 | University of Virginia record February, 1911 |  |
COURSES OF INSTRUCTION.
In the following description of courses, the number of hours represents
the amount of time each student devotes to the course. In addition
to the hours scheduled in the third and fourth years of the course, each
student devotes a considerable amount of time to practical work which
does not appear in the schedule, but the satisfactory performance of which
is essential to graduation. Thus the taking of histories, the visits to his
cases in the hospital, assisting at operations, attendance upon cases of
labour, the employment of microscopical and chemical methods of diagnosis
in the hospital, require much time which it has not seemed possible to
record in a rigid schedule. It should, however, be stated that each
student in the fourth year gives at least two hundred hours to this
required but unscheduled practical work.
FIRST YEAR.
Anatomy 1.—Six hours weekly until November 1st; twelve hours
weekly from November 1st to the end of the winter term. This course
begins with a systematic study of the bones, on the completion of which a
part (either the head and neck with the upper extremity and thorax, or
the lower extremity and abdomen) is assigned to each student for dissection
and study. For this purpose each cadaver is considered as composed
of four parts; on the completion of this course and Anatomy 3 each
student has dissected a lateral half of the body. Emphasis is placed upon
the benefit to be derived by the student who obtains his knowledge at first
hand and by his own personal efforts. While practical dissection and the
consideration of topographical relations make up the essential features of
the course, there are occasional lectures and frequent recitations, followed
by a final written examination in March. The satisfactory performance
of the laboratory work is essential to a passing grade. Dr. Whitehead.
Anatomy 2.—Six hours weekly during the spring term. This course
consists in a laboratory study of the anatomy of the central nervous
system carried out in considerable detail. The gross anatomy of the
spinal cord and brain is first considered, on the completion of which sections
of the more important regions are studied carefully with the aid of the
microscope. For the purposes of the course the laboratory is well equipped.
Fresh brains are obtained each year from the dissecting material of the
departments; and several excellent series of sections of the cord and
brain both of infants and adults stained by the Weigert-Pal method are
thoroughly used. The laboratory work is supplemented by recitations and
occasional lectures. Dr. Whitehead.
Histology.—Three lectures or recitations and nine hours of laboratory
work weekly during the fall and winter terms. The student's record in the
course will depend upon his recitations, laboratory drawing books, and final
examination, both written and practical. The course aims to acquaint the
student primarily with the microscopic structure of cells, tissues, and
organs. Cytogenesis and histogenesis are briefly considered in the case of
many tissues studied; and the relation of the whole subject of histology
to pathology is never lost sight of. The student is also given opportunity
to acquaint himself with the principles and practice of histological
technique. The laboratory is excellently equipped with microscopes,
paraffin baths, microtomes, and various accessories essential to the most
favorable presentation of this course.
A record of seventy per cent. in this course is required for admission
to Physiology, and of eighty per cent. for admission to Pathology. Dr.
Jordan, Mr. Steele and Mr. Williams.
Embryology.—Nine hours weekly during the spring term. The laboratory
work (six hours weekly) is accompanied by lectures, recitations, and
the study of models and text-books. The course aims to give the student
a knowledge of developmental processes, in the light of which he may the
better understand the more abstruse normal conditions of adult anatomy,
as well as many anomalies and variations, neoplasms and malformations.
The close correlation of obstetrics is recognized, and a correct knowledge
of the fetus and its membranes is taught from the embryological approach.
The course is made as practical as possible for the student and practitioner
of medicine. It begins with a consideration of maturation phenomena,
fertilization, segmentation, and the development of the germ-layers. This
study is made chiefly upon the ova and early stages of an invertebrate,
followed by a comparison in an amphibian. The chick is used for the
primary relations of the systems to one another; and this is followed
by the study of pig embryos, where each system is taken up separately
and the organology and histogenesis of its parts are studied. Finally,
the fetal membranes and their relations to the fetus and uterus are studied
in their variations among the amniota. Dr. Jordan, Mr. Steele and Mr.
Williams.
Organic Chemistry.—Lectures and recitations three hours weekly,
laboratory work six hours weekly during the fall and winter terms. This
course includes the systematic study of organic chemistry or the chemistry
of the compounds of carbon, with special reference to substances of importance
in their relation to medicine. The object of this course of study
is to familiarize the student with the more important organic compounds
and with the methods at present employed in chemical synthesis and to
lay the foundation for subsequent work in physiological chemistry, pharmacology,
etc., etc.
