Report of the Parliamentary Committee of the Loyal National Repeal Association on the Bill for regulating the profession of physic & surgery [proposed by Sir James Graham], with observations on medical education / [Sir John Gray].

  • Gray, John, Sir, 1816-1875
Date:
1845
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Licence: Public Domain Mark

Credit: Report of the Parliamentary Committee of the Loyal National Repeal Association on the Bill for regulating the profession of physic & surgery [proposed by Sir James Graham], with observations on medical education / [Sir John Gray]. Source: Wellcome Collection.

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    sident pupils.”* Mr. Cusack, who is reputedly one of the most safe operators in Dublin, while he is at the same time the most dauntless, was a resident pupil. But it is unneces¬ sary to multiply instances—the fact of the superiority of the class is notorious. A careful consideration of this bill has convinced me that the scheme on which its provisions are based is sound in principle. The details, however, present us with but the imperfect rudiments of the reform which is required. The framers of the bill pay too much regard to corporate inter¬ ests—too little to public interests. I feel confident, too, * To a paper which I some years since printed in the Dublin Monthly Magazine on the subject of medical education, I appended a note descrip¬ tive of the manner in which the resident pupil is elected in the Meath Hos¬ pital—it may not be out of place to copy it here. “ The annual election of the clinical clerk, at the Meath hospital, affords a good illustration of what is meant by a practical examination. The du¬ ties of the clerk are in all respects similar to those of a resident physician. He is chosen from among the members of the senior practising class; and, to be admissible as a candidate, he must have devoted a considerable period to the actual study of disease. No person is allowed to become a candidate, who has not had a certain amount of experience, in the practical details of the duties he would be called upon to perform, if elected. He must have had the charge of a certain number of patients, and show, by his case-book, that he possesses a competent knowledge of the method of diagnosing dis¬ ease, and is capable of prescribing for its relief. The candidates are usu¬ ally men who have, during twelve months at least, devoted from four to six hours per day to the investigation of disease at the bedside ; and having sa¬ tisfied the physicians that they are eligible, they are permitted to compete for the office. The examination is thus conducted. Instead of retiring to the hospital lecture room, and there testing the amount of book-knowledge possessed by each aspirant, the physicians (Drs. Graves and Stokes) carefully examine some half-dozen or more patients, upon whose cases no diagnosis had been previously pronounced, and having, by repeated investi¬ gation, satisfied themselves of the nature of the affections nnder which each labours, and of the treatment indicated, they call on each candidate to ex¬ amine, diagnose and prescribe for the disease of each of the selected patients. Each candidate is taken separately through the wards, and, having given in his report and the treatment he would recommend, he is minutely ques¬ tioned as to the grounds on which he formed his opinions, and the result he expected from the remedies prescribed. In this way his book-knowledge is tested by its practical application, while his acquaintance with disease is proved by actual demonstration. Each candidate having been thus singly examined, a correct estimate as to their respective qualifications is neces¬ sarily arrived at by the examiners. The precedent has been long set by the eminent physicians above named. In many other hospitals a more or less perfect practical examination, is instituted for the election to similar offices ; but, by none of the colleges or licensing bodies, has it been acted on, though many of the members of the several courts of examiners are in the yearly habit of acting on it in the hospitals over which they preside.