THE MEDICAL SCHOOL.

Evening Star, Issue 11605, 19 July 1901, Page 3

THE MEDICAL SCHOOL.

\ At tho meeting of the on Wednesday afternoon i deputation from the University Council brought up -a number of recommendations in relation' to the. future management of the Medical School. -The University's Committee mention that the number of medical students who leave for Home after completing their first year is increasing; in other words, those remaining hero for senior anatomy and senior j physiology is less. No satisfactory reason t for this state of things'is. forthcoming. All the evidence taken by the Committee tends to prove that anatomy is excellently taught here, while the systematic teaching of physiology is good; indeed, the whole sub-, ject has grown so rapidly that it is next to impossible'for one professor to teach both branches. 'The general reason given for the exodus of students is that they desire wider experience,, the prejudice in favor of a Home degree, and an impression tliat-it is more difficult to pass ' in the colony. The standard of examination There is somewhat higher than at Home, but in view of the prejudice against the colonial degree it would be unwise to lower the present standard. The principal defects of the Medical School are—the absence of control by the Unuiversity Council over the material for clinical teaching, with little control over the teachers; the minimum number of hosI pital beds should be 100 (for the past year the average has been 103.9, but it has been as low as 88); to obtain the. requisite number of beds either the Dunediii hospital district should be enlarged, the conditions of entrance to the institution should be relaxed, a ward for infectious. diseases or a maternity homo should be established; the outdoor department is not sufficiently used for clinical instruction, since it is under the control of the house surgeons, the medical staff having little or nothing to do with outdoor patients! The present method of appointing the clinical teachers is very unsatisfactory, and tlie staff inadequately remunerated. It is therefore recommended that the clinical staff be reorganised. That following the practice of English and other colonial medical schools, ; anatomy and physiology should be taught by separate professors, and that the professor of physiology should be provided with a proper laboratory and appliances for the modern teaching of this subject. After pointing out defects in the prescribed courses' of study, as pompared with those obtaining in other schools, the Committee made these recommendations:— The training obtainable in the Hospital is so essential to the success of the Medical School that this Hospital district should be specially treated, and toe two bodies controlling the University and the Hospital be more closely united, Tne Board of iiospital Trustees should join the Council in applying to | the Government to pass a Bill providing that the Council and the Board of 'JLrustees meet as one body to appoint the honorary staff of the Hospital. That there be, as at present, three full surgeons and,three full physicians; that an assistant surgeon and an assistant physician be appointed, and' that they should have charge of. the out-patient 'department, and take the place of any surgeon or physician who is absent The Council should appoint two .clinical tutors—one surgical and one medical, at a salary of, say, £SO a year each, and the fees of the tutorial class. There is no reason why these tutors should not be the assistant surgeon and physician previously mentioned. That the whole of the fees paid by the students for hospital training be handed over to the Hospital teaching staff. That the foregoing appointments, and all honorary appointments connected with, tho Medical School, be for a term of two or threo years. That the l Hospital Trustees and Council eonfer on the following subjects:—An increase in the number of beds, the establishment of a ward for infectious diseases and a maternity home, and the building of a morgue. That a professor of physiology be appointed, and be equipped with lecture room, laboratory, and appliances, the salary to be £6OO a year aiid half the fees. This professor should not be allowed private practice. The cost of lecture room, private room, two other rooms, laboratory, and laboratory appliances is estimated at £2.000. if built in wood. That tho lecturer on ophthalmology bo paid £SO a year, and that the lecturer on mental diseases receive a similar amount, if satisfactory arrangements are made for a courso of lectures at the University. That the Dean of. Faculty be, asked to prepare a scheme of study and,'examination, bearing in mind the references in this report with regard to chemistry, physiology, and anatomy, mental diseases, pathology, materia medica, and therapeutics, anesthetics, diseases of •hildren, and the duplication of the principles of surgery in the final year. That an anaesthetist be appointed,' who should also supervise the practical instruction of students, and that each student should obtain a certificate setting forth that he had received practical instruction in the administration of anaesthetics. That special instruction be given on diseases of the throat and ear, and on diseases of children. Thai the Government be asked to appoint a bacteriologist for tho colony, that he be located atT the Medical School, Dunedin and equpped wth an up-to-date laboratory and appliances, and that he should give instruction to the students and graduates. That the lecturer on medical jurisprudence and public health be appointed health officer for the district, and that all post-mortem examinations ordered by the coroner be made by him. That students of physics be excused attendance on that part of the lectures which treats of dynamo machines arid electric lighting. T'hnt it wou'd be an itdvantaffe if the exarainat:on 'n or?a"ic chem : st r y w?ro taken earlier, and that the chemistry course (if possible) be shortened. That the authorities of the New Zealand University be asked to. amend the methods of examination in these particulars:—By allowin? a student who fails in the final examination to come up aeain' after an interval of six months, and pennittine a student who fails in one or more subjects of the final examination to count those in which he has passed; that the Senate be asked to institute medical scholarships, changes involve a total _ expenditure of £?,825 per annum, and it is suepested that the GrcVernnien+. should be asked to assist in making- the' Medical School more complete and so more efficient. The co-operation of the members representing Dunedin and suburbs should \ be sought, and to that end a conference with them be obtained. , Professor Sale, speaking to the report* said all the students who had gone Home emphasised the fact that better clinical instruction was obtainable in the Home hospitals. Dr Hocken said that the mention of the need of instruments should be removed from the report. The Council »were agreed that the Trustees were very generous m supplving instruments. The Chairman said, in fairness to the Trustees, the name of the witness who said that there was need of instruments should be given up. Nothing in that direction had ever been refused to any medical maiii Dr Hocken said that what was referred to was not the shortage of instruments for surgical purposes, but the need of some instruments for use in lecturing to the students. . The Chairman said that it was well known to the hospital authorities that if any very difficult operation had to be performed, application was made to the hospital for instruments. Professor Sale said that nothing more

