House staff made up for many of the deficiencies. With few exceptions, the patients were on 30-bed wards that were full in the beginning of my training but less so by 1958 as hospital insurance began to have an impact. Superficially, absolutely yes. Fundamentally, certainly not. Think what the intervening 40 years have brought.
Hospitals are better, residents' salaries are higher, and the climate of training has changed.
But training has not basically changed. There were 3 fundamental assumptions on which our training in 1954 was based. First, if someone is ill, it was assumed that their disease adequately explained the illness. The third assumption was that to know the science of disease is to know diagnosis and treatment and to know medical science is to know medicine. Substitute the word pathophysiology for disease and these same assumptions underlie current training programs.