Jefferson Medical College - Clinic Yearbook (Philadelphia, PA)

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1977 CLINIC Jefferson Medical College

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Dear Colleagues: Your entrance into the profession of Medicine will be dissimilar from many of your predecessors since the entire health care system of our country is in tran- sition. You must be sufficiently flexible in your practice and related clinical activities to adapt to this transition and at the same time maintain the highest standards of medical care. Some have said that Jefferson is a relatively con- servative medical school, and I would agree that in some instances this state- ment is true. However, Jefferson ' s conservatism is not one of complacency with the status quo, but is a result of careful self-study that indicates that change, for the sake of change alone, is seldom indicated. In addition, at a time when national changes in the nature of health care delivery are so frequent in occurrence and widespread in impact, the solidarity of the educational cli- mate at Jefferson attains even greater significance and importance. The student-physician transition that has occurred over your four years is a remarkable phenomenon of developmental biology. You have learned well the sciences basic to medicine and have equally well applied this knowledge in the solution of clinical problems presented by your patients. My observation is sub- stantiated not only by similar observations by the clinical faculty, but also by the consistently outstanding performance by Jefferson students on the exami- nations of the National Board. These examinations serve many purposes: they are a reliable extramural yardstick of the didactic efficiency of the overa ll edu- cational program and in addition, provide a convenient pathway to you for medical licensure. Another extramural index of the quality of a Jefferson graduate is the type of hospital in which the physician obtains a position for post-doctoral residency training. Your class has ontinued the pattern set by your predecessors in obtaining positions for graduate medical training at hos- pitals of exceptional quality. Perhaps the most significant change of recent note among students at Jeff is their increasing desire to become proficient not only in the science but also in the art of Medicine. Your class has desired to become adept in those aspects in the life of a physician not contained in textbooks — an example of such skills include the management of the terminally ill patient, not as an exercise in pathophysiology and therapeutics, but rather as an individual with a serious medical problem who is a member of a family unit. Proper management must, therefore, of necessity, include not only the patient ' s problems, but also the needs, anxieties and uncertainties of the patient ' s family. A reflection of your concern is the increasing number of graduates choosing broad areas of primary care in Family Medicine, Internal Medicine and Pediatrics rather than circum- scribed specialties and subspecialties. It is relatively easy to become proficient and insolate one ' s ego in the niche of a medical or surgical subspecialty. On the other hand, to say that primary medical care is difficult would be a naive understatement — however, in my judgement, the personal rewards that those of you who enter primary care specialties will experience are greater than those of the subspecialties and more closely parallel the thoughts set forth in the code of Maimonides and the oath of Hippocrates. This medical renaissance among students at Jefferson has given the administration and faculty the very clear impression that those about to enter the profession have charted them- selves a noble course, and will re-establish the physician as one schooled not only in the science and art of Medicine but one equally conscious of the role that the physician must properly play in society if we are truly to be worthy to serve the suffering. Students of Medicine must appreciate that their scholarship is a life-long endeavor and must not terminate with receipt of the Doctorate in Medicine. Over the years, students at Jefferson have responded progressively less as passive recipients of knowledge dispensed ex cathedra by the professor and more as active inquisitors into the intricacies of a disease process. This is a good prognostic sign for such students upon entering into practice will not re- gard their participation in continuing education as required drudgery but rather as an opportunity for adventure in new knowledge. Those who aspire to excel- lence in Medicine will experience a certain joie de vivre in their daily lives that is unmatched by or in any other profession. I wish you all God Speed! Robert Mackowiak, M.D. Associate Dean