University of Michigan Medical and Nursing School - Aequanimitas Yearbook (Ann Arbor, MI)

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Other changes at the Mecca include additions to the physical plant.- the Parkview Convalescent Home, the new medical science building, the Charles Stuart Mott Childrens Hospital, and the post-graduate edu- cation building. New department beads are Dr. Wil- liam Fry in General Surgery, Dr. Richard Harrell in Dermatology, and Dr. William Oliver in Pediatrics. At this writing no replacement bas been chosen for Dr. Reed Nesbit in Urology. On the University scene, it is the end ry' the sesquicen- tennial celebration and the beginning if Robben Flem- i ng's tenure as University president. The Vietnam war qualyies as the most immediately critical event afecting medical graduates and all Amer- icans. Everyone wants the conflict to be over, but no easy solution comes to mind. So this cancer with no easy cure, this Vietnam war, continues after seven years of pghting, after over 15,000 men killed, and after millions of dollars have been spent on it. The ter- rain in Vietnam and the tenacity of the enemy preclude the easy victory that was lsrael's over Egypt last sum- mer. At home, the war has draft-card burners and anti-war demonstrators. Ironically these doves oppose the war more militantbi than the hawks support it. The major questions appear to be whether the United States has any right to he in Vietnam at all, whether the South Vietnamese have the abiligy or desire to sus- tain a democratic society, and whether the altercation is an unrelated incident or another step in a Com- munist plan to control the world. A more basic ques- tion must also be considered: Do the economic and technical advances made in Russia justmf subjugation :ja people for pftyyears. Nationally, Lyndon johnson still reigns in this an elec- tion -year. No doubt he will survive the polls in Novem- ber. The Republicans offer such men as George Rom- ney, who has struck his colors as a politician, Richard Nixon, eager for another crisis: and Nelson Rocke- feller, unwilling to run and refusing to campaign, on which plajortn he is likely to snare the nomination. Another paradox at home is the presence of poverty in the face of tremendous prosperigi. The awareness if this inequity has fostered a similar awareness inf the distribution of' medical services in the United States. The result is a clamoring for total care fir all peoples, regardless of economic or geographic position. Walt Faggett, active in establishing and perpetuating the Student Health Organization, writes of these medical needs. Iohn Lipson, this -year's recipient ofthe Galen's Foreign Fellowship, demonstrates the universality rn' the problem. Methodist Mission Hospital, Ganta Liberia. Starting 40 years ago as a bush clinic, this hospital has grown into a modern medical unit, com- plete with laboratory and school of nursing. 8 wivz3f '4 Modern medical care is provided by American physicians. However the primary purpose of the hospital is to train the Liberians so that they may eventually be able to supply their own doctors and nurses.

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The New Curriculum M. Zanotti In spite of what the upperclassmen may say, the big change brought about by the new curriculum is not the 40'Zi cut in the basic sciences. In fact, physiology feels the cut is merely a slight of hand trick and that there has been no effective reduction in their material. On the other hand, anatomy, when queried about the new system, gives forth with a wry smile and politely but firmly refuses to even comment upon it. But one must under- stand the fact that anatomy has been getting the axe with every curriculum change since the days when medical school and hu- man anatomy were practically synonymous. It is my feeling that the biggest change has been the new posi- tion assumed by the clinical faculty. The idea of introducing fresh- men to clinical material from the very beginning was exciting to both students and staff, but at times awkward and frustrating. There were occasions, especially at first, when there existed a communication difficulty in lecturing to a group on the intrica- cies and complexities of a patient's disease when my classmates and I didn't know a prognosis from a prosthesis, to say nothing about our complete lack of knowledge of the human organism. Throughout all this, the faculty has been very patient and even empathetic with our naivetes, our hesitations and inadequacies, and our growing pains in general. At the same time, they have been supersensitive to our criticisms and recommendations as they are eager to see the new curriculum work and to correct any flaws while the system is still malleable. Perhaps the biggest initial benefit to the entering class is the fact that the big medical school course, gross anatomy, is now post- poned a semester. N0 one, including the dean's office, felt that they could say for sure how effective the curriculum change would be until they could see how we reacted to gross. As I write this, I have had only one week of the second semester, but one thing is certain: if nothing else, the first semester primed us for the sec- ond. We have had time to orient ourselves to a new environment and are now, hopefully, more readily adaptable to the lowering of the academic boom. Thus, I look forward to a relatively less traumatic experience with gross than tradition dictates. The new courses such as those covering auto accidents and sex were not only interesting, but also a realistic approach to prob- lems that we will encounter many times over in our careers. The substitution for some of the physiology and biochemistry labs of class demonstrations proved efficient and the latter were proba- bly of more teaching value than the individual experiments of past years. One of the best aspects of the new curriculum is the vertical core method of teaching. For example, while studying metabolic endocrinology in physiology, we were doing glucose tolerance tests in biochemistry and being presented with a patient suffering from diabetes mellitus in the clinical correlation course. Seeing an actual patient representing the sum total ofwhat we have been learning in the basic sciences is, I feel, the most important teach- ing tool of the new curriculum. Seeing the victim of disease drives home the educational message to the medical student more than any other didactic device. In summary, I feel that the curriculum change has'been all for the better and although there has been some elimination of course work, this was, I trust, extraneous material that may not be quite as useful as the material that has replaced it. When I re- flect back on the Hrst semester as a whole, the thing that stands out foremost in my mind is the attitude of the clinical faculty to- wards the freshmen. These are the men we identify with and one day hope to emulateg they have in turn established a certain esprit de corps, and it is this spirit which has in a very large way made the new curriculum a success for all of us. The above mentioned surveys were completed two years ago hy the present Iuniors and Seniors. The sur- vey data reveals a consistant variance of opinion be- tween the two classes: the then Sophomores were more unanimous in their dislike of existing institutions, no doubt rtjlecting growing apathy. Whether the new curriculum will prevent apathy is unknown, hut at least the current Freshmen have received it with ex- ul1erance!a good result. 7

