(&0lwmMv&<£olX£Qt in tfoe ®it« oi l£ew IgmU REPORT OF THE FACULTY OF THE COLLEGE OF PHYSICIANS AND SURGEONS ON A FOUR-YEARS COURSE IN MEDICINE PRESENTED AT THE MEETING OF THE TRUSTEES HELD FEBRUARY 5TH, 1894. in ifte ©its at How Uorfc President's Room, Feb. 5TH, 1894. To the Trustees: I have the pleasure to submit herewith the report of the Special Committee on the four-years' Medical curriculum, which report was submitted to, and adopted by, the Faculty of the College of Physicians and Surgeons at a special meeting held January 29th, 1894. This report embodies as concise a statement of the four-year course and its advan- tages as it is possible to make at the present time. The approval of the curriculum as outlined therein is respectfully asked for, in accordance with Chapter III., Section 2, of the Revised Statutes. As the Trustees are already committed to the policy of a four-years' curriculum in the Medical School, and inasmuch as changes, even of detail, in the curriculum as now submitted, can only be made with very great care, it will facilitate a prompt publication of the details of the four- year course, which are now being generally asked for, if the Trustees will at this meeting pass a resolution approving the course as now outlined. This being done, any modifications not affecting questions of policy will remain within the power of the Faculty, as heretofore. A resolution to this effect is appended. It gives me pleasure to say that the Medical Faculty, without difference of opinion, so far as I am aware, believe that the four-year course now presented is an improvement on the present curriculum likely to be worth all that it costs in its results upon the education given by the College of Physicians and' Surgeons. Respectfully, SETH LOW, President. Resolved, That the four-years' course in Medicine as adopted by the Faculty of the College of Physicians and Surgeons January 29th, 1894, be, and hereby is, approved, subject %r such modifications as the Faculty may hereafter make i- the exercise of their statutory powers. (Adopted.) Columbia College in the City of New York. College of Physicians and Surgeons, January 29, 1894. To the Faculty: Gentlemen : The committee on a four-years' course in medicine begs leave to report as follows : — It will be remembered that in October, 1891, at the first meeting of this Faculty after the merger with Columbia College, the President of the University stated that the Trustees would entertain a proposition to establish a required four-years' course in medicine; that, at the same meeting, this Faculty unanimously resolved that such a course was greatly needed, asked for its establishment, and appointed a committee to frame it; and that, on June 2, 1893, the President announced officially that the four-years' course had been established, and would begin with the session of 1894-95. Two professors have been added to the original committee, and the President also has become both a member and the chairman of the committee. The first report of this committee was made at the next meeting after its appointment. During the sessions of 1891- 92, 1892-93, and the present one, repeated reports have been made to the Faculty, and instructions received from it; the views of the several heads of departments as to details have been gathered; studies have been made through sub-com- mittees as to how far these views could be, and ought to be, carried out; and these studies have been submitted for criti- cism to the various officers concerned. The Statutes of Columbia College, by Section 1 of Chapter III., authorize the several Faculties (subject to the reserved power of control by the Trustees and the provisions of the statutes), "To fix the requirements of admission, the course of study, and the conditions of graduation." 5JC 8|f >|S *J€ *JC k ' To prepare and publish from time to time a statement of the course of study, specifying the studies to be pursued in each year, and in each of the departments of instruction." In Section 2 the same chapter of the Statutes declares that— " No exercise of the powers conferred on any of the Faculties, which involves a change in the educational policy of the College in respect to the requirements of admission, the course of study, or the conditions of graduation, shall take effect until the same have been submitted to the Trustees at one meeting, and another meeting shall have been held sub- sequent to that at which it was submitted." It is desirable that the details of the new curriculum should soon be published; and it is proper and necessary that first such a statement of it should be submitted to the Trustees as will comply with the requirements of Chapter III , Section 2, of the Statutes. In view of these facts your committee has prepared for adoption, if thought best, by the Faculty, such a statement of the intended curriculum, based on the orderly collection of working details at hand, as will, it is hoped, fully satisfy the statutory requirements, and form a basis for publication. At the same time we have judged it best, although the carefully gathered details above referred to are at hand, not to make the statement too minute, inasmuch as adjustments will certainly be called for as the successive parts of the scheme come into actual operation. Such adjustments are already within the discretion of the Faculty. For the same reasons, the publication of too minute details should, in our judgment, be avoided. We therefore respectfully recommend to the Faculty for adoption the following statement of the four-years' course in medicine, to be required of all who shall matriculate for the first time for the academic year 1894-95, and thereafter. The statement expresses the instruction offered to a single student. FIRST