SUNY Downstate Medical Center - Iatros Yearbook (Brooklyn, NY)

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By 1879 the faculty was thoroughly con- vinced that the method of teaching medicine then in vogue in practically all medical schools was entirely unsatisfactory. As the Annual Annouticement of that year stated, ' ' the system of medical teaching generally followed in this country, of repeat- ing the same lectures annually . . . is radical- ly wrong. The Council and Faculty have adopted an elective graded course of in- struction for such as desire more thorough and more systematic training in the primary before passing to the more advanced prac- tical branches. Dr. Skene had been a pupil and an assist- ant of Dr. Austin Flint, so it is not surpris- ing to find that two of his outstanding characteristics were in always insisting the patient be studied as an individual, and being conservative in treatment. History of the Long Island College Hospi- tal and SUNY Downstate Medical Center Austin Flint Professor of Medicine 1860-1868 The lack of geographic diversity at our medical school has long been a source of concern to a good number of students at Downstate. While it may seem to be a matter of little consequence, in ac- tuality the existing situation indicates an issue of important magnitude. Few would argue against the idea tliat diversity among the individual members of the student body is a stimulus to new ideas, an aid to the students ' maturational growth, and a necessary condition for an exciting and intellectual community. Ideally, the students should come from a large variety of social, political, economic, intellectual, and cultural backgrounds. While such latitude is not presently feasible, this situation could be approached. One major problem in this regard is that those in- dividuals who are accepted to medical school have already undergone numerous screening processes, all of which inevitably work to decrease tlie degree of diversity in the group. Christine Hry- cien transfer stu- dent from Bo- logna

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t I f ' iiiif mil mil mil ini ' ' r liiilniiimnim If lit If ' ' i!inlunSiiim fffff I ' isissssss -, Hon and very real loss in doctor-patient relationsl is a decline in prestige for the medical professionT We live in a science-fiction age and the mystique of medicine does not impress as it did formerly. In recognition of ' the necessity or family physicians, the AMA recently created a general practice specialty willi residency training in inter- na! nu-dicine. surgery, pediatrics and ps)cliiatr ' . This program ai:)pears most aimed at peer accei)- tance of general practice in the face of medical schools ' emphasis on specialization. It is hoped that by strengthening peer image as well as background, the trend away from general practice will be reversed. The role of the physician is in a rapid phase of evolution. He seems headed for greater conrnumity in ' ol ement, pn bably more on a political ;md ci it association level ratlier than through work in the ghettoes. At Downstate, we have seen exidence of student interest in all three of the above areas. The anti- ' ietnani war group and Biafra Medical Relief are two o rganizations showing shong commitment to world events. Tlie Student Health Project in the summer of 196S made slight impact on Brook] n ' s poor, but marked impact on the medical students involved. Student participatiori on committees and in curriculum e ' ahiation and revision point to interest on the part of physicians-to-be in local pohtic. In five or ten years, the Class of 1970 will begin, perhaps, to project a ne - image to those it serves— an image forged in ideals, tempered by daily frustration and sharpened by pride in being a physician.

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The argument for wide geographic distrihution, howexer, is not as pertinent as that for diversit ' among indi iduals in general. It is probably true that all of the ariables mentioned have a degree of ar ing representation in Neu ' York Cit ' alone, and that it is not necessary to search far and wide for students with widely divergent backgrounds. Howe er, due to a combination of factors, including prior selection of students, local cultural forces which work to interest particular groups of people in medicine, and Downstates present philosophy con- cerning the selection of students, a somewhat limited type of student finds his way to our school. In all fairness it must be stated that there is some degree of diversity in our student body. In our class alone, 72 different undergraduate schools are represented and these run the gamut from small New England colleges to Ivy League schools, large Midwestern and Western uni ersities, and New York Cit) ' colleges. We also have a small number of transfer students from European and otlier . merican medical schools. We are therefore not without our geographic diversity, but when the distribution is broken down into numbers the problem presents itself .Appro.ximately 60 f of our class is from New York State colleges, with 485 coming from New York Cit schools. If New York, New Jersey, Pennsylvania and the New England states are taken as a unit, this encompasses 86? of our class. Fourteen percent of our class comes from Ivy League schools. In addition, a number of students coming from schools other than those mentioned are originalK ' from the Nortlieast; the reverse is not true. The situation is not simple. Even if greater geographic representation e.xisted, this would not necessarily guarantee greater diversity in the areas already discussed. College is an environment where exposure to various points of view and Hfe styles should take place. Yet medical students in the past, and to a great degree today, conform to a specific mold. They are basically compulsive indi iduals, who have spent a large part of their undergraduate training, whether by choice or neces- sity, competing in a rigorous academic tournament for the ul- timate prize of standing o er a noxious gross anatomy table. This contest demands that the student spend many hours in a laboratory, and if he chooses, poring over his books. Is it therefore possible for a diverse medical school population to exist? More important, is it the responsibility of an admissions committee to be involved with these matters or should the academic medical hierarchy continue to congratulate itself on its (successful?) selection of the stereotype? At Downstate, the desire for a more varied student popula- tion is tempered by the important fact that our school is a member of the State University of New York, and is therefore supported to a great extent by the state. It is unlikely that the legislature in . lbany is that concerned with the contribution Joel Bass Brooklyn College Alan Rote Harvard Colle ge