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Medical Needs Abroad john Lipson Externing in an isolated area of the United States or serving in a foreign country was probably the most exciting part of medi- cal school for twenty-four members ofthe senior class. Members of the class of 1968 went to places as close as Haiti, and in such diverse locations as London, Liberia, Nigeria, Ethio- pia, and Formosa. Each saw a different segment of the medical problems of the world and yet each came home with a better understanding of the medical needs. Most returned with a desire to someday return to the place where they had worked. The mo- tives for going ranged from the search for adventure and excite- ment, to humanitarian interest, to Christian Witness, yet all shared in expanding medical knowledge and understanding throughout the world. Liz and l spent four months in Liberia during the Hrst half of the senior year. We worked at the Ganta Methodist Mission Hospital which is a thirty-Hve bed bush hospital, but practices modern, western medicine. My wife taught in the school of nurs- ing and l worked in the clinics and surgery. The lasting memories we bring back are not of the specihc diseases and problems. Rather they are memories of the friendly people we encountered and their desire to advance their country into the modern world. And yet, in their desire to advance, they are utterly frustrated by lack of education and lack of a skilled working and middle class. To be considered literate in Liberia, a citizen must have a second grade education, yet less than 1405 of the population meet this requirement. Because of this, it is very difhcult for the people to be their own storekeepers, mechanics, bankers, teachers, nurses, and doctors. Those who are educated usually enter gov- ernment service or fill managerial positions for foreign-owned business. With this lack of education, it is not surprising that the medi- cal needs of the country are served primarily by foreigners. Church-sponsored medical missions were the first to provide medical assistance. More recently, other groups such as private industry and the Peace Corps have begun to provide medical care. For the developing countries to have their own medical school is a major problem. There are not enough physicians to staff a medical school or enough college graduates to make up a student body. Nursing education, however, is a rapidly expanding field. New schools are opening to train high school graduates to be reg- istered nurses and to teach nurses new diagnostic and therapeutic skills. The nurses, in many areas, are serving the function of physicians in tinding and treating disease. The changing medical emphasis has changed the type of for- eign medical assistance desired. The need for the foreign mission- ary doctor in the bush is rapidly decreasing. Rather, the develop- ing countries are in need ofthe specialist and the educator to help them create their own medical and nursing programs. They need American physicians as consultants, both in person, by letter and radio. The hope of the future for the emerging nations is the develop- ment of their educational facilities, so that each country may be able to train its own people to supply its own medical care. The class of 1968, through the bonds established during the foreign externships, may someday be leaders in the promotion of world health. 1 ..... . Young, bright citizens of many countries are gradually developing their own medical training programs. This male nursing student is learn- ing maternal and pediatric care through the Ganta School of Nursing. 9