Boston University - HUB Yearbook (Boston, MA)

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SYJIPTOMS IN MEDICAL EDUCATION. 25 medical colleges under a general law prescribing the num- ber and work of the chairs, the length of the curriculum, Ste. Here is despair of the State, and a coveting of the progressive and self-helpful influences which are insepa- rable from such powerful competing institutions as the great universities of Germany! The aspiration is a wise oneg but the profession seem to have small hope of its early realization? Is Germany, then, the paradise of this profession, the land in which the ideal has been made real, the country where the medical reformer finds his occupation gone? Here is the omnipotent State, here, furthermore, the fore- most seats of learning. The State demands more rigid training than the most enthusiastic representative of American medical colleges dares suggest. The Univer- sities are ready and able to give it. Can any thing be Wanting here ? Alas! even the German physician is not happy. By recent laws the new Empire has changed his occupation from a liberal ffprofession to a mere trade CGewerbejg has substituted for the old-fashioned free honorarium a legalized tariff of prices for medical serviceg and finally, while exacting the utmost possible in the way of training from all candidates for honorable and legitimate practice, has opened to all others - so, at least, it is alleged-the widest opportunities, if not the strongest invitations, to quackery. Moreover, still further humiliations are appre- 1 Aveo nos mceurs actuelles il n'y a. rien a esperer de nouvelles loisg trop sever-es,el1es ne seront pas appliquees, trop indulgentes elles ne seront qu'un encouragement a recommencerf' M. A. Lnroua. Le Progres Medical, p. 344. Paris, 1879. - Avec1a participation future des agregcs D. Penseignement, avec Padjonction des cours cliniques spcciaux et le con- cours de Penselgnement libre, on peut afiirmer que nos facultes de maide- cine offriront des sources d'enseignement aussi abondantes que les univer- sites allemandes, xuunies de leurs professeurs ordinaix-es et extraordinaires et de leurs privat-docenten. CHAUFFABD. Revue des Deux Mondea, 1878, p. 155. - 2 Etant dormees nos habitudes, nos moanrs et nos lois contraires ln. Pinitiative individuelle, il est peu probable que, de longtemps, on essaie de fonder de pureilles soci6t6s. Le Progres Medical, Nov. 8, 1879.

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24 Bosrozv UNIVERSITY YEAR Booze. until the physician is emancipated from his humiliating dependence on his patients for recognition and pecuniary support, there can never be an appropriate testing of can- didates, an unselfish professional body, nor a safe practice. The State should prescribe the most thorough education possible, and it should institute the most searching exami- nations as thc portal to practice g but, when the candidate has met all these preliminary demands of the State, it, in turn, should make him a member of the civil service, duly appoint him to a medical parish, and provide him an adequate salary. Thereafter his services, like those of a judge or general, should belong wholly to the community, and even the acceptance of the smallest present from a grateful patient should be strictly forbidden by law. All medical practice by persons other than the State-appointed physicians should also be made a punishable misdemeanor. That such a proposal should come from a country where the State has sought to give the maximum of free- dom to the citizen, both as physician and as patient, is, to say the least, significant. It is another utterance of that 'f despair of freedom which has lately led the advocates of medical reform in England to place their only hope in a prompt and thorough-going intervention of the civil power-.1 W Meanwhile, to the despondent American it should be instructive, that in France, where five years ago the State created and administered all appliances for medical educa- tion, and more entirely regulated medical practice than perhaps i11 any other country in the world, there has been complaint of sore evils in the profession, and an attempt to remedy them by authorizing the establishment of free 1 Boston University Year Book, Vol. IV. p. 20. - In what piquant contrast to this blind faith in an omnipotent State stands the delicious bitterness of this utterance of President Henri Roger at the opening of the last annual meeting of the Association Gcncrale de Prcvoyance et de Secours Mutuels des Mcdecins de France! - Aprcs lc vote de cette loi, une simple autori- sation d'un ministre incompetent et omnipotent ne suifra plus aux, xnedecins ctrangers pour exercer en France. '

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26 BOSTON UNIVERSITY YEAR BOOK. hended. In the language of a leading English journal, speaking of recent government proposals in Germany: ff The medical profession is to be lowered,-its emolu- ments are to be diminishedg the mode of life of its mem- bers rendered more abject, and nearer that of the peasant class,-and thus to become less worthy as an object of ambition by those who from birth are likely to ennoble a trade so miserable. On the other hand, the standard of preliminary education is to be lowered so that men of a lower stamp may find their way into the medical profes- siong for the authorities are too keen not to perceive that it is far easier to stop the entering than hinder the parting medical candidate, and that an easy entrance-examina- tion or abbreviated preliminary training is a far greater inducement than a lowering of the professional standard in another way .... We shall await the issue of this miserable business with great interestg and our German brethren may be assured of the sympathy of the p1'Of9S- sion in Great Britain. From these great evils the German sees no deliverance, save in a fuller organization of the whole body of the pro- fession, and in a discussion of them and of remedies in strong voluntary medical associations like those of Great Britain? 991 1 The Questions of the Day, in the German Medical World. Medi- cal Times and Gazette. London, April 12, 1879, p. 402. -In the face of both of these perils the German physicians pluckily respond, NVir wollen nicht abgedriingt werden aus der Reihe der ukademischeu Berufsarten. VVir wiinschen fiir unsern Stand die hiiohste allgemeine Bildung. -Berliner lclinische Woclaenaclzfift, 1879. CXVI., S. 113.J 2 This feeling is found also in France: Nulle profession n'a plus que la notre besoin de ces reunions perlodlques, oil chacun vieut apprendre ou communiquer quelque chose de cot art qui n'a pas de fln. En France le clroit de se rcunir est si nouveau que les medocins en usent a pelne, et doivent aller a 1'6tranger pour eveiller en eux-meme la valcur des mots 'As- sociations M6dicales,' 'Congrbs M6dicaux,' etc. -Le P7'0gTl?8 Medical, p. 560. Another lwriter complains of the same fact, saying, C'est plus qu'ennuy- eux, c'est humiliantf' p. 683. Paris, 1879. -Meantime the Germans say, Wir Dentschen haben keine Ursache, die franzosische Einrichtung im ganzen nachzuahmenf' Dr. R. Slalsmmn. Berliner klinische Wochen- schrift, 27 Jan., 1879.