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 offers 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
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, assisted by Mr. Hawthorne.

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, and 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 during
the first two terms, supplemented by regular two- to three-hour 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 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. Dr. Hedges and Dr. Compton.

Hygiene.—One hour weekly throughout the session, and thirteen additional
hours in the second term.

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.