The Vermont watchman. [volume] (Montpelier, Vt.) 1883-1911, 1897-09-22
HOSPITAL SURGEONS.
POSITIONS HARD TO GET, AND 1T
ISN'T EASY TO FILL THEM.


Cases q Year - The Ambulance Doctor
Defended-Merit Wins, but Little Pull
Is Not q Bad Thing.
Every graduate Of the New York med
lcal SCHOOLS would be glad to hold for the
first IS months of his professional life
post on the staff Of q metropolitan hospi-
tai. Perhaps one graduate in 30 obtains
buoh an appointment. So valuable to
physician or surgeon Is hospital practice
In New York that graduates in medicine
from all the region round flock to the ap-
hual examinations OF the hospitals II the
staff vacancies are to be filed, go, 80, 80
young men present themselves for exami-
nation. Graduates of the Harvard Medical
school come over to these examinations,
partly because there is wider experience
10 be had here than In Boston, partly per-
haps because young man going upon the
staff Of Boston hospital must come not
as graduate in medicine with the diplo-
ma OF M. D., but as a sort of house pupil
or apprentice In medicine.
All physicians and surgeons to the New
York hospitals, save the Psychologists, serve
without pay. Newly graduated doctors,
men from % to near 80 years Of age, have
appointments for about 10 months. Con-
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highly distinguished, are glad to serve
without pay for two years together, be-
cause 1t is here that experience is gained
and regulations are made. A visiting
surgeon may see 10, 900 or 1000 cases In
o single year, such number as not the
busiest surgeon could see In private practice
during a like season.
Junior, senior, house-that Is the order
Of promotion In the hospital service for
both physicians and surgeons The young
graduate has in the natural order Of things
six months in each place. Every hospital
has from to go doctors on Its house staff
The house surgeon proper has general
charge Of all surgical cases after they have
been seen by the visiting surgeon. The
same Is true of the house physician. The
Junior or senior, as the case may be, must
| 90 out with the ambulance when q call
comes in. The police or private persons
now and then complain that a man has
lain 40 or 80 minutes perhaps two hours,
awaiting an ambulance after the call has
| been sent out. Most of the time the am
bulance surgeon has an entirely sound ex-
ouse for the delay Sometimes he is off In
another direction ON ambulance duty.
More often perhaps the call finds him aid
ing at q surgical operation, and he must
reach stopping place in that duty and
change his clothing before he con go out
In response to a call.
The hospital surgeon and his friends
have q multitude Of answers to the charge
Of brutality now and then brought
against the former. "Should you see me
OF my hospital work." said the visiting
surgeon of a famous hospital, you'd think
pe rude and perhaps brutal. I have In
two hours to see from go to 90 patients
| oil ~ ~ IND, %
finger to broken thigh. must diagnose
rapidly, and should listen TO demands
for anesthetios or heed the hundred and
one other pleas Of the patients I should
never finish my work. 1t Is SO with the
young ambulance surgeon kneeling beside
the injured man on the sidewalk. He
must do what he has to do with all speed
without stopping to heed the advice or
comments Of q sympathetic crowd"
Tender the hospital surgeon should be,
but sympathetic he must not be. The
sympathetic junior is marked out for fail
ure just as the sympathetic nurse Is
marked out for dismissal. A surgeon
never performs an important operation
upon a member Of bis own family. He
distrusts HE own skill as affected by sym
pathy.
Hospital surgeons are among the hard
|
have no fixed hours of duty and may be
called upon for service at any hour of the
day or night. When O hospital has a large
staff Of medical men, 1t Is possible for the
members of the staff to arrange among
themselves for days and hours off, but the
doctors Of small hospital are often on
duty night and day, and 1t is lucky
night when the busy junior has seven
hours of unbroken sleep. The house sur
geon and the senior Of a small hospital
must never be absent at the same time,
and an absent house physician must never
be many hours away without leaving word
where he may be found.
But II the service of the New York hos
pitfalls is hard 1t furnishes the very best
practical school In medicine and especially
In surgery, to be found anywhere in
America. At the end of 10 months serv-
ice the young hospital surgeon has seen per-
formed, and perhaps has helped to perform,
nearly every operation that falls to the
duty Of an ordinary surgeon in a lifetime,
and some of such operations he has seen
and taken part in many times over. The
cosmopolitan character of the city and its
immense floating population make 1t the
temporary home Of more strange diseases
| than any other city of the continent, so
that the hospital physician has beneath his
eyes the ailments of the world.
Considering the great opportunities open
to the hospital surgeon, laymen often
wonder whether influence has aught to do
with appointments to hospital stats. 1t
| has and 1t has not Examinations are
rigid and fairly conducted, yet the man
that passes the best technical examination
Is not always the man that gets the ap-
pointmeDt Yet, on the other hand, an
incapable man Is seldom or never appoint
ed. The personal equation always helps
, TO determine an appointment. A candi-
dates appearance, manner, speech and
general record at school are taken into con-
| sideration. The examiners are often the
same men who have instructed the candi-
dates In the medical schools, and an ex-
aminer puts together his knowledge Of a
candidate as obtained in three or four
years. contact with him In the lecture
room and at clinics and the knowledge of
him drawn from the examination. A stu
dent of known bad habits, of conspicuous
defects, will not be appointed to hospital
staff, no matter how good his examina-
| ton.
1t is the most ambitious students that
| seek appointments to the hospital stats,