University of Maryland School of Medicine - Terrae Mariae Medicus (Baltimore, MD)

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One hundred sixty-five men and women gathered in the Assembly room of the Health Sciences Library one day in late August, 1974. Though we would never assemble inside that auditorium again, thousands of hours would be spent with the same company in less comfortable surroundings. That particular day was a hot, humid, typically Baltimorean summer day. Those of us newly arrived from College Park or other pastoral college campuses looked forward to four years of the heat, traffic, noise and commo- tion of city living. Yet as time “pooshed on,” the climate and surroundings passed unnoticed by medical students busily engaged, in other matters. It started out as a full-time investment; part-time jobs were forsaken. In 1974 the curriculum at the University of Maryland School of Medicine called for four nine-month blocks, with three-month vacations interspersed; by the time we left it was fast becoming a continuous 48-month proposition. To us these curricular changes came as Minimester and more Junior Medicine and Surgery. The majority of us were fresh out of college, accustomed to arranging our own schedules, where for some “academic freedom” was translated to a sure “A” in art history and geology. Those halcyon years were soon relegated to a distant gyrus in the temporal lobe. Instead of wandering from classroom to classroom, building to building, we found ourselves in the same room, virtually the same seats, eight hours a day. It would not have taken long for a frequent lecturer to memorize where each of the 165 sat, if indeed he wanted a seating chart. For many of us the real test of whether we belonged here was the first Biochemistry exam. But one week later came the Anat- omy exam, and soon rising and falling levels of anxiety became a monotonous sequence. On that first day in August many of us were reunited with high school friends; not long afterwards the class was re-introduced to another high school throwback, the examination proctor. Escorts to the bathroom, however, were a medical school first. After two years all this changed; the study sessions in the old Howard Hall modules, the slide-tape shows with the classical music, the videotapes, the bluejeans, the post-exam Campus Inn get-togethers, even the Psych courtyard football games, all van- ished into thin air. Soon there were new goals, new skills, and new knowledge to master. Now attention was drawn to the patient, the problem list, the differential diagnoses, side-effects, progress notes, the discharge summary and follow-up. In one word it was “clinical,” and for the perennial classroom student it was to become a new way of life. Not long after we had forsaken the “playground” of the classroom, we found ourselves leaving the familiar University medical center and venturing out into the “provinces,” the community hospitals where most doctors work and most patients go. Although our rotations varied in location and particulars of experience, what we all had in common was the opportunity to learn how to use our hands and their tactile sense, our hearing, powers of observation, and our minds to coordinate these in arriving at a logical evaluation of the patient. Our needs included taking an adequate, coherent history, understanding what actually ails the patient, relating this to our comprehension of health and disease, translating it into the physician’s vocabulary for contemplation and pre- cise communication with our colleagues, swiftly and logically formulating a treatment plan, and finally reviewing this with the patient to facilitate his understanding and cooperation. This new profession of ours teaches not only how to diagnose and treat a patient, but also a unique perspective of human nature and a special way of dealing with the patient and truths we are trained to see. The physician has been given the privilege of prob- ing with his fingers and machines into all of man’s crevices, sulci and secretions, establishing a professional relationship with his patient based on trust and grounded in scientific principle. With this privilege, responsibility is entrusted to the physician by the public; judicious, compassionate management earns him society’s respect. Further clinical experience during our post-graduate training will refine our newly developed skills. As we continue to learn, we look forward to teaching ourselves, our patients, and our colleagues, as directed by the literal meaning of the word “doctor.” “Okay, ril play house with you. You take care of the house and kids while I finish med school.” 4