MEDICAL TRAINING

Auckland Star, Volume LXVI, Issue 47, 25 February 1935, Page 5

MEDICAL TRAINING

THE OTAGO SCHOOL.

HOW DOCTORS ARE MADE.

A THOROUGH SYSTEM,

(By R.G.P.)

I What is the cost of a medical eduoaI tion ? The question, put to the average ! citizen with a son at the medical school, would probably bring the answer "A thousand pounds!" As a matter of fact the actual cost of each doctor turned out with the necessary qualifications in this country is somewhere about three times this sum. The balance is supplied by the Government. That our medical men are trained by the State at a substantial yearly loss is a fact not generally realised. A medical school is an expensive luxury—expensive to establish and expensive to maintain. The full-time services of professors of anatomy,' physiology, pathology, bacteriology, I medical jurisprudence, public health,' midwifery and gynecology, and part-! time professors of medicine, surgery and j materia medica —all these, experienced i specialists the lot of them, with their assistants and lecturers, make up a large establishment, two of which are well beyond New Zealand's humble purse. A High Standard. New Zealanders have long prided themselves on the high quality of the medical training to be had at their school in Dunedin, a pride which is something more than the usual patriotic boast. It is borne out by the performance of New Zealand men in other countries, their showing in competition for positions, and the ea§e with which they negotiate examinations at Home.

The fact that in New Zealand we have a six-year course of study, as compared with the usual five years of England and Scotland, does much to raise the Ataiuiajii c*T. q\it medical training, but

apart from this there is a genuine high) standard demanded in examinations at | the Dunedin school. The student who | enters it from his first year, which is I almost that of a science student, is sur-j | prised at the high standard required of; him. Here he has to work, and work hard. It is, indeed, no royal road to medicine that is followed in this Dominion of ours. There is a thoroughness about the way the course has been planned, and i it is a methodically sound grounding that the student receives before . he' ( begins the true practice of his art. His, first year is scarcely medical at all, fori he studies almost the same subjects as | the first }"ear student in such branches as ' dentistry, home science, 4 forestry and j agriculture. This he may do at any of j the university colleges, and it is not until his second year that he enters the doors of the Medical School at the Otago University. Laying the Foundations. For two long years at Dunedin he is in the "dissection-room stage" of his ! career, struggling with anatomy and j physiology. Not till the end of his i third year, half way through his medi- I cal course, does he finish with mastering j the knowledge of the healthy human | body, all its mechanisms and architecture. For "untjl we are familiar with I the normal body, how can we attempt | to tell when it is out of order," much j less try to coax it back to its everyday ; habits? ' j The principles of the thorough ground- | ing is carried on in the fourth year. | His most important subject this time, the student finds, k pathology, the basic I ' study of the processes of disease, and : a branch that in other medical schools 1 is usually left to the final examination. Here he has an insight into the ground- j work of all human ills, a systematic j ' survey which serves him more faith-j' fully than what he would have picked | up in the hospital for himself, though I ' perhaps a little duller in the learning, j In this fourth year, too, work of a ; more practical nature is forthcoming. , ' It is now that he begins to see where, j ' it is all leading to. how his apparently i meaningless knowledge can be applied to his future profession. He starts regu- • lar work in the hospital wards. ha«s patients to examine for himself, and,' learns the art of bedside investigation, j He learns about drugs and their use i i in. madicaxLa, -ghat ih&y du and iiaw to j ]

} prescribe them. Lectures are given to 1 him on the subject of bacteria, those j tiny organisms to which so many I diseases are due. | From this time onwards the medical I student may be said, comparatively speaking, to have hardly a dull moment in his studies. His fifth year brings him further practical work, and a great variety of interests in a great variety of special departments. In the hospital Ihe assists at operations and gives ! anaesthetics, he visits the asylum and j the Karitane Home, and generally indulges in the thousand and one varied j pursuits of his craft. At this time, too, he experiences, for the first time, • one of the thrills of the medical practitioner, the thrill of being wanted ! urgently. This comes to him when he : is attending confinements, forty in all, ! at the Dunedin maternity hospitals. When the student completes his fifth year he is finished with the medical school. Then he retires to one of the big hospitals, perhaps in another centre, when under the eyes of eminent medical men he spends a year in the practice of hospital medicine and surgery, and the accompanying study that he may care to do of his own initiative. By this system the disadvantage of the small size of the Dunedin Hospital, which is only the fifth in the Dominion, is overcome, and the student is given the chance of exploring the greater clinical material to be found in the larger infirmaries. Too Many Applicants. That, in brief, is the method of educating doctors in New Zealand; a method which has produced some famous men. The most recent problem that it has had to meet is that three times as many young men are wanting to subject themselves to it than have done so in the past. The necessary weedingout, which must be done, cannot be accomplished in the ideal way —testing their ability for medical work —for as yet they have none. At present New Zealand's future doctors are being chosen from a large field on a" nonmedical examination by non-medical examiners after they have wasted a year at the medical course. The last factor appears rather an unnecessary one to be in operation. Time alone, however, can provide for the. best means of selection, and time will piobably itself, end the - problem.