University of Virginia Library

FOURTH YEAR.

Theory and Practice of Medicine.—The same plan is followed in the
clinical work as that already described for the third year, each of the two
sections of the class devoting itself for half the year to the medical service
in the wards of the hospital. Full histories are taken of every case, thorough
examinations made, and management indicated by the students of
each division. These records are considered in the final grading of the
student.

The subjects treated with the approximate division of time between
them are as follows:

Nervous Diseases and Insanity.—Three lectures and recitations weekly,
supplemented by clinical work during the first term. In this course is given
also instruction in electro-therapeutics. Dr. Davis.

Pediatrics.—Three lectures and recitations weekly, supplemented by clinical
work during the second term. This course of lectures is intended to point
out in a brief way how disease is modified by childhood and to indicate how
the difficulties of diagnosis and treatment due to early age may best be
encountered. The principles of infant feeding are emphasized and the
student is taught how to prepare the food. Dr. Davis and Dr. Rea.

Dermatology.—A brief course of lectures is given on this subject, embodying
a consideration of the commoner diseases met with in medical practice.

Case Teaching, Medical Ethics and Economics, and Insurance Exam-
inations.—Two hours weekly during the third term. Dr. Davis.

Therapeutics.—The treatment of internal diseases is discussed in a systematic
course of lectures and practically demonstrated in the wards of the
hospital. Especial attention is given to the bedside teaching of this subject,
the student being required to follow closely and make a record of the
results of the therapeutic agents employed in cases assigned to him. Dr.
Flippin.

Surgery and Gynecology.—Two hours weekly of surgical clinic throughout
the session; three hours weekly of ward classes, supplemented by clinical
work in the wards and operating room for one-half the session with each of the
two sections of the class.

Instruction in surgery is carried on by clinics and bedside demonstrations
in the hospital. In the wards the students are assigned cases, whose
histories they must take. They must also make complete physical and
clinical examinations, urine analyses, blood examinations, etc. In the ward
rounds the diagnosis, operative and other treatment, post-operative care of
the cases, complications, prognosis, etc., are discussed in detail. A large
variety of cases is available, and the close contact of the students with their
cases and with the routine of hospital management offer many of the opportunities
that an internship affords.

In the operating rooms the students, in small groups, take part in the
operations, thus acquiring familiarity with technique, anesthetization, etc.
Those of the class who are not assisting witness the operations, whose
important features are demonstrated to them.

In gynecology the students have the same general work as in surgery,
consisting of the examination and the recording of the cases in the public
wards, attendance on ward rounds, at which the cases are discussed, and observation
and assistance in the operating rooms. Dr. Watts, Dr. Goodwin, Dr.
Neff, Dr. Woodberry and Dr. Wright.

In addition to the above course, required of all students, the following
elective course is offered in the Department of Surgery.

Surgical Pathology.—An optional course. Two hours weekly during one-half
of the session.

This course is intended to supplement the general courses in Pathology

and Surgery and consists of lectures upon the pathology of surgical lesions,
demonstrations of fresh tissues obtained from the operating rooms, and
examination of microscopic sections.

The student reviews pathological technique and frozen section work
is emphasized. Dr. Goodwin.

Clinical Pathological Conferences.—One hour weekly is assigned for
the study of pathologic material in connection with the clinical aspects of
cases coming to autopsy. A history of the case is presented by the student
in charge, the autopsy is reviewed, the tissue and microscopic sections are
examined, and all the information thus derived is collated and contrasted.
Dr. Marshall.

Obstetrics.—The student attends, under the guidance of an instructor,
the labor cases in the hospital, is required to prepare the history of patients,
and to follow up the cases through the puerperium. Instruction is also
given in the care of the new-born. In addition the student has the opportunity
of attending patients in the out-patient department and each student
is expected to attend at least six cases of labor. Dr. Macon.

Forensic Medicine.—One lecture weekly during one term of the fourth
year. Dr. Waddell.

Diseases of the Eye, Ear, Nose and Throat.—Two lectures weekly from
the beginning of the session to the first of March, supplemented by regular
clinics twice weekly throughout the session and clinical lectures to sections of the
class as suitable cases occur.

The class is divided into small sections and each student is taught the
methods of examination and the use of the opthalmoscope, head-mirror,
and of the laryngeal and post-nasal mirrors. In the clinics each patient is
assigned to a student, who must take the history and keep the record of
that patient; the case is then demonstrated by the professor in charge, and,
if possible, each student makes his own examination under the personal
supervision of the attending physician. Clinical cases are abundant, and
during the year the student sees and handles practically all the common
diseases of the eye, ear and upper respiratory tract. Dr. Hedges and Dr.
Compton.

Hygiene.—Three hours weekly throughout the session.

The course begins with a historical sketch of the developments of preventive
medicine, including short biographical sketches of the pioneers of
hygiene. With this introduction the story of the natural history of contagious
and infectious diseases, modes of propagation and methods of prevention
engage the attention of the student. With this preparation, the
chemical and bacteriological contamination of food, water, air and soil is
made an important study. Instruction is also begun in the proper location
and construction of habitations, hospitals, schoolhouses, etc., with special
reference to the modern methods of heating, ventilating and draining.
Notice is taken of the special relations involved in military and naval
hygiene. Dr. Lambeth.