Medical Education 1926-1928. Bulletin, 1929, No. 10
Author: Colwell, N. P.
Date: 1929-00-00
Type: Historical Materials
Subjects: Foreign Countries,Graduate Study,Teaching Methods,Undergraduate Study,Medical Services,School Buildings,Preventive Medicine,Physicians,Educational Experiments,Educational Innovation,Graduates,Dropouts,Costs,Misconceptions,Curriculum,Professional Associations,Enrollment,Medical Education,Educational Trends,Educational History,Educational Policy,Educational Finance,National Surveys,Specialization,Graduate Medical Education,Clinical Teaching (Health Professions),Labor Supply,Medical Students,Scheduling,African American Students,African American Education,International Education,Comparative Education

This bulletin reports on the status of medical education in the United States for the years 1926-1928. During the past two years the number of medical schools recognized  by the American Medical Association has been reduced from 80 to 74. Reports to the American Medical Association show that the enrollment of medical students has increased from 18,840 in 1926 to 20,545 in 1928, an increase of 1,705 students. Various reports during the past several years have made it appear that many qualified students were finding it impossible to obtain enrollment in medical schools. An investigation revealed that on average applicants had applied to two and one-half medical schools; thus, at the beginning of the college year 1926-27 there were vacancies still existing, or one-fourth of the entire first-year capacity. Fortunately the medical schools had waiting lists so these vacancies were filled. The investigation also reported that most medical school rejections were attributed to unsatisfactory qualifications. During the past two years the number of students graduating from medical schools has increased from 3,962 to 4,262, an increase of 300 in the two years. During the past 20 years new medical school buildings or enlarged teaching hospitals have been erected in at least 48 medical schools, of which 24 were new and complete medical teaching plants. Statistics regarding Negro medical students and graduates show that during the past five years 2,644 students have been enrolled and 586 have received medical degrees. Of the students, 2,193 were enrolled and 475 were graduated from the two Negro colleges, while 451 students and 111 graduates obtained their medical training in other medical schools in the United States and Canada. On the topic of "saving time in medical education," during the past two years the idea of a more continuous method of medical instruction, usually given under the so-called quarter system, has been strongly advocated. This system allows a student to complete the four required college years of medical education of eight or nine months each in three calendar years. Under this plan, any three consecutive quarters of completed work would count as a "college year." Since the biennial report of 1924-1926, more complete statistics from foreign countries showing the supply of physicians in proportion to population as compared with the United States has been obtained. This information indicates that, although the United States has a greater percentage of physicians to population than any other country, it has a smaller number to each 100 square miles than 18 other countries, but a larger number than 22 other countries. Data are also provided on the number of physicians in each State, in proportion to each 10,000 people, as well as each 100 square miles. On the topic of medical school finances, reports received from 63 of the 74 medical schools give a total income of $11,983,783 and a total expenditure of $11,308,800. Statistics regarding graduate medical education for 1927-28 showed that 3,472 students were enrolled during the year, of whom 2,336 were in the 41 approved graduate medical schools and 1,136 were taking higher internships--better known as residencies--in 272 approved hospitals. Reporting on the status of experiments in medical teaching, there has been a tendency on the part of certain schools to try new methods in medical teaching, some of which appear to be objectionable. For example, a few have overemphasized research in the undergraduate medical schools, and some have granted higher grades to the students undertaking certain assigned experimental work. Certain others have provided an extreme degree of elective work, and placed an unjustified degree of responsibility on the individual student, apparently without providing the essential supervision through consultants or advisory committees, such as are usually provided for graduate students. Institutions adopting such extreme methods should not overlook the first duty of a medical school--that of providing its students with a thorough grounding essential for every practitioner of the healing art. Additionally, a physician's undergraduate training should provide him with a thorough knowledge whereby he can intelligently examine any patient, make a reliable diagnosis, and prescribe or apply reasonably efficient treatment. Such a training should include or be followed by a year's internship in a general hospital, where he comes into contact with all varieties of diseases and can put his general knowledge into practice. The increase of hospitals in both numbers and capacity during the past 15 years has added impetus to the trend toward specialism. In the long run, it is believed that the physician who has acquired a good, comprehensive knowledge will prove to be of greater service to the public and more successful than the physician who limits his practice to a narrow specialty. In 1925, a commission under the auspices of the Association of American Medical Colleges was appointed to carry on a five-year investigation of medical education. It has issued three annual reports, the third of which details criticisms and perceived shortcomings of the state of medical education, i.e., (1) prolonging unnecessarily the student's period of preliminary and professional education; (2) overcrowding of the curriculum with nonessential details; (3) undue emphasis on teaching about separate organs and systems rather than the complete human being; (4) lack of more systematized instruction in preventive medicine; (5) unwise legislation or rulings of boards and agencies; (6) the desirability of providing students with more time to think and use the library; and (7) the advisability of more electives in the curriculum. An important investigation by a special committee on the cost of medical care was begun in 1928. The modern trend toward specialization, and the public belief that the best treatment can be obtained only from "specialists" and hospitals, has necessarily added to the cost of medical care. The urgent problem, therefore, is to ascertain how the benefits of modern medical care can be brought within the reach, both physically and financially, of the greatest possible proportion of the people. (Contains 8 tables and 4 footnotes.) [Best copy available has been provided.]