Not only must the physician be practically fit, he must have a natural aptitude and love for his profession. He should care more for medicine than for any other calling in life. By natural aptitude for medicine is meant certain foundation qualities which are essential.
It goes without saying that the physician, because of his close relationship with his patients, must be of the highest moral character in order to gain and retain the confidence of his patients. A kindly and tactful manner are essential also in gaining this confidence. One must be alert, too, particularly at the present time when rapid advances are being made in medicine—more rapid than in many other professions. Self-reliance is essential in medicine because unexpected situations are constantly arising, and emergencies, too, in which the help of other physicians can not readily be gained. To practice medicine successfully one must be constantly learning. Because of the rapid changes in medical science one’s apprenticeship is never completed. Each day some new method or means of treatment must be mastered. Moreover, one’s work is never ended. One great element of success is faithfulness to the patients one already has. This means love for the work and enthusiasm over the idea of service to mankind.
Among the characteristics that lead to failure in the practice of medicine are dislike of the work, inability to decide quickly and definitely, and lack of ability to get along well with other practitioners and with patients.
General Education Necessary as a Basis for a Course in Medicine
As a basis for a course in medicine one must have completed not only the eight grades of common-school work, but the four years of high school. Twenty-eight medical schools require two years of college work for entrance, and there is some tendency to require even four years of college work. This tendency, however, will probably not grow very fast. Certainly if the requirement is made it can not be a hard and fast rule, for the simple reason that it would raise the age of graduation from the medical school to a point higher than the age at which it is wise for one to begin practice.
The question of what subjects should be taken in premedical work is very important also. Not long ago some 300 graduates of the Harvard Medical School were asked to fill out answers to questions, giving their opinions in regard to the value of their premedical education. They were asked to state whether they thought it best in this premedical work to have a large amount of general culture—such as history, philosophy, economics, literature, and art—or a large amount of natural science—such as physics, chemistry and biology. Of the 300 reporting, 120 favored a large amount of science, while 110 favored a large amount of general culture. Seventy favored an equal amount of general science and culture. It would seem, therefore, that according to the present opinion there should be an equal amount of general culture and science in one’s college education previous to taking up the special training in medicine.
Available records show that in 1904 there were only 20 States that had made any legal provision for preliminary education to go before the definite education in medicine. Now 26 States have such a provision. At that time only 10 States required four years of high school as a minimum amount of preliminary premedical education and none required college work. Now 30 States require the four years, or an equivalent, and 8 of these 30 require either one or two years of college work in addition. At that time 36 States required that all candidates for license be graduates of legally chartered medical schools. Now 44 States make this requirement by law. At the present time 48 States require an examination to be taken by all those who are seeking license to practice medicine, unless they hold a license granted by some other State.
It is necessary, therefore, that the course of instruction taken in medicine shall include courses that will qualify the graduate to meet the requirements of the examination for license to practice in the State in which he wishes to locate. There is a tendency at present for the examination to consist not only of questions and answers, but of some practical test of one’s ability to practice medicine successfully.
The Length of the Medical Course Itself
At the present time one can not hope to get a satisfactory medical education without taking a full four-year course in the medical school. The course of study in American schools of medicine at present is definitely laid out, and one can know beforehand just what subjects will have to be taken. Even at the end of the four-year course in medicine it is not advisable to begin the practice of medicine immediately. Those who are looking for good positions in the profession should add to the theory gained in college some actual practice. The best way to get this practical work is to serve as an interne in a hospital. Appointments to such positions are often made on the basis of an examination. Such positions last sometimes for one year and sometimes for two years. During the first period of his work in the hospital an interne is directed to some extent by other physicians, but largely by his senior internes. During the last six months of his experience as an interne, however, when he is usually acting as the house doctor or surgeon, he is shown especial attention by physicians and surgeons who have patients in the hospital. There is generally no pay given the interne aside from board and lodging. The period in which one acts as an interne is considered as a further educational period. It has been said that the experience gained during the two years’ interneship in New York City’s largest hospital is considered equal to that acquired in 10 years of ordinary undirected practice.