Evening star., 1939-07-23
Medical Profession
Voluntarily Reforms
Field Of Specialists
IS Per Cent of Doctors
Have Token Arduous
Examinations for Title
BY the Associated Press.

By the Associated Press.
NEW YORK, July 22.-About one
quarter Of all the American sick in
the last year were treated by medical
specialists"
But not one person in 10000 knows
how his doctor got to be specialist,
or has heard the story of the swiftest
revolution in medical history-the
recent change of IS per cent of
American doctors into specialists.
Take the case of "Dr. Smith"
Until this summer he had been
practicing obstetrics and gynecology
in large city. He rated high. Last
winter he decided he wanted to be
certified as specialist in this field.
"Dr. Smith" was already gray
about the temples. But he got out
the books and for weeks stole some
of his meager hours of sleep to cram
again as in college days.
Takes Long Examination
In the spring he went to the Of
flee of fellow physician in his home
city and took long written exami-
nation. His fellow toWnsman did
not make up the questions, but mere
| ly loaned his Office and supervision
to make sure of rigorous answers to
an examination drawn up by a ma
tional board.
This doctor was "diplomate," an
authorized representative of the Of
fetal examining board in this spe-
cialty.
"Dr. Smith" passed Then, in May
he went to st. Louis to appear in
person before the members of the ex-
amining board. There are nine men,
bers. each of national repute in this
field. The candidate was ushered
into the presence of an examiner and
an assistant examiner, and the usher
announced:
This is DR.. Smith"
The examiner looked up and then
he frowned.
"ShoW DR.. Smith out" he ex-
claimed II have known him many
years. Take him to another ex-
aminer."
1t is rule that no examiner may
hear any one with whom he is per-
sonally acquainted. He cannot even
hear a candidate from his own Sec
ton of the country, or especially
from his own state.
Another Long Test
"Dr. Smith" went before another
examiner. There he stayed three
hours. First he had to show that he
knew pathology the changes which
take place in tissue and organs as a
result of disease processes. He had
to look at unlabeled microscopic
slides and tell the examiner what
abnormal conditions they showed
He had to exhibit familiarity with
the literature" which means not
only medical books enough to stock
private library, but any outstand-
ing research work not yet in books.
Lastly. he had to pas an examina-
ton on his experience, personal
character and integrity.
Again "Dr. Smith passed. Fiji
teen to 25 per cent of the candi-
dates do not pass the first time.
But most of them come back for
another try. 1t costs $50. This Is
the only money involved and all
of 1t goes to pay the actual operat-
ing expenses of the examining board.
The examiners serve without re-
muneration.
amining boards, each for different
medical speciality. All except three
of them have come into existence
since 1881. The eve specialists set
the example in 1917; ear, nose and
throat. and obstetrics and gynecol-
ogy followed in the late 20s. All are
organized on the same basic prin-
ciples.
A Voluntary System.
The system was started voluntar-
lily, by doctors in the National Spec
ialty Societies. and not by the
American Medical Association. The
A. NJ A. did not participate in the
new boards until several specialists
had established their own national
examining boards. An A. M. A.
section" no wcontributes examiners
to each speciality, but cannot con-
troll the organizations. which are
separately incorporated.
Prevention of abuses was the rea-
son for this self-starting medical
revolution. 1t is explained as fol-
lows by one of the leaders in special
ization:
The public is entitled to ask what
particular qualifications specialist
possesses and by what uthority he
so designates himself
The term specialist carries with it
1f 3v,;,,
and a background of extensive clin-
ical experience. Unfortunately in
man yinstances few weeks at
tendance in clinic, at home or
abroad, or merely the individuals
intellectual dishonesty, has been re-
sponsible for deliberate misrepresen-
tation, and served as pretext for
the genesis of the self-styled but
incompetent specialist"
The new system of professionally
recognized boards renders a mush-
room specialists path difficult. The
specialist is a physician to whom
other doctors can turn for consulta-
ton in difficult cases. If the special
iSt cannot make good wit hadvice, he
is not likely to succeed.
Will Publish Directory.
To qualify for the examination a
doctor must be a member of the
A. M. A., that is, member of his
county medical society, have one
year of approved internship, three
years of postgraduate training in
his speciality and two additional
years study and practice.
One privilege heretofore denied
the public, directory of these spe-
cialists, is about to be published.
The new directory will be available
to the public, both lay and profess
sional.
The directory will be issued by
another voluntary, national organ
ization, the Advisory Board for Med
ical Specialties. Members of this
board are elected from medical COL
leges, medical specially examiners,
| Ctoto yoeS;oo1 ooI boerytele