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 outpatient
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.
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 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, operaative
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. Banks and Dr. Jones.
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.
Clinical Pathological Conferences.—The pathological material from the operating
tables and from the autopsy 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.
