American College of Surgeons - Yearbook (Chicago, IL)

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The Clinical Congress of the American College of Surgeons 7 the value of all phases of these opportunities even among hospitals of like or comparable equipment. The Regents of the College were therefore confronted with two questions: First, what are the actual standards in the practice of medicine and surgery among hospitals? Second, what is an acceptable standard in the practice of medicine and surgery among hospitals? This second question involves the larger question as to whether the standards among our best hospitals are too good for the humblest patients anywhere on this continent. Both as an obligation of their trust, therefore, and as a constructive service to the profession and to the public, the Regents of the College entered the field of hospital standardization. THE CLINICAL CONGRESS OF THE AMERICAN COLLEGE OF SURGEONS By the joint action of a committee of the Clinical Congress of Surgeons of North America, appointed with power to act, and of the Regents of the College, the Clinical Congress of Surgeons became, on October 25, 191 7, the Clinical Congress of the American College of Surgeons. The resolution which effected the merger of these two organizations is self explanatory: Whereas, the past presidents of the Clinical Congress of Surgeons were, on October 26, 1916, in Philadelphia, appointed as a Committee with power to act, to confer with the American College of Surgeons with a view to closer affiliation between these two organizations; and, Wheeeas, the Regents of the College, in accordance with Section VI, Article 3 of the By-Laws of the College, consti- tute a governing board with power to act with regard to the proposed affiliation. Now, therefore, Be it Resolved, that it is the unanimous decision of the Committee of the Clinical Congress of Surgeons of North America, as above stated, and of the Regents of the American College of Surgeons in joint session, first, that for the welfare of the two organizations the management and the control of the Clinical Congress of Surgeons shall be vested hereafter in

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6 American College oj Surgeons having to do with the keeping of records and the second being case record forms, the aim being, in the latter, to suggest forms that are practical, simple, and adequate. These two bulletins will also be ready for distribution early next year. In order to obtain accurate information with regard to the entire hospital field in advance of visits to the hospitals, the College sent a questionnaire to approximately all general hospitals dis- tributed throughout the United States and Canada. In response to these requests for information approximately i,ioo hospitals promptly returned the data. The questionnaires had to do with the financial status of the hospitals, the capacity and scope, the hospital staff, the clinical laboratories, case records, departmental organization, and the training of internes and nurses. The reason the College took up hospital standardization as part of its work is here briefly stated: The admission of Fellows to the College made necessary at once that the Regents adopt a sound standard of surgical train- ing. From this fact it followed that the Regents must necessarily acquire accurate data with regard to the training of surgeons not only in the medical schools, but also in hospitals. But this approach to hospitals involved the Regents in more than a con- sideration of the training of surgeons in these institutions. The training of the internist is also the training of the surgeon, and in fact every procedure of a hospital designed for the welfare of its patients is inseparable from the training of a surgeon. Further, at an early date the Regents were convinced the usefulness of the Colleg e could find its most adequate expression in a continent-wide standardization of hospitals. A sound analysis of hospital conditions was, therefore, not merely a task which the College may do. It was a task which the College must do, for the College is a responsible society of about 4,000 surgeons which aims to include in its Fellowship all who possess practical scientific knowledge of medicine and surgery, together with honor, trustworthiness, and strong moral character. In so far as the problem is concerned with hospitals, it is compli- cated by the fact that among hospitals there is wide discrepancy in the educational opportunities offered; there is confusion as to

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8 American College of Surgeons the American College of Surgeons; second, that hereafter the Clinical Congress of Surgeons shall be known as the Clinical Con- gress of the American College of Surgeons with its invited guests. REQUIREMENTS FOR ADMISSION TO FELLOWSHIP In Bulletin No. i the requirements for admission to Fellowship are pubUshed in full detail. Briefly stated, these requirements are as follows, — 1. The candidate shall be a graduate of medicine, Ucensed 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 eligible for Fellowship without technical examination 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, 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 apprenticeship of equivalent value. Five to eight years after graduation in med- icine, devoted to special training and to practice, are normally the time-requirement for eUgibility to Fellowship. Due impor- tance is attached to laboratory and research work. 4. The moral and ethical fitness of the candidate shall be deter- mined by the reports of surgeons whose names are submitted 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