ASSOCIATION OF AMERICAN MEDICAL COLLEGES ao <.l:1 1:: PROCEEDINGS OF THE THIRTY· FIFTH a ANNUAL MEETING, HELD AT BOSTON, § MASSACHUSETTS, MARCH 5, 6 and 7, 1925 Q Document from the collectIOns ofthe AAMC Not to be reproduced wIthout permIssIon CONTENTS PAGE ADDRESS OF PRESIDENT: THE FUTURE PRACTITIONER. Ray Lyman Wilbur 5 ENVIRONMENTAL MEDICINE: MEDICAL SOCIOLOGY. Charlas P. ~nterson 13 PSYCHIATRY. PUBLIC HEALTH AND MEDICAL EDUCATION. Albert lJ,[ Barrett 24 EDUCATION IN PREVENTIVE MEDICINE IN THE MEDICAL CURRICU- LUM Haven ~nterson_____________________________ 36 COOPERATIVER. HayPLANthornOF TEACHING PREVENTIVE MEDICINE. Santuel 50 Discussion on Papers of Drs. C. P. Emerson, Barrett, H. Emerson and Haythorn_____________________________ 58' CORRELATION IN THE CURRICULUM. Bernard F. McGrath________ 69 TEACHING OF OBSTETRICS. J. M. H. Rowland__________________ 82 Discussion 91 TEACHING OF PHYSIOTHERAPY. W. H. lIlacCraken______________ 94 Discussion 99 EDUCATION. A. Lawrence LowelL 102 THE HONORS COURSE. ~. P. Lyon 107 THE HANDLING OF THE SUPERIOR STUDENT. David L. EdsalL 114 Discussion on Papers of Drs. Lyon and Edsall 122 FULL TIME: THE LETTER OR THE SPIRIT? Frederick T. Van a Beuren, Jr. 125 o COOPERATIVE EDUCATION IN MEDICINE Newton Evans 131 <.l:1 1:: Discussion 135 (1) a ORGANIZATION AND ADMINISTRATION OF THE HOSPITAL MEDICAL 8 SCHOOL. Thontas Ordway 137 o Q THE CURRICULUM. Frederick C. Zapffe----- 141 IMPORTANCE OF PHYSICAL PLANT IN THE CORRELATION OF TF.ACH- R.INGHugginsIN MEDICINE THE PLAN FOR PITTSBURGH. Raleigh 150 CONTENTS- Continued PAGE PROMOTION OF FRIENDLINESS BETWEEN FACULTY AND STUDENTS. Walter L. Niles 158 Discussion 159 AN INITIATORYStephen lZushntoreCOURSE FOR FRESHMEN MEDICAL STUDENTS. 161 MINUTES OF THE PROCEEDINGS OF THIRTY-FIFTH ANNUAL 'MEET- ING 165 Program 165 Executive Session 167 Roll Call 167 Report of Secretary 169 Report of Executive CounciL 172 Report of Committee on Education and Pedagogics 174 Discussion 176 Report of Committee on Survey of Medical Education__ 183 Reports of Delegates: American Hospital Association 185 American Conference on Hospital Service 185 Federation of State Medical Boards 185 Memorials: Theodore Hough: By Irving S. Cutter 186 ao John Lorenzo Heffron: By H. G. Weiskotten 188 <.l:1 Amendments 190 1:: a(1) Report of Nominating Committee 190 8 Place of Next Meeting 190 o Q MINUTES OF ORGANIZATION MEETING OF EXECUTIVE COUNCIL 192 OFFICERS AND COMMITTEES FOR 1925-1926 193 MEMBERS 193 ADDRESS OF PRESIDENT THE FUTURE PRACTITIONER RAy LYMAN WILBUR President Stanford University The physicians of the next generation are now in the public schools. What is done for them or to them there is in our con­ trol only in so far as we interest ourselves in general education. How they are to be chosen from the rest is perhaps our concern, but certainly what will and can be done for them in the way of medical education is to a unique degree in the hands of the insti­ tutions represented by this organization. 'rVe are entering a fortunate period in public education where we are less sure of just what work should be required from children. We still have many advocates of return to the good old days of the three R's. There are always people who turn backward to go fOl ward so that they may watch the rear and meet the future blindly. The mental preparation of a growing boy or girl who is to meet the unknown difficulties of a new era requires much more looking forward, much more taking of inventories to discover the out­ worn stock on the part of educators, than is often given. It is always easier to exercise prejudices than to think, and particu­ larly at a time when all the currents of life are flow:ng at an accelerated rate and f~ster than ever before in history. We must necessarily prepare men more thoroughly and more ao rapidly for professional life than we have done hitherto. A short <.l:1 time ago in discussing this question with an admiral of the navy 1:: (1) I was informed that a few years after graduation from the Naval a Academy the young officer must accept responsibilities on board 8 o ship which, twenty years ago, would have come to him only after Q he had reached his fortieth year. The great advance in medical knowledge and the peculiarity of the relationship between patient and physician, so that the very first patient coming to a young physician may be the one that demands superior knowledge anJ attention, makes it imperative that our young physicians be trained most thoroughly in essentials at the time they actively enter on medical practice. Since a physician must be world wise in order to be a satis­ factory guide for many of his patients, it is necessary that he should not only have a first class preliminary and general college education but that his medical training should