A record of seventy per cent. on this course is required for admission
to Physiological Chemistry. Dr. Kastle and Dr. Edgar.
Physiological Chemistry.—Three lectures, three recitations and nine
hours of laboratory work weekly during the spring term. This course has
for its object to afford instruction in the fundamentals of physiological
chemistry, especially the chemical structure, properties, and reactions of
the more important compounds with which the student must deal in his
subsequent studies of physiology. The laboratory work, for which ample
facilities are provided, consists of the thorough study of the properties
of the carbonhydrates, fats, soaps, fatty acids, and proteins, and of the
more important members of each of these groups; the composition of blood,
milk, muscle, pancreas, and other organs; the action of the more important
digestive enzymes and of the bile; and the chemistry of the urine.
Accurate quantitative determinations are required of urea (Folin), total
nitrogen (Kjeldahl), uric acid (Hopkins-Folin), ammonia (Folin), sugar
(Fehling and Benedict), and kreatinin (Folin). Other processes of
quantitative analysis, such as the Soxhlet method of fat determination
and the silver nitrate method of determining the total purins, are either
demonstrated or their essential manipulations carried out by the student
himself. The exceptional preparation of students not only in general but
also in organic chemistry makes it possible to acquire in this course both
a clear understanding of the problems of physiological chemistry, and
also skill in the use of the fundamental qualitative and quantitative
methods.
A grade of seventy per cent. on this course is required for admission
to Physiology. Dr. Kastle and Dr. Edgar.
SECOND YEAR.
Anatomy 3.—Ten hours weekly from October 1st through the fall and
winter terms. This course is the continuation of Anatomy 1, and consists
of the systematic dissection and study, by essentially the same methods,
of the parts not studied during the first year. Mr. Waddell.
Physiology.—Four hours weekly of lectures, recitations, and demonstrations
throughout the year; six hours weekly of laboratory work in
the fall and winter terms. The physiology of muscle and nerve; blood
and lymph; the circulation; respiration, secretion; digestion and nutrition;
excretion; the sense organs; and the central nervous system. The
laboratory is equipped with kymographs, induction coils, signals, muscle
and heart levers, tambours, manometers, etc., for thirty men working at
one time in pairs. The work of the laboratory closely follows the lectures
and is an integral part of the study of each subject. The student becomes
practically acquainted with the methods of modern physiological investigation
and is required to hand in tracings or other records together with
full descriptions of his experiments. The satisfactory completion of the
laboratory work is as necessary to a clear record on the course as is the
passing of the final examinations.
Open only to students who have obtained a grade of seventy per cent.
in Histology and in Physiological Chemistry. The satisfactory completion
of the laboratory work of this course is necessary for admission to
Pharmacology. Dr. Hough, Mr. Irvin and Mr. Porter.
Bacteriology and Pathology.—Thirteen hours weekly throughout the
year.
In Bacteriology the student is taught to prepare culture media and
to employ the usual methods necessary for the isolation and identification
of bacteria, and he learns the biological peculiarities of the microörganisms
concerned in the common bacterial diseases.
After a few days have been spent in the making of culture media,
sterilization, etc., the general technic is learned by isolating the bacteria
from the air and from exposed surfaces. Following this, the pathogenic
bacteria are taken up serially. Those receiving special attention are the
bacteria concerned in wound infections, in respiratory and intestinal
diseases, and in tuberculosis.
With several diseases the pathogenic action of the bacteria is studied
directly upon animals, the anatomical changes are observed, the bacteria
are recovered, and the diseased tissues are prepared by the student for
microscopic examination.
The lectures which accompany the laboratory work are designed to
set forth clearly the relation which bacteria bear to disease, to immunity,
and to preventive medicine.
The course in Pathology extends from January to June. The greater
part of the practical work is devoted to the study of the microscopic
changes occurring in disease. This is supplemented by the study of autopsy
material and museum specimens. Wherever it is possible the development
and progress of the lesions are studied experimentally. The practical work
includes the consideration of the vascular disturbances, degeneration, inflammation,
regeneration, and of benign and malignant tumors. The
diseases produced by animal parasites are considered briefly. During the
course the student has an opportunity to learn the standard methods
employed in preparing tissues for microscopic examination, and he is called
upon to witness and assist in the autopsies.
A lecture precedes the practical work each day and in addition selected
topics are discussed more fully in a series of lectures.
