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is in the larger and more advanced schools, the very ones that are best equipped as to men, money, buildings, and laboratories, that there exists the greatest unrest and dissatisfaction with present achievements, and the chief reaching forward to better and larger things. Among these stands the Jefferson Medical College. While conservative, she is progressive; "Nulla vestigia retrorsum" is her motto. That she is alive to the need of progress and has met it in the past, the contrast I have described between my own student life and yours gives ample proof. That the new era in medicine demands still more she recognizes, and, as you will have seen by the announcement, she again meets the demand. To your joy no less than to mine, for the student-mind is ever alert to notice signs of progress, this year we inaugurate a full and required three years' graded course. Time was when the comparatively narrow field could be reaped in two combined hearty attacks. Even then it was hard work; but now it has become simply impossible. The profession and this college alike recognize it, and accordingly we provide for it. If, with increasing branches of science, and increased demand for a deeper as well as a wider knowledge, a reasonable experience shall, as I believe it will, conclusively show that more is needed, I am persuaded that the Jefferson College will recognize that need, and provide for it in due time.*
In connection with this progressive step, I am glad to be able to announce to you that, during my late visit abroad, I had an interview with Mr. Hallett, the courteous and intelligent Secretary of the Conjoint Board of Examination of the Royal College of Physicians of London and the Royal College of Surgeons of England, and that these two colleges have accorded to the diploma of the Jefferson Medical College
*The three years' graded course was quickly followed by the establishment of the four years' graded course.--(W. W. K., 1905.)
precisely the same rights and privileges that are accorded to the diploma of the universities of Paris, Berlin, Bologna, and all the best foreign schools.
As an earnest of the progressive disposition of this college, I have also the honor of making to you another announcement. Within a short time, the wise forethought of the Board of Trustees has been well shown in the purchase of a lot eighty-two feet in front on Walnut street, south of the hospital, upon which a new and commodious college building will be erected, an ornament to the city, and a more active center of scientific life. Nor will the old and battered college building be given up to baser uses. Hallowed by the memories of McClellan, Dickson, Mütter, Bache, Pancoast, Dunglison, Gross, and scores and hundreds, yea, even thousands, of earnest teachers and pupils, and remodelled, it will take a new lease of useful life by gathering under its hospitable roof the many well equipped laboratories of the college, all of them the product of the last twenty-five years. This is happy news, especially to the workers in the ill-equipped, insufficient quarters of the past, which yet have been the scenes of persistent, patient, and most useful scientific work.
But to erect a new college building and alter another, and equip the laboratories, will take money, and a deal of money. For this we must appeal largely to the generous sympathies of a community long noted for its intelligent benevolence. Yet it is an odd fact, to which I call especial attention, that, while to academies, colleges, seminaries, and other institutions of learning, millions have been given, and to hospitals scores of millions, yet, to fit the men who are to serve these very hospitals, to educate the doctors who are to have the health and lives of the whole community in their care, nothing has ever been given until of late. At last we are awakening to the fact that good doctors are as important as good teachers and preachers, and that physical health is no less important
than mental development. To erect suitable buildings for an important medical school, and to equip and endow its laboratories and museum, is as much a work of philanthropy, and brings back ultimately to the community as large a return as similar gifts to academic institutions or to hospitals. We have already hospitals and dispensaries, and asylums and homes in excess of the needs of the community. What is needed now is the strengthening and development of the medical schools which educate the men who make the hospitals useful; the endowment of laboratories in which original research will continue for all time; researches which will repay for their outlay a thousandfold; and the establishment of scholarships and fellowships, to enable young men whose devotion to a scientific career is hindered and often blighted for want of reasonable pecuniary help. For these innovations and encouragements we now ask money, and the indications are that the community is alive to the need for them. The recent endowment of the Chair of Surgery in the University of Pennsylvania, the erection of the new buildings at Harvard, the establishment of the Carnegie, the Loomis, and the Hoagland laboratories, and especially the magnificent gifts of the Vanderbilt family in New York, and of Johns Hopkins at Baltimore-all these are encouraging signs.
The Jefferson now boldly proclaims its work, and asks for similar help. The new era in medicine compels us to enlarge our facilities, and this wider and better instruction will benefit the public at large. To them we appeal confidently, knowing that they will not disregard an appeal founded alike in justice, mercy, and charity.
And the reasons urging on this college to these large and wise advances apply equally to the other medical schools, and to the profession at large. The demands of the new era in medicine will only be complied with when the medical colleges give all the necessary facilities in equipment and in
time, to study thoroughly every branch of medicine, and the student comes to the college with a suitable preliminary education, avails himself during his college course of the ample means provided there, and after graduation grows into the cultured and experienced doctor by the means and methods I have pointed out.
THE REAL REWARDS OF MEDICINE.*
GENTLEMEN OF THE GRADUATING CLASS:
HE revolving cycle of the passing years makes it to-day my pleasing duty to say a parting word of advice, of caution, and of cheer to you. And first let me say the word of cheer; not only because it is the pleasantest to be spoken, but because in your earlier years of practice you will need it far more than any other word I could speak to you. I am sure that the public do not understand, nor do they appreciate, not only the many years of study before a young doctor can even begin to be self-supporting, but the many years of discouragement, with an empty purse and accumulating bills, which beset his early professional life. Should he desire to enter upon the profession thoroughly equipped, it means, first, the years of preparation in the common schools, from seven to eighteen; then four years in college; then four years of study in the Medical School; then at least a year in a Hospital, and, if possible, a year or two abroad. In other words, twenty-one years of study are practically what is required completely to fit a man even to begin to earn his living by the practice of medicine in any of its branches.
And in his earlier years the doctor is paid in many cases far less than the pittance which is bestowed even on the humble day laborer. I remember very well one of the brightest young men in the profession, who had all the advantages I have just described, and who, some time after
*The Valedictory Address delivered at the Commencement of the Jefferson Medical College, May 2, 1893. Reprinted from the College and Clinical Record, May, 1893.