SHORTAGE OF MEDICAL MEN

Dominion, Volume 9, Issue 2729, 25 March 1916, Page 2

SHORTAGE OF MEDICAL MEN

ORGANISING HOUSE SURGEON SERVICE i THE FACULTY'S SUCCESTION. Tho Dean of tlie Medical Faculty (Dr. Ferguson) presented to tho Otago University _ Council a report bearing upon the Minister of Health's inquiry how to increase the number of medical men qualifying shortly, and how tho Department may assist the Medical School. Dr. Ferguson stated (inter alia): — "Wo cannot increase the number of medical men wo turn out by shortening their course of, study, and obvioasly tho number who graduate is dopendent on the number who enter.' The number of graduates next year depends on the number of thoso who began their studies four years ago, and one can only say that ( the classes have been steadily growing for some years back, and that last year tho number of those entering on their medioal course was over 40, and this year is somewhere about 60. No suddon effort can add to the number of students in the last year of their course. It might be possible to increase the number entering tho first year bv directing the attention of parents to exceptional facilities or prospects, but with the end of the war medical conditions ij ome 110nna ' on ce more, aiid it would be very risky > double the size ot the entering class on the assumption that there-mil be the same acute shortage ol- men five or six years hence when their medical studies are completed, whuo thoso surgeons who have gone to the front have overy right to expect that no special steps will be taken which win make their position more difficult on their return. The Hon. Minister dSKs Jiow lie can help to increase tho number of men qualifying shortly. It is impossible to incrcaso the number in classes some years in existence. There is tho possibility that with more coaching and individual teaching some would got through thoir examinations who are now stopped, but with the marked growth m the classes individual teaching has become impossible in the sense that characterised tho early teaching in the school. The necessity for increased teaching power in the way of assistants and demonstrators has been urged before, and will become more pressiu'" overy year, and those teachers will have to 1m reasonably paid. One cannot expect to retain the.services of a competent teacher if he sees the pupils he has coached through their examinations commanding tivjce or three times his income. ■

. "A simple and obvious way of helping the school and at the same tinio faying the foundation, of the training in public, health whioh the Hon. Minis! tor desires, is for the Department to grant the services of its local officer as lecturer on public health to the finalKar students The Hon. Minister Btiould be made aware that from unforeseen causes tlio cost of the now eohoul buildings will esceed the funds at the council's disposal, and that tile mortuary and autopsy department, to necessary for public health work, t>as had to be eliminated in the meant'.mo from the plans. The course of studies I lias to be carefully balanced, and it is impossible to unduly direct a student's attention to one special subject without impairing the all-round efficiency cf Lis training. The further study in publie health which is required by t.'ie Department must come as a post-grarfnate course in the shape of the course now given for tho diploma in public health. "It is eminently desirable thai g>aduates should have a couplo <jf years' experience as house surgeoiis obtain a general knowledge of their work before any attempt ia made to specialiso In this directipn, and it is 'ilso : omiuently undesirable that young graduates should be taken into mental hospitals befo'o they have had this amount or hospital training in connection with the physical conditions of disease which thsy will have to treat iu their "liental cefcs. Where the Department could ve:y materially help tlie school would be by taking over the supplying ot house surgeons'to all tue hospitals in the .Dominion, and undertaking to place all graduates in one or other of the hospitals.

"They would all enter the services on an .equal footing as to pay and conditions of service, and alter two years' service such as elected to take the spccial D.P.H. courso might bo sent hero by the Department to go through tliis course of study and provided with (positions as demonstrators or assistants in the laboratory departments. Dc-i monstratorships in bacteriology or pathology would fall naturally into the work ot their own course of study, and might well be looked on as a portion of their continued sorvice' in tho Department, while they would bo of very great sorvice in the heavy teaching work of the school.

"Those who, alter their two years' house surgeoncy, wished to enter the Alental Hospital Department could begin their work at Seaclifi, . and no <ioubt it would be possible to arrange for sjwcial courses in pathology lor them m connection with tlio school, and some course leading up to a, special certificate l'or knowledge of nervous diseases (analogous to the D.P.H. in Public Health) might be evolved, which might possibly lead to a moro scientific standard of treatment/ of mental cases, aud would certainly tend to increase the efficiency of the junior members of the. mental hospital 6orvice. "if tlie Health .Department had the control of the bouse .lUrgeons of the Dominion it could promote or transfer them from oiie hospital to another.as need arose, or retain in the service-for longer periods those who showed special abilities, with a view to training them for superintendentships. In this way a man who had been house surgeon two years at Dunedin might be sent as senior house surgeon to Wellington or Auckland, becoming, after a year, assistant'superintendent, and theiu being fit to fill a vacancy as superintendent at Greymouth or Napier, or elsewhere, as [ vacancies oocurred. Provision, could be made for visits to other countries for post-graduate_ study without sacrificing continuity of service in the Department., The department will always have to compete with the outside demands of the public for medical services, and the bulk of the graduates will drift into private practice after two or, at the outside, three years of hospital work. Tho only way to increase the number of candidates is to make the career an attractive one, and if a student eaiters on his studies knowing that tho superintendentships are positions he can hope to work up to, and that the public health" and mental hospital appointments and medical inspectorships of schools can he reached by the same road, he has before him a career free of all doubts as to being ablo to make a living. "This combination of tho public medical services would offer a career to those to whom private practice does not appeal, which to some extent would represent the opening the army and naval medical services afford at Home. •'

"It' the department is prepared to [ face this scheme it will be in tile interests of botli the department and tho students that arrangements should bo mado that all students should occupy resident positions in the Dunedin Hospital during somo portion of tlioir final year of student work whiln they are holding their clinical appointments. No graduate would be then quite without experience as a resident wlion lie was called upon to fill a hous6 surgeon's position, and their work when in residence would be. a valuable guide in placing them after araduation. The department could very materially help the

school by urging tliig scheme on ths Hospital Board, and, if necessary, contributing to its cost. "The house problem for these students can be solved' at onoe by the adaption of a portion of the old nurses' homo to tlie purpose, but the department must take prompt steps in this matter if they mean to act at all. "lo recapitulate, the department can help the school by— (a) Granting tlie services of its local officer as lecturer on public . liealth. ■ , (b) Granting such funds, as are necessary to complete the scheme 'for the pathology department of the new Medical School block. (e) Affording assistance in the provision of demonstrators for the laboratory departments. 1 (d) Organising and systematisine tho house surgeons' service' of all the hospitals of the Dominion, and making it a stepping-stono to the higher positions in the medical, health, and mental division of the Public Service of the Dominion. (e) Assisting tlie anatomical department in the matter of material and in the cost of carriage of bodies." —Dunedin "Star."-