Both in Bacteriology and Pathology frequent recitations are held, and
the standing of the student is determined largely from these and from
the character of his daily work.
In addition to the courses outlined above, there will be opportunities
for qualified students to engage in special work.
The work in Pathology is open only to students who have obtained a
record of eighty per cent. on Histology. Dr. Marshall, Dr. Thalhimer,
Mr. Woodberry and Mr. Bray.
Pharmacology.—Five hours of lectures, recitations, and demonstrations
and six hours of laboratory work weekly during the third term.
In this course a study is made of the chemical characteristics and physiological
action of representative drugs from the different pharmacological
groups. The satisfactory completion of the laboratory work of Physiology
is required for admission to the course. For the present year in charge
of Dr. Hough.
Physical Diagnosis.—Four hours weekly during the spring term.
Instruction is given in the principles and methods of physical examination.
Attention is especially given to study of the normal subject. Dr. Flippin.
THIRD YEAR.
Materia Medica.—Three hours of lectures and recitation and four
hours of laboratory work weekly during the first term of the third year.
The more important drugs and preparations of the Pharmacopea, together
with newer non-official which bid fair to attain or have attained considerable
use, form the subject of study. In the laboratory the student becomes
familiar with the pecularities and methods of preparation of the different
preparations of the Pharmacopea, as well as solubilities and other characteristics
of the more important drugs. Especial attention is paid to
chemical and pharmaceutical incompatibility. Prescription writing is
dealt with by lecture and frequent practical exercises. For the present
year in charge of Dr. Lambeth.
Toxicology.—An optional course consisting of one lecture and four
hours of laboratory weekly during the second term. The methods of
separation and identification of poisons. For the present year in charge of
Dr. Kastle.
Clinical Diagnosis.—Six hours weekly during the fall and winter
terms. In this course the student is made familiar with those modern
laboratory methods which are practically helpful in the diagnosis of
disease. These include, among others, the systematic examination of
blood, sputum, urine, gastric contents, feces, exudantes, transudates, and
milk. The student is not only required to understand the methods employed
in such examinations, but by practice to acquire the skill necessary
for accurate results. The instruction is given in the new Clinical Laboratory,
situated in the north wing of the Hospital. This laboratory is well
equipped with instruments and apparatus, and the wards of the Hospital
furnish ample material for the proper presentation of the subject. Dr.
Flippin and Mr. Cabaniss.
Theory and Practice of Medicine.—Three hours weekly of lectures
and recitations throughout the year; nine hours weekly in the clinics
for one half the session. A systematic course of lectures, supplemented
by work in the Dispensary and Hospital. The class is divided into two
sections, each of which devotes itself for half the year to the medical
service in the Dispensary and also twice a week receives instruction on
selected cases in the wards of the Hospital. There is a general medical
clinic once a week in the hospital amphitheater for the third and fourth
year students. Dr. Davis, Dr. Flippin, Dr. Magruder, Dr. Nelson.
Surgery and Gynecology.—Five hours weekly of lectures and recitations,
and two hours weekly of surgical clinic throughout the session,
with six hours weekly in the Dispensary for one half the session.
The study of Surgery begins in the third year and continues through
the fourth year. In the third year the class room work consists of
lectures and recitations, as arranged in the schedule, in which the Principles
and Practice of Surgery, Surgical Diseases, Surgical Diagnosis, etc.,
are thoroughly discussed. This also includes the surgical specialties,
Orthopedics, Genito-urinary Surgery, etc.
The Dispensary course in the third year gives opportunities for
diagnosis and treatment of clinical cases under close personal supervision.
Experience in dressings, bandaging, anesthesia, and minor surgery is
afforded. Surgical appliances and technique are demonstrated to the
students, divided into small groups.
The work in Gynecology follows closely the outlines already described
for surgery. The general principles of gynecology are taken up in lectures
and recitations. In addition, the dispensary affords practice in palpation,
diagnosis and treatment. Dr. Watts and Dr. Goodwin.
Obstetrics.—Three hours weekly of lectures, recitations, and manikin
demonstrations during the year, supplemented by work with living subjects
in the wards of the Hospital.
The class is divided into sections of five for manikin instruction
and for examination of patients in the Hospital. The manikin course
forms an important part of the work, not only for teaching presentation,
position, and posture, but also the mechanism of normal and abnormal
labor and the application of forceps. When the section is taken into
the wards of the Hospital, the methods of examination, particularly
abdominal palpation, are practiced on the living subject. Dr. Macon.