YEAR. PHYSICS AND CHEMISTRY, INCLUDING MEDICAL CHEMISTRY. Lectures, four a week. Conferences, two a week for one-half the year. Laboratory work in practical physics, two-hour exercise once a week, for one-half the year. Laboratory work in practical medical chemistry, two-hour exercises twice a week, for one-half the year. ANATOMY, begun. Demonstrations to sections, four a week to each student. Laboratory work in dissection, eighteen to twenty hours a week for from three to five periods of four weeks each. NORMAL HISTOLOGY, begun. Laboratory work, two-hour exercises three times a week, for one-half the year. PHYSIOLOGY, begun. Lectures combined with demonstrations, three a week. Demonstrations to sections, from one to three a week for each student. SECOND YEAR. ANATOMY, finished. Lectures combined with demonstrations, three a week. Demonstrations to sections, four a week for each student for one-half the year; five a week for each student for one-half the year. Laboratory work in dissection, ten to twelve hours a week for from one to three periods' of four weeks each. NORMAL HISTOLOGY, finished. Laboratory work, two-hDur exercises twice a week, for one-half the year. PHYSIOLOGY, finished. Lectures combined with demonstrations, three a week. Demonstrations to sections, from one to three a week for each student. PATHOLOGICAL ANATOMY, begun. Attendance at autopsies, with practical instruction, twice a week for four weeks. BACTERIOLOGY. Laboratory work, two-hour exercises three times a week, for one-fourth of the year. MATERIA MEDICA AND THERAPEUTICS, begun. Lectures, three a week. TOXICOLOGY. Laboratory work, two-hour exercises twice a week, for one-fourth of the year. OBSTETRICS AND GYNECOLOGY, begun. Recitations combined with demonstrations for sections, one a week for each student. THIRD YEAR. MATERIA MEDICA AND THERAPEUTICS, finished. Lectures, three a week. PATHOLOGICAL ANATOMY, finished. Demonstrations to sections, two a week for each student. PATHOLOGICAL HISTOLOGY. Laboratory work, two-hour exercises three times a week, for one-half the year. THE PRACTICE OF MEDICINE, INCLUDING THE DISEASES OF THE MIND AND NERVOUS SYSTEM, begun. Lectures, three a week. Clinical lectures at the Vanderbilt Clinic, once a week. Clinical lectures or instruction in the wards at the Roosevelt Hospital, once a week ; at the New York Hospital once a week for one-half the year; twice a week for one-half the year. Practical clinical instruction to sections in physical diagnosis, for each student twice a week for sixteen weeks. Practical clinical instruction to sections in general diagnosis, for each student twice a week for eight weeks. THE PRINCIPLES AND PRACTICE OF SURGERY, BEGUN. Lectures, three a week. Clinical lectures at the Vanderbilt Clinic, once a week. Clinical lectures and the witnessing of operations at the New York or Roosevelt Hospital, once a week ; at the New York Hospital (in addition to the above), once a week for one-half the year ; at the Presbyterian Hos- pital, once a week for one-half the year. Practical clinical instruction to sections, for each student twice a week for sixteen weeks. Optional: Clinical lectures and the witnessing of opera- tions at St. Luke's Hospital. OBSTETRICS AND GYNECOLOGY, continued. Lectures, three a week. Clinical lectures in Gynecology at the Vanderbilt Clinic, one a week. Clinical lectures and the witnessing of operations in Gynecology at the Roosevelt Hospital, by sections, six exercises for each student. Practical clinical instruction to sections in Gynecology, six exercises for each student. VENEREAL DISEASES. Clinical lectures at the Vanderbilt Clinic, one a week. Clinical lectures at Bellevue Hospital, one a week for one-half the year. Practical clinical instruction to sections, twelve exercises for each student. Optional : Clinics at the City Hospital, Blackwell's Island, one a week for three months. DISEASES OF THE EYE. Clinical lectures at the Vanderbilt Clinic, one a week. Practical clinical instruction to sections, twelve exercises for each student. DISEASES OF THE EAR. Practical clinical instruction to sections, six exercises for each student. io FOURTH YEAR. THE PRACTICE OF MEDICINE, INCLUDING THE DISEASES OF THE MIND AND NERVOUS SYSTEM, FINISHED. Lectures, three a week. Clinical lectures at the Vanderbilt Clinic, two a week. Clinical lectures or instruction in the wards, at the Roose- velt Hospital once a week ; at the New York Hospital once a week for four months. Practical clinical instruction to sections in the wards of the Roosevelt or Bellevue Hospital, for each student two-hour exercises, three times a week for eight weeks. Practical clinical instruction to sections in the diagnosis of diseases of the nervous system, six exercises for each student. Optional : Clinical instruction in Bellevue and Presbyterian Hospitals, once a week. CLINICAL MICROSCOPY. Laboratory work, two-hour exercises twice a week for eight weeks. THE PRINCIPLES AND PRACTICE OF SURGERY, FINISHED. Lectures, three a week. Clinical lecture at the Vanderbilt Clinic, one a week. Clinical lectures and the witnessing of operations at the New York or Roosevelt Hospital, once a week for one- half the year; at Bellevue Hospital, once a week for one-half the year ; at the Presbyterian Hospital, once a week for one-half the year. Surgical demonstrations at the Roosevelt Hospital, once a week for one-half the year. Practical clinical instruction to sections in the wards of Bellevue Hospital, for each student two-hour exercises twice a week for eight weeks. Operative surgery on the Cadaver in sections, twelve lessons ; required or elective as may hereafter be determined. Optional : Clinical lectures and the witnessing of operations at the New York Hospital (additional to the above) at St. Luke's Hospital; at the Cancer Hospital. ORTHOPEDIC SURGERY: Clinical lectures at the Vanderbilt Clinic, one a week. Practical clinical instruction to sections, twelve exercises for each student. OBSTETRICS AND GYNECOLOGY, finished. Attendance upon confinements at the Sloane Maternity Hospital. Practical clinical instruction in Obstetrics to sections, at the Sloane Maternity Hospital, for each student, daily for one week. Clinical lectures in Gynecology at the Vanderbilt Clinic, one a week. DISEASES OF CHILDREN. Clinical lectures at the Vanderbilt Clinic, one a week. Practical clinical instruction to sections, twelve lessons for each student. DISEASES OF THE SKIN. Clinical lectures at the Vanderbilt Clinic, one a week. Practical clinical instruction to sections, twelve lessons for each student. 