Page:Carnegie Flexner Report.djvu/39

Rh The attempt will be made in this chapter and the next to account for these discrepancies in so far as they are traceable to circumstances that antedate the formal beginning of medical education itself. The mastery of the resources of the profession in the modern sense is conditioned upon certain definite assumptions, touching the medical student's education and intelligence. Under the apprentice system, it was not necessary to establish any such general or uniform basis. The single student was in personal contact with his preceptor. If he were young or immature, the preceptor could wait upon his development, initiating him in simple matters as they arose, postponing more difficult ones to a more propitious season; meanwhile, there were always the horses to be curried and the saddle-bags to be replenished. In the end, if the boy proved incorrigibly dull, the perceptor might ignore him till a convenient excuse discontinued the relation. During the ascendancy of the didactic school, it was indeed essential to good results that lecturers and quizmasters should be able to gauge the general level of their huge classes; but this level might well be low, and in the common absence of conscientiousness usually fell far below the allowable minimum. In any event, the student's part was, parrot-like, to absorb. His medical education consisted largely in getting by heart a prearranged system of correspondences,—an array of symptoms so set off against a parallel array of doses that, if he noticed the one, he had only to write down the other: a coated tongue—a course of calomel; a shivery back—a round of quinine. What the student did not readily apprehend could be drilled into him — towards examination time — by those who had themselves recently passed through the ordeal which he was now approaching; and an efficient apparatus that spared his senses and his intellect as entirely as the drillmaster spared his industry was readily accessible at temptingly low prices in the shape of "essentials" and "quiz-compends." Thus he got, and in places still gets, his materia medica, anatomy, obstetrics, and surgery. The medical schools accepted the situation with so little reluctance that these compends were—and occasionally still are — written by the professors and sold on the