have made such use of his time so as to broaden his public and social conceptions. The young doctor who has learned to become a mere technician and who has failed to sense his relationship to the whole human family is apt to proye a liability to the medical prof~ssion in its forward march. In thinking of the practitioner of the future, it is worth while to review some features of a recent experience in which large numbers of medical men were brought into military service. \Vhile there may be some argument as to just what the so-called intelligence test gives us in the way of information, there can be no dispute that in a large percentage of instances it does give certain values of importance in estimating intellectual ability. It is rather disconcerting to study the report of Cobb and Yerkes on the intelligence test rating of various branches of our great army in 1917-1918, published in the BIll/etill of the Natio/lal Research COltllci! for February, 1921. It is true that a considerable num­ ber of the physicians they surveyed were the product of medical schools in times which have largely passed. They state that "the typical medical officer is a high school graduate with about four years of professional training. He has devoted more of his life to schoo'ing than ha!' the officer of any other arm of the service. His median length of schooling is 15.8 years. whereas that of the engineer is 15.3 and of the quartermaster 12.4." In spite of this, ao <.l:1 medical officers, while ranking in intelligence above the quarter­ 1:: master's department, fell below several other branches of the a(1) service, particularly that of the engineers. "Four principal causes 8 have been suggested for the relatively low inte1Iigence rating of o Q medical officers,o, state Cobb and Yerkes. "They are, first, lack of agility and speed in the examination because of age, second, tendency to work carefully and accurately as a result of pro­ fessional training and experience; third, special characteristics 1 of tests rendering them easier for men of mathematical and me­ chanical training than for medical officers; and fourth, method of selection for military appointment. ... It is reasonably cer­ tain that age and method of military selection" (according to Cobb and Yerkes) "are largely responsible for the relatively low intelligence of medical officers. The medical department obtained the services alike of the best and the poorest members of the profession, but the proportion of intellectually inferior and profes­ sionally incompetent men was much larger in this group than in many other arms of the service. These explanations of the status of medical officers must not be taken as a justification of that status. It is wholly clear that the medical profession has a large number of men who are intellectually incompetent and who should not have been allowed to study medicine, or, having studied it, should not have been licensed as practitioners. The army was constrained to accept their services because of an im­ perative need of medical officers. Ordinarily their applications would have received scant consideration." The authors state that neither professional training and experience or th<: charac­ teristics of the test were important influences, so far as their analysis indicates, upon the intellectual rating of the medical group. But they further b'elieve that, given identical age groups, it would seem probable that the status of the medical corps would differ little from that of the engineers or artillery. It is encourag­ ing to note their conclusion that "the intelligence of the medical officer is highly correlated with the standard of entrance require­ ments of the school from which he was graduated. The median score, in army examination alpha, of graduates from schools requiring but one year of college work in addition to high school graduation is 118.7, whereas that of graduates from schools requiring more than 3 years of college work is 154.2, ao <.l:1 a difference of 35.5 points. The earnings reported by men from 1:: schools with high entrance requirements are also strikingly larger a(1) than those from schools with low entrance requirements." § Such studies as those of Cobb and Yerkes, together with the o Q point of view that comes to one after considerable experience with medical students and physicians, indicate that. while a good brain is required, there are certain vocational adaptabilities on the part of those individuals particularly happy and most successful 8 in .the actual practice of medicine. A large percentage of the ordinary class in medical school is made up of men and women who have determined at a comparatively early age that thev would go into medicine. Others find their way to this field after trying one or- more others.