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

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Fellow students, every man has a philosophy of life in thought, in word, or in deed, worked out in himself unconsciously. In possession of the very best, he may not know of its existenceg with the very worst, he may pride himself as a paragon. -SIR WILLIAM OSLER Sharing Osler's belief that the fate of an institution lies in the men who work in its halls, and in the ideals which they cherish and teach, we solicited from a repre- sentative group of the faculty the following collection of essays. Each was asked to describe his philosophy of medical education and practice. We have assembled a tangi- ble record of the various philosophies that mould in intangible ways our medical think- ing and our professional growth. These are the philosophies that make a Duke medical education unique nowg in the future these essays will recall the personalities of our teachers who did more than expound fact. twenty-one

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13512 ma , . Z fa ,, 2 W av Some patients, though conscious that their condition is perilous, recover their health simply through their contentment with the goodness of the physician. HIPPOCRATES dm Y 2 .Tv - fy fi r tts ' t L J, H it spr .J rzpp i :kp , s g 4-2 ly Mk A f t Wh A twenty J .fi 11 .,:.,.,,..,,.7sL1 I

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The Department of Medicine traditionally has the responsibility of preparing the student for a life- time 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 Diagnosis and Clinical Mic- roscopy-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 excellence. He learns to properly identify the problems of the patient. Having identified the problems, he marshalls 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 problem. Using the patient as his means of integration, he re-reads his anatomy, physiology, microbiology, pharmacol- ogy and biochemistry. In this clinical setting he has the opportunity to speak many words which he has previously only read, he discusses the prob- lem with his fellow students, interns, residents and senior staffg he gains familiarity with ideas and concepts by actively manipulating them. The student crystallizes his idea of the best diag- nostic and therapeutic approach to this particular patient. He identifies the reasons for each of these EUGENE A. STEAD, JR., M.D. MEDICINE Our role is to identify the area where the indi- vidual will be most happy and productive and to help him reach this goal. decisions. He has real curiosity to see if his evalua- tion of the situation is correct or if he will have to admit that certain data which he had 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 uniniluenced by strong state- ments, by the rank of the faculty member, or by the number of supporting references not quite ap- plicable 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 sub- strates. Part of a doctor's learning is only experi- mental. He knows from living with his patients that certain things are possible, but he does not know the underlying sequence of events. In other in- stances, 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 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 twenty-two