Thursday, December 19, 2013

Medical Education


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In reading The Law, it sounds like a formula for today, a Flexner Report[1] from 25 centuries ago, and it would not hurt to reread the Flexner Report either.
          1. Medicine is of all the arts the most noble; but, owing to the ignorance of those who practice it, and of those who, inconsiderately, form a judgment of them, medicine is at present far behind all the other arts. Their mistake appears to arise principally from this, that in the cities, there is no punishment connected with the mal practice of medicine except disgrace, and that does not hurt those who are familiar with disgrace. Such persons are like the figures in tragedies, for as they have the shape, and dress, and personal appearance of an actor, they are only stage dressing, so also physicians are many in title but very few in reality. [They wear the stethoscope around their neck and pretend to the knowledge]
          2. Whoever is to acquire a competent knowledge of medicine, ought to be possessed of the following advantages: a natural disposition; excellent instruction; a favorable position for the study; early tuition; love of labor and leisure. First, a natural talent is required; for, when Nature leads the way to what is most excellent, instruction in the art takes place, which the student must try to appropriate to himself by reflection, becoming an early pupil in a place well adapted for instruction. He must also bring to the task a love of labor and perseverance, so that the instruction, taking root, may bring forth proper and abundant fruit.
           3. Instruction in medicine is like the cultivation of the products of the earth. For our natural disposition is, as it were, the soil. The tenets of our teacher are, as it were, the seed. Instruction in youth is like the planting of the seed in the ground at the proper season. The place where the instruction is communicated is like the air imparted to vegetables by the atmosphere. Diligent study is like the cultivation of the fields. It is time, which imparts strength to all things and brings them to maturity.
           4.  Having brought all these requisites to the study of medicine, and having acquired a true knowledge of the art, we shall thus, in travelling through the cities, be esteemed physicians not only in name but in reality. However, inexperience is a bad treasure, and an empty purse to those who possess it. Whether in opinion or reality, being devoid of self-reliance and competence, fosters both timidity and audacity. For timidity betrays a want of powers, and audacity a lack of skill. There are, indeed, two things, knowledge and opinion, of which the one makes its possessor truly to know, the other to be ignorant.
           5. Those things, which are sacred, we must impart only to sacred persons, and thus it is not lawful to impart them to the profane until they have been initiated in the mysteries of the science.



[1] Flexner Report is a book-length study of medical education in the United States and Canada. , written by the educator Abraham Flexner and published in 1910, sponsored by the Carnegie Foundation. Flexner lived 1866-1959. Flexner reformed medical education in the United States; he also helped found the Institute for Advanced Study in Princeton. Many aspects of the present-day American medical profession and educational system stem from the Flexner Report.
 

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