THE ADVANTAGES OF AN ACADEMIC TRAIN

ING FOR A MEDICAL CAREER.*

THER

HE time is rapidly approaching when all over the country our colleges will send forth several thousand young men to begin their active work in life. The necessity for a wise decision as to what shall be each man's career needs no comment.

The Editor of the "Brown University Magazine" has asked me to present to its readers some of the advantages which attend an academic training before entering upon a medical career. Before doing so, however, I must add a word of commendation of the excellent work of the Brown University Medical Association, which has done so much to foster the medical idea among the students of the University, and to suggest changes and improvements in the college curriculum which adapt it to the requirements of future students.

As a teacher of surgery for now just thirty years, I feel that I may speak with some confidence as to these advantages, and it is with no little pleasure that in my own case I have always recognized the fact that whatever success may have attended either my writing, my practice, or my teaching has been due chiefly to the training I received in my dear Alma Mater. The logical acumen of Chace, the inspiration from Lincoln, the rhetorical grace and fine criticism of Dunn, the historical generalizations of Gammell, and the extraordinary knowledge of Sears all had a most influential part in forming my mind and shaping my subsequent life. I can

* Reprinted from the Brown University Magazine for April, 1896.

never be grateful enough to them and their colleagues in the then Faculty, and I feel it is but a very small repayment on account of a large debt when I can do anything for Brown University.

That college men take precedence of others who have missed such invaluable training is shown by the statistics some time since quoted by the "Medical Record." Of 912 physicians deemed worthy of notice in Appleton's "American Cyclopædia of Biography," 473 are college-trained men. The 'Record" estimated that during the present century about 300,000 men have entered the medical profession. Of these, therefore, nearly 1000, that is about 1 in 300, had gained more or less prominence. But on the basis of there being about 500 of these latter who were college men, the chances of distinction and influence for a college-bred man in medicine were increased from 1 in 300 to 1 in 60, or five times as great as if he had not had such intellectual training.

Never has there been a time when the demand for the best and ripest intellect in medicine was more pronounced than at present. The medical horizon is broadening most rapidly. The complexity of the problems constantly presented by disease and by the conditions of modern social life and the multiplicity of the means of investigating them; the logical methods necessary for the solution of these problems; the laboratory facilities which are required to that end; the relation of medicine to public health in matters of sanitation both for the individual and for the public, in peace and in war, in city and in country, all attest the marvelous activity of the medical mind.

To anyone about to enter upon such a life, the question will naturally occur: what are the requirements for such a professional career?

They may be stated, I think, under four headings: first, that a man shall have a strong body and an active mind; secondly, that he shall have the ability to acquire knowl

edge; thirdly, that he shall have the ability to use this knowledge; and, fourthly, that he shall have the ability to impart this knowledge.

As to the first, it has been a great pleasure to me in the years since I graduated to see what enormous strides have been made in the development of vigorous bodies in our college men. Saving for a few who took to rowing and for some sporadic games of ball, which would now be laughed to scorn, there were no athletics in my day. A few men went to a gymnasium in the city, but the great bulk of students at that time if they kept their health were fortunate. If they lost it, they were not blamed, though, as we all now know, it was largely their own fault. But I am thankful that at the present day the most important class of the future citizens of the republic, from the intellectual point of view, are also bound to be the strongest and best from the physical point of view, and that the men who are going to influence our public affairs in the senate, at the bar, in the pulpit, in engineering, in commerce, and at the bedside are to be men of a wholly different physique from those of thirty years ago. Moreover, the athletic field does far more for men than merely give them a strong body. It develops mental and moral characteristics of the highest order and the greatest importance in the later struggle for existence. But to the students of a college whose President has more than once declared himself convinced of the importance and value of athletics, both to scholarship and health, as President Andrews has done, it is not necessary for me further to enter upon this subject.

The strain of a medical life is very severe. The loss of sleep during many continuous hours of service (and the severer and more responsible the case, the greater the likelihood of such long hours of endurance); the responsibility which attaches to him who holds a human life in his hand; the acute nervous strain of difficult surgical operations; the

need of constant study and the necessity for the relinquishment of most of the recreations of life, all require that the physician should be, above all, a strong man both physically and mentally, or he will be in one respect or another unequal to the task set before him.

II. Let us turn, however, now to the more immediate professional requirements, for it may be well said that strength of body and alertness of mind are prerequisites for every calling. In many years of teaching I have seen large numbers. of students, and I have been struck with the great differences in their ability to acquire knowledge; not only that personal difference, which one may say is inherited in nearly all men, but in their mode of handling intellectual tools; in their ability to grasp and master ideas; in their quick comprehension of logical sequences; in their correlation of ideas, which is but another way of saying that there is a difference in seeing the bearing and value of any one fact, physical sign, or medical symptom, a faculty which one man will possess in largest measure and another in least, if, indeed, he possesses it at all. This very difference in the ability of the trained mind to acquire more knowledge in less time than the untrained mind has led the Jefferson Medical College and several other of the leading colleges to admit students with a University degree, and who have pursued certain studies covering largely those of the first year in medicine as well as the last year in a college course, to advanced standing in the second year, thus requiring them only to devote three years to their technical training, instead of four years, or, including the college course, seven years instead of eight.

A man who goes through Brown, Princeton, Harvard, Yale, etc., is furnished with a knowledge of chemistry, biology, physiology, anatomy, and other branches such that he has not only acquired a large part of the knowledge of the first year in the medical school, but, above all, has learned how to learn. In a given time he will acquire double the knowl

edge that the man fresh from the counter or the plough or even the High School can obtain. More than this, there is developed by such a college training a subtle ability to distinguish that which is essential from that which is incidental or accidental, which enables a college man quickly to get a broad, fundamental knowledge that the non-trained man can never get. This is not saying, of course, that there are no exceptions; but, as we all know, exceptions, by the very fact of their being such, prove the rule.

Even in one single small thing, which, however, counts for more than would appear upon the surface, the very knowledge of Greek and Latin, from which the vast bulk of our medical terms are coined, facilitates the gaining of knowledge, and, more than that, gives a man an insight into the real meaning of terms, which the man who simply takes them memoriter knows nothing about. But, happily, academic studies are not limited now as formerly to the narrow range of Latin, Greek, mathematics, history, logic, rhetoric, and their allies, but have widened their scope, and embrace very many of the scientific branches of the day. Whatever advantage may have been considered to arise from the study of Greek and Latin as means of training the mind and its logical powers, there is no question that science develops power of acute observation which no mere literary course can give; that upon these facts so observed is built a series of logical propositions as technical, as difficult, as acute as any that may be found in philosophy or literature. The men, therefore, who come from our colleges to the study of medicine have had to a very large extent their powers of observation and of logical deduction developed far more than the untrained minds of the ordinary country or even city young man. I know of no one who needs a training in strict logical methods more than the doctor.

Anyone who follows carefully the experiments, reasoning, and conclusions of Bernard in his physiological discoveries;