Introductory Address DELIVERED AT ST. THOMAS'S HOSPITAL, On the Opening of the Winter Session, October 2nd, 1882

SeymourJ. Sharkey
1882 The Lancet  
561 most grievous error to exclude it from the subjects required for the higher qualifications. A student who has been thus prepared by a short preliminary course of science, commences the study of the more special subjects of the medical curriculum with a mind trained to a proper habit of thought, and prepared to follow the inductive reasoning upon which medicine is founded. He is sufficiently trained in habits of observation to commence without difficulty the study of anatomy and histology,
more » ... d his knowledge of chemistry and physics is sufficient to enable him to understand those parts of physiology to which these sciences are essential. I need not follow further in detail the course of education according to this plan ; the same system is followed to the end. The student does not commence to study the diseases of the body till he is familiar with its structure and functions in a state of health; and in studying disease he is encouraged to apply himself to medicine and surgery simultaneously, in order that he may learn that the same general principles apply to both, and that they are in fact merely branches of the same science. The fault of this system of education a few years ago was that it was too theoretical, and contained nothing in it to take the place of the practical instruction given so abundantly in the old system of apprenticeship. This has, however, of late years been corrected by the insti. tution of practical classes and compulsory hospital appointments, and by teaching in the out-patients' room, until, at the present time, I am inclined to believe that the student gets quite as much practical instruction in every branch of his profession, except pharmacy, as he did under the old system. Although the University of London, being unfettered by any previous system of education, was able thus to establish a scientific course of training according to the best theoretical principles, it has been otherwise with the corporations, and the consequence is that the education of the student whose object it is merely to obtain a licence is now conducted on principles which do not agree accurately either with the old empirical or the new scientific system, and consequently, he does not get the full advantage of either. The great majority of students in the present day begin medical study immediately after they leave school, having first passed one of the preliminary examinations conducted by one of the corporations or the College of Preceptors. This examination includes no science as a compulsory subject, except the rudiments of mathematics, which, although of course a useful training in methodical thought, is, as a purely deductive science, of comparatively little value as a preliminary training for medical study. A student, therefore, who has passed only the compulsory subjects, arrives at his medical school without any preliminary training in natural science. He finds then that he is expected to attend three classes during his first winter session-anatomy, physiology, and chemistry. One of the first things he will learn also is that, if he follows the course perhaps most commonly adopted, the first examination for which he will have to present himself is the primary at the College of Surgeons, and that this includes two subjects only-anatomy and physiology--and will not take place for two years. Upon these two subjects, therefore, he concentrates his attention, in but too many cases neglecting chemistry more or less completely; for I fear it maybe said of but too manythat the fear of examinations is the beginning of wisdom. In anatomy, with a mind totally untrained in accurate and minute observation, he begins by trying to learn the infinitude of details concerning the bones; and it is not to be wondered at if he finds it not only a difficult but a distasteful task. The study of descriptive anatomy, however, makes no demand upon any of the higher faculties of the mind, and, consequently, preliminary mental training is, as far as it is concerned, of comparatively little importance ; and if the student will only give time and attention to it, he will almost certainly succeed in reaching the required standard of knowledge ; although, perhaps, he will not master the subject as quickly and easily as if he had had some preliminary training in biological science. Physiology being a subject full of fascination and interest, should naturally be very attractive to any student who takes real pleasure in his work; but, unfortunately, it consists in great part of the application of chemistry and physics to the study of life, and the ordinary student is at first ignorant of both these subjects; it is therefore impossible that he should gain more than a confused notion of what he tries to learn. I From this point of view of mental training physiology, I valuable as it is in its proper place, is perhaps the very worst of all subjects with which to commence a scientific education. It is not an independent and self-contained subject, nor has it as yet acquired, or is ever likely to acquire, a place amongst the exact sciences; and it is a rule of scientific education that some training in the exact sciences should precede the study of the inexact.
doi:10.1016/s0140-6736(02)12414-7 fatcat:7qe3jcbp6jc4xe6wc2bnihzrba