Duke University School of Medicine - Aesculapian Yearbook (Durham, NC)

Page 24 text:

MEDICIN The Department of Medicine traditionally has the responsibility of preparing the student for a lifetime of learning as he gives care to patients who ask him for help. The first step is to begin to think and act like a doctor. Two courses in the second year, Introduction to Clinical Practice and Clinical Microscopy, prepare the student so that he can take an active role in patient care. In the third and fourth years. the student assigned to Medicine acts in the role of a physician. His desire to give good care is the motive which drives him to ex- cellence. He learns to properly identify the problems of the patient. Having identified the problems, he mar- shalls the information which he can bring to bear on them by his past training, he recognizes the gaps in his knowledge as he attempts to focus the information learned from the basic sciences onto the specific clinical prob- lem. Using the patient as his means of integration, he re-reads his anatomy, physiology, microbiology, phar- macology and biochemistry. ln this clinical setting he has the opportunity to speak many words which he has previously only read, be discusses the problem with his fellow students, interns, resident and senior staffg he gains familiarity with ideas and concepts by actively manipulating them. The student crystallizes out his idea of the best diag- nostic and therapeutic approach to this particular pa- tient. He identifies the reasons for each of these de- cisions. He has real curiosity to see if his evaluation of the situation is correct or if he will have to admit that certain data which he interpreted as rock-like support for his house of cards have turned out to be shifting sand. He learns that the course of biology is unin- 251 Huenced by strong statements, by the rank of the faculty fl l . Q Ls t--' iiii fi 4? 4 A i ,f at 1 if ,., f ' ...,.,, it w Zts ':': ' 1 i: 1-- :- ',,,er: t' DR. STEAD member, or by the number of supporting references not quite applicable to the points in question. Under guidance from his fellow students and from faculty of all ranks, he slowly appreciates the difficulties of learning in this system of multiple variables operating on only partially defined substrates. Part of a doctor's learning is only experiential. He knows from living with his patients that certain things are possible, but he does not know the underlying sequence of events. In other instances, his learning is more precise because he understands and can control some of the important variables. He must learn both the liabilities and virtues of attempting to use logic in clinical practice. The goal of the Department of Medicine is for the student to have as many learning experiences as possible in which he plays an active role. We hope that he will -N., .-,.. N. ,. ,,., .. . X X,-5-cfs-P' DR. ORGAIN DR. HANSEN-IDRTTSS DR. RUFFIN twenty

Page 23 text:

PSTCHIATPCY The Department of Psychiatry has a three-fold pur- pose. lt is dithcult to assign priorities, but they may be stated as follows: the preparation and training of students of medicine to practice better the art and science of medicine through an understanding of normal and ab- normal behaviorg the training of the resident to practice his specialty. and through the demonstration of psychi- atric practice by the faculty coupled with a vigorous, broad and imaginative research program contribute to that body of information which will better equip society to deal with the physically and mentally ill. A century ago, the mentally sick were herded into large hospitals and segregated away from the main stream of life. Treatment in the main was custodial. With the advent of a liberal movement. the psychodynamically oriented psychiatrist focused upon the individual patient and his intrapsychic and interpersonal life. The one-to- one interaction with the emotionally disturbed patient brought hope and the focus turned away from the dis- turbed group and onto the disturbed individual. The second world war demonstrated dramatically that even the normal person under stress could develop a re- versible emotional illness and psychiatric care could lead to a speedier and more humane restoration of function. The concept of psychosomatic medicine popularized in the thirties received greater recognition and in medical education, attention was focused upon the role of emo- tions in the genesis of physical symptoms. It became more acceptable for a patient to consult a psychiatrist. The sixties will see more progress into the realm of preventative medicine by the understanding of those social patterns which lead to the dissemination of emo- DR. E. W. Bossa Chairman of the Department social and community psychiatry. An additional drive will be made at all levels of medicine to make available the skills of the psychiatrist in the therapeutic armamen- tarium of the non-psychiatric physician. Although this is the age of the gene, the biochemical equation, and the neurophysiological dysrhythmia, the psychological reaction to disturbed organic patterns cou- pled With a sound medical orientation still remains as the treatment cornerstone for the reversal of inappro- priate behavior and the maturing growth of individual personality. The physical therapies, such as psychotropic drugs, permit the disturbed patient to receive appropriate treat- ment designed to relieve his condition while remaining fContinued on page 1332 tional illness and the growth of what is now known as ::.,- Q. l a I gy I ff f gi DR. LLEVVELLYN DR. BRESSLER DR. LOVVENBACH nineteen

Page 25 text:

DR. CALLAWAY DR. WYNG.8.ARDEN DR, NICHOLSON enjoy these learning experiences so much that he will continue them as long as he sees patients. We are not interested in covering the entire field of medicine. If one of our graduates meets a new problem, correctly identifies it and has pleasure in solving it, we are satis- fied. We are 11Ot concerned that a new area of knowl- edge is being explored without our guidance. In caring for our patients with ill-defined genetic and acquired differences and with many variables of unknown strength at play, many erroneous conclusions are drawn. The student has to learn to examine statements both oral and written with care and to ask for all authorities the source of data which underlie their conclusions. One way for the student to learn the difhculties in drawing accurate conclusions about biological systems is to give him the opportunity to establish some fact on the basis of his own work. We call this research and find it a very effective method of teaching. The intellectual dis- cipline involved better prepares him for the role of a lifetime learner. ..., .,,. ..... . W --H:--:rv ..... ......, ' ., :. - afar-afls 1 si A ' V E i 'f The health Held is a broad one. Anyone with intelli- gence enough to gain entrance to the Medical School can find an area where he can be happy and productive. We are interested in producing manpower for the entire field. We are not interested in molding our students into any single career in the health field. The faculty accepts the fact that our intake is heterogeneous and that our output will be heterogeneous. Our role is to iden- tify the area where the individual will be most produc- tive and happy, and to help him reach this goal. We will continue to produce general practitioners, specialists, administrators, research workers, biologists, government workers and various combinations. There is no special honor attached to any of these roles. Our primary in- terest is that our graduates are productive, and receive emotional and intellectual satisfaction from their work. EUGENE. A. STEAD, IR., M.D. Cfzairmcm of the Department Florence Mcdlistcfr Professor of Mealicine DR. RUNDLES DR. I'IEYlX'IAN DR, ROBINSON twenty-one