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 among 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 electrotherapeutics. 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. There is also a baby welfare clinic once
a week in the out-patient department. Dr. Davis and Dr. Rea.

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

Internal Medicine.—Two lectures weekly throughout the session. In this
course the endeavor is made to bring to the attention of the senior student
the more important problems of Internal Medicine. The relationship of
recent investigations in the fields of normal and pathological physiology,
biochemistry, immunology, etc., to internal diseases is especially emphasized.
No text-book is used; students are referred to the files and current issues of
journals and to reference works in the Medical Library as sources of information.
Dr. Flippin.

Dermatology and Syphilology.—Two lectures weekly during the first
term; ward rounds once weekly for one half the year. Dr. Smith.

Surgery and Gynecology.—Two hours weekly of surgical clinic throughout
the session; five 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 beside 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 interneship 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, urology and orthopedics 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. Voshell, Dr. Bigger, Dr. Jones and
Dr. Page.

Surgical Pathology.—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. Bigger.

Clinical Pathological Conferences.—The pathological material from the
autopsy table is correlated with the clinical findings. The conference is
participated in by the students and internes in charge of the patients, the
physicians in charge and the pathologist. Dr. Marshall and the visiting staff
of the hospital.

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. A clinic for third
year students is held one day in the week in the out-patient department for
recording and examining pregnant women. The patients are instructed in
prenatal care, and students are assigned to each case for attendance during
labor under the guidance of an instructor. Dr. Macon.

Medical Jurisprudence.—One lecture weekly during one term of the fourth
year. The application of medical knowledge and skill to the needs of the
law is presented. References to literature are assigned for the fuller development
of special topics. Dr. Waddell.

Phthisiotherapy.—Two lectures weekly for four weeks supplemented by
demonstration clinics at the Blue Ridge Sanatorium. Dr. Brown.

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.