MEDICINE IN AMERICA

Otago Daily Times, Issue 23930, 4 October 1939, Page 5

MEDICINE IN AMERICA

TRAINING STUDENT AND GRADUATE CONTRASTS WITH NEW ZEALAND IMPRESSIONS OF DR HERCUS Returning from a few months spent with the leading medical men in various parts of the United States of America and Great Birtain, Dr C E. Hercus,'dean of the Otago Medical Faculty, has brought back with him many deep impressions of a tour which he described to a Daily Times reporter yesterday as most stimulating, refreshing and valuable. Chief among these impressions stand the great value of the work of the Carnegie Foundation, the remarkable hospitality of the American, the intensive research that is being carried out, interesting-con-trasts of American university and postgraduate work, and the important conclusion that the standard of medical work by student and doctor in New Zealand compares very favourably with that prevailing in the United States. A United Purpose 4*l spent two months in America as the guest of the Carnegie Foundation." Dr Hercus said, " and I was profoundly

impressed with the hospitality accorded me. When I arrived in New York I was met by an official of the Foundation and was taken to my hotel where everything possible for the comfort of my wife and myself had been done. The day after my arrival I was the guest at a luncheon which was attended by the beads of. all the: important medical institutions and I was told the various medical schools to visit to study matters of New Zealand interest. ■ ■ " The Carnegie Foundation is doing a great work in bringing together men and women from all parts of the- world to study in the big creative things of life—science, medicine, art—which tend to units nations and not destroy civilisation. The foundation is doing a good piece of work for the creation of better international relationships.'" Active research was being carried on at the various institutions in America, Dr Hercus continued, and progress was particularly marked in the study of the various virus, including that which caused infantile paralysis. An interesting, piece of research was that being conducted at the United States Public Health Research Laboratory at Washington;' wlnere a study of rheumatism wfas being made. It was thought that this complaint was also due,to a virus, and' progress had been made along these lines. The general:stimulation to the mind given by visits to these institutions - was most beneficial. Dr Hercus added.

American Medical Students

>"One of the things that impressed rile most of all about the study of medicine was the great numbers who applied 'every year to enter s medical schools" he continued. "Every year there are 31,000 applicants for medical schools, and a most rigid selection has to be made to choose the students tij> fill the 6500 places available. This selection is one of the contrasts'to be noticed with the system ruling in New Zealand, - where there is no annual selection. This great surplus, of applicants may be attributable to the immensely increased demand for education in the United States. An instance of this is given in these statistics:—From 1890 to 1930 the population of the United States practically doubled, but in this period the number of pupils in secondary schools increased from 357,000 to 4,799,867—an increase of 150 per cent., I believe." The desire to enter medical schools was so great, Dr Hercus added, that the authorities were increasing the scope of pre-medical school education. All medical schools were insisting on two years' study in a university .college, • most schools demanded three years, and some required as miich as four years. At the present*-time ■SO per cent, of the medical students, had had four years' study in a university college, and a further 27 per cent had. had three years. Even these requirements did not eliminate' 'sufficient students. One school, for example, received 1200 applications for 120 places, and all the applicants had done three or four years' work in a university college. The school received reports on the. applicants from graduates in various districts and also carried out aptitude -''tests. ; The number was reduced to 150 and these applicants were interviewed separately by a committee before the required 120.. were selected. The final selection was made on character and personality as well as intellectual, qualifications. "The pre-medical course has much to commend it," Dr Hercus continued. "In the two, three, or fout years, the prospective doctors are given a wide ■cultural education embracing such subjects as history, English, and philosophy. In fact, an endeavour is made to make them thoroughly, educated men. This is certainly desirable, and is a most arresting fact in these medical schools. The medical course itself is four years. The first-year study of scientific subjects done by New Zealand students is covered in

the pre-medical study. At the completion of the four years, the graduate spends a year's internship, which is similar to the sixth year work in New Zealand. Thus it takes the average American 10 years from the time he leaves secondary school to when he is a c.iualifled doctor. This brings his age to 27 years, and that is one criticism I make of the American system. The graduate is too old and the course is a little too long. Moreover, if is extremely expensive to become a doctor in America." , '....''.'■'

A Comforting Thought

Asked whether Neu Zealand lagged much behind -the United .States.., in medical matters, Dr Hercus" stated that one' of the most comforting things about his tour was to realise.that medicine in the Dominion could hold its own. There were, of course, .many 'that could be learned from America, but on the whole he was very pleasfd with rthe showing New Zealand made. New Zealand graduates, he said, compared Very favourably with .the, American graduates, even with'.those I 'from Harvard, which had the best medical .school in the .United States.. '. •■' ' .-'■••. •■• ~.'• -,v -■■*

" One . thing tha-t struck me," Dr Hercus stated,'''is the endeavour .thai is being made'to. break, down the artificial barriers that, exisl between the various branches medicine The profession is being -treated as a whole, which is all. to the good. Great emphasis is being giv,en. to self-education and to the giving of greater responsibility to the student. "Post-graduate work in the United States' also impressed me deeply" he continued. " Each , year there are about 3500 doctors, taking post-gradu-ate courses Then there are itinerant medical teachers who go round the men in .practice and give lectures to district branches-of .the Medical Association. Besides, 'there is a well ganised library service at each school which provides doctors with the latest medical books and magazines Doctors generally are far more closely linked with the medical schools than are in New Zealand. And in the States greater emphasis is laid on the practical side rather than the examination side when it comes to higher degrees'