American College of Surgeons - Yearbook (Chicago, IL)

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General Survey 7 and to the profession of medicine upon subjects of medical pro- cedure and the whole meaning of fitness to practice surgery. As one comes into wide acquaintance with the Fellows of the College and catches some fair notion of their earnestness, he sees the future of the organization not by means of logic. There is something more subtle and potent than argument. A determined optimism carries a momentum of its own. Without a logical process it seeks concrete expression; and, more than this, it really recreates circumstances through all shifts of weather or play of incident with a certainty not excelled by an utterly rational course. The Fellows of the College, in their widely scattered districts, fuse their consciousness of the organization with a splendid hope in their hearts to advance all that is important and valuable in the profession. This very attitude of mind is the first promise for the future of the College. It is a promise that admits of no defeat. It is a pledge of loyalty to medical patriotism which means loyalty to the public welfare exercised through intellectual sincerity and scientific accuracy. It means a safe-guard to the public, for it indicates where honest and adequate surgery may be found. REQUIREMENTS FOR ADMISSION TO FELLOWSHIP In submitting the following regulations , for admission to Fellowship by examination, the Board of Regents is conscious of its trust to the profession of medicine, first, that the regulations shall be administered without favor or prejudice; second, that the regulations shall be effective in their scrutiny. Further, the members of the Board feel that the regulations as outlined below mark a passing stage in the development of the College. It is probable in the near future that, in addition to these require- ments, the candidates for Fellowship will be asked to appear per- sonally before an examining board for further verification of fitness. 1. The candidate shall be a graduate of medicine, licensed to practice medicine in his respective state or province, or accepted as a medical officer in the service of his respective country. 2. To be ehgible for Fellowship without technical examina- tion the candidate shall be a graduate of a medical school approved by the American College of Surgeons. If the candidate ' s school of graduation is not accredited by the American College of Surgeons,

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6 American College of Surgeons foreground. In this connection, the following lines of activity are now under consideration, — 1. Since the whole problem of the training of specialists for the practice of surgery is the primary purpose of the College, the Regents propose at an early date to present a clear conception of the College to the undergraduate medical students of this con- tinent. The Regents, further, will ask each senior student of this group who has in mind to specialize in general surgery or any branch of surgery to register with the College. As these students, then, serve later as internes and as surgical assistants, they will be requested to report these facts to the College. The College, in turn, will systematically seek information as to the ability and character of such men ; and the information thus obtained becomes the basis of admission to Fellowship in the College. In addition to this procedure, the Regents will insist upon the proper keeping of case histories, and they will endeavor to stimulate in these men in training right ideals of medical practice. In this program they ask the active cooperation of the faculties of the medical schools and of all practitioners of medicine. 2. Inasmuch as proper training in surgery is inseparably involved with the conduct and efficiency of hospitals, the College will seek accurate data on all matters which relate to hospitals. From time to time it will publish studies upon hospital problems, the purpose being always to be helpful to the hospitals and to increase public confidence, where it is merited, in these institutions. These publications, further, will inform recent medical graduates as to where they may seek adequate general or special training in surgery. To be concrete, the College will deal with such problems as (a) the proper equipment for medical diagnosis, e.g., well equipped laboratories for chemical, pathological, and X-ray work; (b) the proper forms for case histories and the facilities for keeping these records; (c) the management and the curricula of the nurses training school; (d) the specialization essential in any well organized hospital. 3. The College will ask the faculties of medical schools to consider the advisability of conferring a supplementary degree of proficiency in general surgery and in the various specialties of surgery. 4. The College will issue readable monographs, educational in nature, to the press, to the general public, to hospital trustees,

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8 American College of Surgeons he may be required to pass a technical examination in one or all subjects of the medical curriculum. 3. The candidate shall give evidence that he has served at least one year as an interne in a creditable hospital and two years as a surgical assistant, or he shall give evidence of an ap- prenticeship or equivalent value. Special importance is attached to laboratory and research work. 4. The moral and ethical fitness of the candidate shall be determined by the reports of surgeons whose names are sub- mitted by the candidate himself and by such other reports and data as the Credentials Committee and the administration of the College may obtain. 5. The professional activity of the candidate shall be limited to the study, diagnosis, and operative work in general surgery or in special fields of surgery, such as eye, ear, nose, and throat, genito-urinary, orthopedics, and gynecology and obstetrics, as follows: First, if the candidate resides in a city of less than fifty thousand inhabitants, at least fifty per cent of his professional activity shall be limited to the practice of general surgery, or to practice within the special fields of surgery as stated. Second, in cities of over fifty thousand inhabitants, at least eighty per cent of the professional activity of the candidate shall be limited to the practice of general surgery or to practice within the special fields of surgery. In other words, the College desires to admit to its Fellowship only those who are primarily specialists in surgery, and the minimum proportion of specialization which is acceptable may vary according to the size of the city in which the candidate resides. 6. The candidate shall make formal application for Fellow- ship, giving specific information upon the following subjects, — Preliminary and medical education Hospital service Assistantship as a surgeon Teaching positions (past and present) Post-graduate work Research and experimental work Department of special practice and years devoted to same Specialization Medical societies of which applicant is a member Writings, publications, and research.