DARTMOUTH MEDICAL SCHOOL, ITS PRESENT STATUS AND ITS POSSIBILITIES
Last April the Dartmouth Medical School granted degrees to its. graduating class for the 117th consecutive year — giving the: degree of Doctor of Medicine for the 103rd consecutive year. These were undoubtedly the last diplomas in medicine that the college will issue, at least for many years. This condition is due to the decision of the trustees, a year ago, to discontinue the third and fourth years of the Medical School. Their reasons were: made public at the time, and will not be entered into here."
There are still offered at Dartmouth the first two years of the course leading to the degree of Doctor of Medicine, but those availing themselves of that fact must,complete" the last two years of their medical education at some school other than Dartmouth. To their second alma mater the public will ascribe the credit and responsibility for their medical education, as well as to those taking the whole four years at the same institution.
Mathematically, then, this meclical school is only half of what it was before; has it by this amputation become a crippled thing, carrying on its function's imperfectly ? Is it a part of Dartmouth College to be treated with kindly forbearance and mentioned with apology ?
To answer this let me propound three other queries' and try to meet them. First: Is the ' Dartmouth Medical School a fraction of a whole or is it a whole in itself? Second: if it is a unit are there good reasons for giving it a continued existence and our hearty support ? Third: what is its future ? An answer to these questions will, I think, also meet the issue of the previous question.
To show that Dartmouth Medical School it now exists is a unit, let me point but that the first two years of a medical course are concerned with the fundamental sciences that underlie the practise of medicine, while the last two years take up, in addition to, a continuation of these scientific principles, their practical application. The first require a laboratory plant, the second a clinical plant, with hundreds of cases to be studied. One needs teachers devoting their whole time to their instruction, the. other utilizes men who are also practitioners. . The non-clinical years offer courses, which in equipment required, in methods of handling . the studies, in quality of work given, and in their mental discipline and training, are very similar to the, courses in the parallel last two years of the academic curriculum (except that the amount of study needed is. on the average considerably more). This is contrary to the belief of some, who appear to think that if a science possess a utilitarian value it therefore automatically ceases to have a purely educative or cultural worth. That it might be all the more cultural in effect because it could be applied to humanitarian purposes seems not to occur to. them; nor do they appear to realize that one of the incentives by virtue of which man strives to learn new truths is that in the. end his discoveries may better his own condition. The laboratory years of the medical course can be given equally well, in city' or town, although the clinical years of necessity are given in the city. It is apparent that there is a natural dividing line between , the first two and the last two years of the medical course, and that a college may very naturally, give the laboratory years in connection with its academic studies, although it might be impossible to attempt the two years of clinical instruction.
Acknowledging the practicability of such a two year school, should Dartmouth maintain one ?
Out of the one hundred medical schools in this country there are nine, including this school, which give such a two year course. Two, not mentioning Dartmouth, are already of highest standing, while the others, being mostly new-born, are only prevented from being first class by reason of local conditions, such as lack of equipment or of money for proper maintenance. Dartmouth is fortunate in already having a plant so splendidly equipped that it is only a relatively smaller matter to perfect it.
The full time members of the faculty,. who taught the fundamental sciences of the first two years in. the school as it used to be, are continuing their work, as are several of the practitioners, who formerly taught the clinical subjects of the last two years, although, naturally their work is lessened in amount.
In continuing the teaching of medical courses at Dartmouth there' is the strong impetus given by the knowledge and influence of 117 years of an honorable and highly successful record, with its wealth of tradition and inspiration.
With equipment, teachers, and tradition urging toward the giving of the fundamental branches in a medical education, and with the ability to give a two year course as excellent as that of any school in the country, are there students who will avail themselves of the privilege?
According to statistics up to 1910 about ten per cent of Dartmouth graduates studied medicine. On this basis out of three hundred men entering the junior class (at which time they may begin their medical course) about thirty would study medicine. In the past few years the percentage of college students studying medicine has somewhat lessened, but at least twenty would be certain to so elect.
The least time in which one can obtain the degree of Doctor of Medicine in the better schools is six years, including two years of preliminary academic study — not to mention the additional one year, at least, of hospital study undertaken by most medical graduates. As a matter of saving of both time and money few men who come to Dartmouth will wish to take their bachelor's degree here before starting upon their professional studies. If there is a chance at Hanover, in a first class medical school, to take half their professional studies at the same time that they obtain their bachelor's degree, the majority will naturally do so.
Most men who come here, intending to take up the study of medicine, will prefer to stay four years in Dartmouth under such conditions, rather than to leave at the end of two years to carry on work at another school, thereby losing their bachelor's degree. Many also will prefer to spend at least two of their years of professional study in the country rather than in the city. Still .others, it is probable, not otherwise attracted, may be drawn to Dartmouth for the very purpose of taking part of their medical course in such an environment.
Facts would seem to indicate that the school will probably soon be supplied with students up to the most efficient working capacity of its plant, about fifty men in the two years of the medical ocurse.
Many of the best schools in our larger cities are anxious to have more students in their clinical years, as, with their expensive equipments, they are able to handle more men than their laboratory years can furnish. Although this is the first year that all the medical students are sent out from Dartmouth Medical School to complete their course elsewhere, arrangements have already been made whereby credit is given by the majority of the better schools, giving the degree of Doctor of Medicine, for the two years work done at Hanover. Some require, others waive, the regular examinations admitting their own men to the third year.
Of course more time is needed to perfect and simplify such arrangements, to give an opportunity for the worth of the school, in its new guise, to be demonstrated, in its plant, in its curriculum, and most of all in the quality of the training of the men sent out. During the immediate years to come, as well as later, the years, in which the reputation of Dartmouth as a two year school is being established, it is of the utmost importance that everything possible be done to perfect the equipment, to give the best instruction, and to turn out the most thoroughly equipped students at the end of their two years course.
Just as the start is made there is urgent need for an increased endowment to enable the school to keep up to date in its laboratory and library equipments, and also for money sufficient to establish and maintain a department of Pharmacology, preferably in a new building.
In these days when it is becoming more generally appreciated how necessary it is to educate our physicians-to-be by the best means obtainable, few more worthy objects can be found than this school to which financial aid can be given, or where it will be put to better advantage. Without some help of this nature the medical school is in danger of suffering some injury to its reputation at an extremely critical period in its life.
To my third question concerning the future of a two year medical school at Dartmouth the answer seems plain. With abundant reason for giving a two year course in conjunction with the work required for a bachelor's degree; with an equipment already excellent, although still needing further improvement, as just indicated; with a faculty on the ground; with students probably enough to utilize the full capacity of the plant; with transferral to the best medical schools, offering the clinical years, assured tcpthe student; and with the addition of earnest, constructive work on the part of president, trustees, faculty, and students; a useful and highly successful life, in evef-y way comparable with the record of more than a century already passed, is assured to Dartmouth. Medical School.
By Frederic Pomeroy Lord '98, D. M. S. 1903