was intended than that small additions might for lecturing purposes. It yr'aa well: known that the Trustees had always done everything for the benefit of their patients. . The Chairman sajd that it was a pity that the clause had ever been inserted. It was a reflection upon the Trustees. ' Professor Sale said that it was never,so intended. The Chairman.of the Hospital Trust (Mr Millar) said that before any of the recommendations could be entertained • the Trustees must be satisfied that the present numbers, of beds in the hospital was not sufficient for > the needs of the sick poor" of Dunedin. Tb'relas the rules would mean bringing into the hospital people who did not belong to the Dunedin Hospital district. To increase the beds by twenty-five meant the erection of additional buildings. If the. outdoor work were handed over to the two gentlemen suggested,, what would the house surgeons have to do? As .regards the ■ appointment of the staff, the-only control exercised by the Trustees lay in selecting the staff, and so long as the latter did their duty to the sick of the district there was no fear of the University lecturers not being appointed. Professor Sale remarked that if it were understood that it was part of the ordinary functions of the Trustees to look after, the Mtdical School the University Council would be satisfied. . ' The Chairman said that that point was covered by one of the by-laws, which made the maintenance of the Medical School one of the purposes of the Hospital Trust. Sir Wills pointed out that in the event of joint control of the medical staff, twelve members of the Council would control the nine Trustees. The offer of £SO per annum would cot attract medical men worth their salt. Mr Myers said that if it was necessary for all the beds to be under one roof, the University lecturer could take charge of some of the beds at the Maternity Home in connection with the Benevolent Institution, and thus make up the requisite number. - Mr Robin "said the New Zealand students weie in "every respect equal to those who went Home. Professor Shand said it was never intended that the Council should outvote the Trustees; that matter could easily be arranged. Dr Hocken said that »the house surgeon had no weight with the students. He was of opinion himself that it would be better for the Trustees to revert to the old. plan of having a competent house surgeon.