Boston University - HUB Yearbook (Boston, MA)

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SYIIIPTOMS IN MEDICAL EDUCATION. 27 Thus, while England has long looked to France as pos- sessed of the true theory and instrument of medical re- form, France has been looking to Germany as showing a better plan g while Germany, in turn, has looked with envy upon the power and commanding leadership of medical societies in the Anglo-Saxon realm. In this way the agitation for medical improvement completes a circuit, returning upon itself. In each of the leading countries of Europe the current sets one way only,- and that a hope- ful one 3 but, studied in international relations, it resembles a vortexlquite as capable of sucking down existing excel- lences as of casting up superior substitutes? Three years ago in these pages, in a paper entitled The Gateways to the Learned Professions, it was shown that the entire and exclusive committal of the custody of these gateways, either to the Profession itself, or to the Scholastic Authorities by which its recruits are trained, or to the State, is fraught with evil, and that only by the co-operation of all these forces can the best results be attained? Precisely this is the impressive lesson of the attempted medical reforms now undergoing discussion in Great Britain, France, and Germany. And one of the fundamentally hopeful things characterizing present move- ments for the improvement of the profession in this coun- 1 As to the system-if such it can be called--of the United States, none seem so poor as to do it reverence. Every one here seems dissat- isfied, and abroad, while English writers are pointing out the superiority of the French or German systems, and French writers are demanding less centralization on the English plan, we nowhere find the system of the United States held up as a model. fzimerican Journal of the Medi- cal Sciences, July, 1878, p. 175.5-But for the symptoms of improvement which we hope to bring out in this paper, we should fear lest our medical education soon cease to possess'the negative virtue of insignihcance, and come to be indicted in the forum of the world's opinion as a nuisance of international dimensions. Already some of the more philosophical stu- dents of civilization have discerned the dehauching influence of our ex- ample upon the ideals and methods of professional education in Europe. See, for example, La Critique Philosophiquc, Politique, Scientyique, Litte- raire. Paris, 1879, pp. 289, 290. Apropos of an article by Ch. Dollfus in Le Temps of Oct. 1, 1879. 2 Boston University Year Book, Vol. IV. pp. 17-28.

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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.

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28 BOSTON UNIVERSITY YEAR BOOK. try is the fact that no one of the factors of true progress is at work aloneg but all are Working together in appro- priate and helpful methods. In any enumeration of these movements a prominent place should be given to the agitations which in many of the States have lately secured, or are now aiming to secure, new legislation more effectively protective of the public against uneducated and unprincipled practitioners of medi- cine.1 This is a good cause, in which the State, the School, and the Profession have cordially and most beneficently co-operated. The precise measures for which legal sanc- tion lias been sought have differed in different States, and at successive stages of the agitation in the same State. Thus the bill now before the Massachusetts Legislature is quite unlike the unsuccessful one of 1878. Still all pro- pose measures far in advance of the old laws, and greatly aid the efforts of those who are laboring for a more thor- ough general and professional training of physicians, and for impartial licensing boards. Moreover, the very effort to secure the new enactments has had most liberalizing effects upon all branches of the profession as at present organized. It has led the antagonistic medical societies to recognize each other, and to assent to the recognition long ago accorded by the State. It has contemplated and demonstrated the possibility of educated men of different views in therapeutics sitting upon one and the same Board of Examination and Registration. It has caused men conventionally debarred from consultation in 1 Since 1875 acts of ever-increasing stringency have been passed in each of the British Provinces, in New Hampshire, Vermont, California, Alabama, Illinois, Texas, and other Statesg and laws modelled on the best of these are now under consideration in Iowa and several other States. The effect of the Illinois law in the flrst year was to cause some fourteen hundred quacks to leave the State, or quit practiceg while hundreds of other partially-educated practitioners have entered medical schools to get degrees. Circular of Health Department of American Social Science Associa- tion. January, 1880. -The Illinois law and extracts from the first annual report of the State Board of Health respecting its working may be seen in The New England Medical Gazette for 1879, pp. 110-116.