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
case, thorough examinations made, and management indicated by the
students of each division. The records thus obtained are kept up by the
student assigned to the case, which he is expected to follow until its
discharge. The accuracy and completeness with which this is done constitutes
a large element in the determination of fitness for graduation.
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 fall 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 winter 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. Instruction in the
practical details of the subject is given by work at the Dispensary and
in the wards of the Hospital. 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. At the Dispensary two clinics a week throughout the year
are devoted to the diseases of the skin. The senior class is divided
into sections for the work in this branch. After a brief review of the
anatomic and histologic structure and of the physiology of the skin,
the diseases most commonly met with are discussed.
The clinical material available at the University Dispensary is
utilized to the best advantage to give the students a practical working
knowledge of the diagnosis and treatment of affections of the skin.
Dr. Davis and Dr. Rea.
Case Teaching, Medical Ethics and Economics, and Insurance
Examinations.—Two hours weekly during the spring term. Dr. Davis.
Therapeutics.—Two lectures weekly during the second half of the
year, with five hours weekly of ward rounds for one half the session.
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 clinical side of the teaching
of this subject, the student being required to suggest treatment
for cases assigned to him and to follow closely and make a record of
the results of the therapeutic agents employed throughout the course
of the disease.
The course includes a discussion of the preparation of food for the
sick; demonstrations of the preparation of stupes, plasters, and poultices;
and the methods of giving therapeutic baths, electrical treatment, massage,
and other therapeutic measures. 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, 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 recording of 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 and Dr. Goodwin.
In addition to the above course, required of all students, the following
elective course is offered in the Department of Surgery.
Surgical Pathology.—Two hours weekly during one half of the year.
The work in this course comprises lectures upon the pathology of surgical
lesions, with especial emphasis upon the clinical diagnosis of tumors and
inflammations, the examination of microscopic sections, and the study
of fresh tissues in the gross, obtained from the operating room. The
purpose of the course is to supplement the general courses in pathology
and surgery, and to acquaint the student with the appearance of fresh
pathological material from surgical cases. Dr. Goodwin.
Obstetrics.—The student attends, under the guidance of an instructor,
the labour 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 outpatient department and
each student is expected to attend at least four cases of labour. Dr.
Macon.
Forensic Medicine.—One lecture weekly during the first term of the
fourth year. Dr. Lambeth.
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 year and clinical lectures
to sections of the class as suitable cases occur.
No attempt is made to train specialists, but every effort is made
to render the class familiar with such common diseases of the eye, ear,
nose, and throat as the general practitioner meets in his daily work.
To this end the class is divided into small sections and each student is
taught the methods of examination and the use of the ophthalmoscope,
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.
At the operations in the Hospital only as many students are allowed
to be present as can really see and appreciate what is being done.
Valuable work is also given in the dissecting room, where the technic
of operative work is shown in a way that cannot be employed with the
living patient. Students do this work as far as possible for themselves,
especially in tracheotomy and intubation of the larynx.
Finally the attempt is made so to ground the student in the anatomy,
physiology, general pathology, and in methods of examination and treatment
that he may diagnose and treat intelligently many of the cases that
cannot afford to go to a perhaps distant specialist; that he may treat
successfully that large class of emergency cases that first come to the
general practitioner and in which immediate treatment is imperative; and,
lastly, that he may recognize and intelligently refer those cases that
need the services of one specially trained to this branch of work. Dr.
Hedges and Dr. Compton.
Hygiene.—Three hours weekly throughout the year.
The course begins with a historical sketch of the development 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
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.
FACILITIES AND OPPORTUNITIES FOR RESEARCH.
The Department of Medicine not only fosters in its methods of
instruction the inductive study by the student himself of the phenomena
presented by the human body in health and disease, but also encourages
the spirit of investigation of unsolved problems of medical science and
practice on the part of instructors and students. During the past few
years there have appeared annually a number of papers from its laboratories
embodying the results of such investigations, and it is the policy
of the department to enlarge this feature of its work in the future.
Students are encouraged to engage in research as they are prepared for
it, usually assisting an instructor in some special study or else conducting
the research under his guidance and advice. For this purpose the
scientific and clinical laboratories offer the necessary facilities and heads
of departments will always be glad to suggest and outline problems for
investigation by any medical student or by others possessing the necessary
training therefor.
| University of Virginia record February, 1911 | |