American College of Surgeons - Yearbook (Chicago, IL)

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4 American College of Surgeons vides, however, that the total payments assessed against any- Fellow shall not exceed five hundred dollars. Further, dues are not asked of those who have retired from the active practice of surgery, or who have reached the age of sixty-five, or who, in the judgment of the Regents, would find payment of such dues a hardship. At any time a Fellow of the College may become a life member by subscribing five hundred dollars to the permanent Endow- ment Fund of the College. Subscription cards used for this purpose are of the form given below, — In case of death all unpaid balances are canceled. ENDOWMENT FUND hereby subscribe Five Hundred ($soo) Dollars to the Endowment Fund of the American College of Surgeons, the amount to be paid in installments as follows: Date Amount Date Amount Date Amount $ $ $ » $ $ further agree to pay interest on unpaid balances of this pledge at the rate of 5 per cent per annum. Siened Date The Regents propose to bring the Endowment Fund up to one million dollars as rapidly as may be. To this end they earnestly request Fellows of the College who have not already done so, and who can do so without hardship to themselves, to subscribe to the fund rather than to pay annual dues. From time to time unexpended balances in the treasury of the College will be transferred by the Regents to this fund. Subscription cards may be had on application from the General Secretary of the College. INVESTIGATION OF HOSPITAL CONDITIONS The admission of Fellows to the College made necessary at once that the Regents adopt a genuine standard of surgical train- ing. From this fact it followed that the Regents must necessarily

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The Endowment Fund THE ENDOWMENT FUND A genuine test of the loyalty of the Fellows of the College to their program was made during the years 1914-15. Funds were needed for the very existence of the College. To meet this need an Endow- ment Fund amounting to $526,000 was by December, 1915, sub- scribed. A brief review of the financial side of the College is here given. In order to provide means for the organization of the College an initial Fellowship fee of fifty dollars from each Fellow was voted at the first meeting of the College. This sum was payable, twenty- five dollars on admission, and five dollars annually thereafter for five years. Realizing that the income to be derived in this way was but temporary, and desiring to place the College on a safe, inde- pendent, and financially adequate basis, the Fellows in June, 1914, voted to raise an Endowment for the College of one million dollars. This plan provided that the Endowment should be invested in perpetuity, the income only to be used for the budget of the College. It provided, further, that each Fellow be asked for a subscription of five hundred dollars. It was understood that all subscriptions should be contingent on the raising of five hundred thousand dollars by December i, 1914, the first payment on the subscription to be made January i, 1915. Subscriptions to the amount of $113,000 were pledged at the first meeting, and it was the intention to push the plan among those Fellows who were absent from that meeting after the summer vacations. But because of the European war, the Regents de- cided to ask those who had made subscriptions to give their consent to extend the time for obtaining the subscription one year. This extension was, with few exceptions, agreed to. As already stated, the first half million dollars in due time were more than subscribed. Those who subscribed five hundred dol- lars to this fund are life members of the CoUege and are not sub- ject to the payment of any further dues whatsoever. But, in the meantime, the work of the College called for expenditures beyond the income provided by the interest of the Endowment Fund, and the Fellows of the College, in annual meeting held in Phil- adelphia on October 27, 19 16, voted that those who had not sub- scribed five hundred dollars to the Endowment should be assessed by annual dues of twenty-five dollars each. The resolution pro-

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Investigation of Hospital Conditions 5 acquire accurate data with regard to the training of surgeons, not only in the medical schools, but also in the hospitals. It is prob- ably a fair statement to say that eighty per cent of what the sur- geon actually uses in practice he acquires during his interneship and surgical assistantship in a hospital. The conditions under which this training is offered are, therefore, conditions with which the College must be well versed ; and to know what these conditions are means that the College must undertake a thorough investiga- tion of all phases of hospital work. The Director of the College recently, in making a report to the Fellows, said in this connection, — The particular training ground for the surgeon is the hospital. Forced upon us, then, is the obligation to know what this training ground is, and what kind of a standard we should hold up to ourselves as the proper training of a surgeon in a hospital. Further, the problem of the training of a surgeon in a hospital cannot be iso- lated as a separate factor of the hospital ' s program. We cannot say that here the training of the surgeon begins and that there it ends, for the training of the physician is also largely the training of the surgeon. The problem involves us in the whole question as to what is the proper care of sick people. There are specific divisions, however, in every hospital which we may investigate, and, having accurate data, we may point the way of progress. For example, what is the condition of the case-histories of a given hospital? Are they complete? Are findings of surgical operations recorded immediately after the operations? Are the records accessible for study and future guidance? Are end-results followed up with conscientious common sense? Are summaries of these results made public as evidence of the competence of the physicians and surgeons practicing in the hospital? We may ask, further, what the conditions are of the hospital laboratory. Important elements in the training of the surgeon are that he know how to use the laboratory, and that he form a habit of using it. What are the laboratory facilities which a hos- pital of a given number of beds may reasonably be expected to provide? Are the laboratory findings made a part of the case- histories? Does the pathologist report his exact findings as a part of the case-histories? Do the superintendent and the trustees who are responsible for the government and the administration of the hospital take pains to assure themselves that the work of the