12 DISEASES OF THE THROAT AND NOSE. Clinical lectures at the Vanderbilt Clinic, one a week. Practical clinical instruction to sections, twelve lessons for each student. ELECTIVE COURSES. It is recommended that each student of the fourth year be required, within such time as shall be prescribed after the beginning of the academic year, to elect from a list of elective courses either one course or more, as shall be determined hereafter; such election to be final. The course or courses thus elected, the student shall be required to attend, and he shall be required also to be exam- ined thereon at the end of the fourth year, as a prerequisite for the degree of M. D. It is recommended that the elective courses be numerous, and in various departments, both clinical and otherwise; and that the choice be not confined to departments represented in the Faculty of Medicine, but be extended to allied sub- jects. In view of the wide range of choice thus to be provided for, it is recommended that no student be admitted to any elective course unless his attainments shall be adjudged adequate by the head of the department by which the course is offered. It is recommended that elective courses be organized, if possible, in the following themes or their subdivisions, and in such others as may be approved hereafter: Surgical Diagnosis; Obstetrics; Diagnosis of Nervous Diseases; Localization of Nervous Diseases ; Insanity (clinical course) ; Ophthalmology (including operations at the Ophthalmic and Aural Institute in Twelfth Street); *3 Venereal Diseases; Therapeutics of Diseases of the Skin; Contagious Diseases ; Microscopic Technology; Pathologic Anatomy and Histology of the Organs of Generation ; Pathologic Anatomy and Histology of the Nervous System ; Human and Comparative Morphology ; Neuro-muscular Physiology; Physiological Technique; Comparative Neurology; Comparative Embryology; Cellular Biology; Morphology of the Mammalia; Botany ; Philosophy ; Physiological Psychology; Experimental Psychology ; Chemistry ; Physics. It is recommended that, at the end of every year, each student be examined in the work of that year, including, at the end of the fourth year, his elective course or courses; that the system of examination in each department be sub- ject, until otherwise ordered, to the rules at present in force; and that the result in each department, for a given student, if successful, be accounted final for the work represented by the said result. It is recommended that for each student there be possible either of three results of the examinations of each year, taken collectively: first, that he proceed with his class; second, that he proceed conditionally; third, that he do not proceed with his class. It is recommended that candidates be admitted to ad- vanced standing at the beginning of the second or third years, but not of the fourth year, without the special consent 3 0112 105619743 T4 of the Faculty, upon satisfactory evidence, either by certifi- cate or examination. It is recommended that no one be admitted to advanced standing in the new curriculum at the beginning of the second year, before October, 1895; of the third year, before October, 1896; or of the fourth year, before October, 1897. It is recommended that your Committee be continued, and that it be its duty immediately to report to the Faculty for adoption a detailed working scheme for the first year of the new curriculum, including the examinations at the end thereof, to carry into effect the recommendations of the pres- ent report, provided the said report be approved by the Trustees. It is further recommended that it be the duty of the Com- mittee to present in the same manner a working scheme for the second year, early in the academic year 1894-95; of the third year early in 1895-96; and of the fourth year early in 1896-97. We have reserved for the close of this report a brief state- ment of the advantages of the four years' course hereby recommended, and which, as stated earlier in this report, is based upon detailed studies. The purpose of the new curriculum is to enlarge the oppor- tunities for instruction in medicine, and especially to strengthen object teaching in medicine regarded as essentially a department of physical science, theoretical and applied. In departments which teach largely or wholly by demon- strations, by laboratory exercises, or by both, a greater range and thoroughness are secured for the themes now taught, and time is found for courses practically or absolutely new, such as practical physics, practical toxicology, practical bacteri- ology and clinical microscopy. In advanced themes where demonstration and practical work take the form of clinical exercises for larger or smaller divisions of the classes, the same holds good ; various new courses at hospitals or at the Vanderbilt Clinic being created ; existing courses being much strengthened, or lifted from their present plane as purely optional courses to be part of the