than in the selection of subjects to be studied. When so much of value must be omitted, every subject included in the curriculum should be taught in the most practical way. It must be made a part of the practitioner's outfit, which he can never afford to lose. His knowl edge of the anatomy of the living body must enable him to see its organs in their relation to one another as clearly as if it were transparent. In some degree, dissecting room work has given way to surface anatomy and the study of models and frozen sections although training in the use of scalpel and forceps is still the only means of acquiring dexterity in the surgeon's craft. In physiology, during the first year, the student is in most schools given more practical work than formerly.

The greatest changes have been introduced in the third and fourth years of the curriculum. Physiology has been extended into pharmacology, an ever-growing body of exact knowledge derived from the study, with instruments of precision, of the effects produced upon guinea-pigs and rabbits by chemical com pounds of which some, like caffeine and morphine, are vegetable products, whilst others, such as phenacetin, have been prepared synthetically in the laboratory for the express purpose of modi fying the behaviour of the body. When used to correct disorders, these various chemical substances, with the apparatus which has been designed for the purpose of studying their effects, belong to the sphere of therapeutics (q.v.).

At about this stage in the student's training, bacteriology (q.v.), a science which is growing so rapidly as to be for the most part relatively new, claims his attention. The micro-organisms which cause disease present biological problems of the highest interest. Every medical man needs to be expert in the methods of making preparations for identification with the microscope (see MICROS