THE WAR AND MEDICINE

Otago Daily Times, Issue 16709, 1 June 1916, Page 2

THE WAR AND MEDICINE

PRESENT TENDENCIES OE MEDICAL. EDUCATION. VIEWS OF PROFESSOR BERRY. A distinguished member of the medical profession who has been visiting Dunedin is Dr R. J, A. Jiorry, Professor of Anatomy in tho University ol Melbourne. Dr Berry has recently l>oe,u examining students of tile Ol.ago (School of Medicine, ami special significance attaches to his visit from tho fact that this i.; the first occasion on which the modioal students liavo boeu judged by an examiner from outsido Now Zealiuid. Dr Berry told a reporter yesterday that ho was much struck with tfie system of bringing in an outside examiner. Tho visit iwxi been very beneficial to liim, personally, and had given him an opportunity to loarn much. The association with loading members of hia profession had proved a groat stimulus to him, and ho trusted that they also had received some stimulus from his visit. Dr Berry had much that was valuable to say on the subject of the trend of modern medical education, and on the bearing of these tendencies on the future development of tho Otago Medical School. "This war," he said, "is going to change our whole outlook on many matters. A very large number of returned soldiers are suffering from extraordinary injuries—gunshot wounds, affecting bone, nerve, and brain. These injuries are causing the medical profession a great deal of anxiety as to the best method of treatment It follows from this that tho old-fashioned idea that ono man could cover tho whole range of a doctor's work alone is no longer tenable; in other words, tho profession must unite for the treatment of disease. Apart from that, 1 want to show whero tile general public ! comes in. These war conditions are causing ■ the spread of other diseases, such as meningitis— a very dangerous disease, about which not very much is yet known. Its prevalence in Melbourne at tho present time is primarily duo to the large number of soldiers living together in camps. " We must concentrate all our efforts of the medical profession on the treatment of disease," continued Dr Berry. "What we want to see is that, in centres like Dunedin or Melbourne, where there is a medical school, the whole of the school shall be absolutely alongside the hospital. The principle is that, in the treatment of disease, the physician or tho surgeon must have every assistance that he can get from the anatomist, the physiologist, the pathologist, and the bacteriologist. That means having the whole of tho medical school right alongside tho hospital. The closer you can get them the better. If that is done, then the hospital and medical school combined form the home of the medical profession in the province. Ii) thoso two buildings aro concentrated tho medical libraries and medical appliances of your scientific teachers, of your practising physicians and surgeons. Take a case in point. Suppose a soldier comes in suffering from some obscure nerve condition, tho result of a gunshot injury. If everything is. on the spot, the surgeon can say to the anatomist, 'Let me see the section of the body illustrating theso particular regions.' He can go to tho neurologist, and he can consult all the latest periodicals and books. He can thus concentrate the whole of the varied medical knowledge in Otago on the treatment of that one case. Under any other system that is impossibla " What I am advocating has been very strongly advocated by Dr Flexner, who was authorised by the Carnegie Foundation for the Advancement of Medical Teaching in America to make a special investigation of the medical schools in America, Canada, Great Britain, France, and Germany. As a result of his investigations he divided medical schools into three groups. In tho first class he placed the schools where the conditions I have described operated. These were chiefly found, I am sorry to say, in Gormany. The second grade included schools such as you have here, where the Medical School is partly dissociated from the Hospital. In the third grade were the very bad proprietary medical schools, as they are called in America."

Dr Borry proceeded to discuss tho facilities that ought to be afforded the teachers of medical science. "You put into your medical schools," he said, " certain professors and lecturers, and you say that they are to teach and, investigate such subjects as anatomy, physiology, bacteriology, and pathology. Thoso are the subjects on which the scientific treatment of disease primarily rests. It is, therefore,. most important that tho people you put in these positions should have every facility for tho prosecution of those sciences. These sciences are making great progress in all parts of the world. It follows, therefore, logically that tho men occupying teaching positions in any centre of medical education remote from Europe and America, as we are in Australia and New Zealand, must bo given frequent opportunity for travel and study abroad. They must be able to see for themselves what is being done elsewhere. . To carry that out tho professors of theso subjects

should bo made to travel in the interests of the people of this province at sot periods which may be determined. As the salaries paid to these men are not as big as they could make in general or consulting practice, it follows that the university ought to assist them by paying a full salary and giving them travelling allowances. It also follows that in every department where there is a full-time professor there ought to bo an linder-study who must be trained in duo course to become a professor himself. Ho would take the place of the professor in times of illness, or when he was away travelling, and share the teaching work so as to set the professor freer for the prosecution of research and study and any work which will advance the scientific study of medicine generally. Besides that, a skilled mechanic is required in every department— a laboratory assistant, a man who does photographic and museum preparation work, the mounting of specimens, and all that sort of thing. To get the best results from university teachers of clinical subjects like medicine and surgery they must be at least half-time university professors. They should, therefore, be paid a good salary to make them independent of their profession, and be given the right to consulting practice, the principle being that you want that particular man to be head of the profession in the particular provinco in which ho is situated. By devoting half time to the university he can do his teaching and still prosecute his research, and so advance and ennoble the whole of the profession. This would give a direct incentive to every one of the younger men who may be practising medicinc or surgery to prosecute research work and qualify themselves for these positions as soon as they become vacant. "In conclusion," said Dr Berry, "it means that all those things that I have stated are merely an adaptation of modern thought to the now requirements that are going to be forced on us by this war. The country that does not adopt these ideas is going to be sadly _ left behind. You make your mcdical university the training ground for the medical profession and the centre round which the whole of your medical education gathers, and so you benefit not only the profession by mating them better medical men, but you benefit the whole population by enabling the medical men to treat disease more adequately. Naturally, to carry out these ideas means a certain amount of financial ex-pend-'ture; but if any community can spend money on picture palaces and drink and

gambling they can well afford an insigni ficent part of the sum they so spend for these ideas wliich I maintain are going to make the whole nation a better nation, and benefit every man, woman, and child in the State. That cannot be sa : d of gambling, picture palaces, and so forth." The carrying into effect of the principles advocated by Dr Berry would involva the transfer of the whole of the medical equipment at the University to the immediate vicinity of the Hospital. The laying of the foundation stone of the large new medical block in King street this afternoon may be regarded as an important stop in this direction. It is pointed out that the centralisation of all departments of theMedical Sehool round the Hospital would free valuable buildings at the University in which to provide for the further expansion of the work of other faculties.