University of Virginia Library

FOURTH YEAR

Theory and Practice of Medicine.—One hour weekly of medical clinic
throughout the session; five hours weekly of ward classes for one-half the session
with each of the two sections of the class. Full histories are taken of every
case, through examinations made, and management indicated by the students.
These records are considered in their final grading. Drs. Davis, Flippin,
Mulholland, Wood and Koontz.

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

Case Teaching, Medical Ethics and Economics, and Insurance Exami-
nations.—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 ward rounds weekly for nine weeks.
The interesting cases seen in the out-patient department are admitted to the hospital
for detailed study. Dr. D. C. Smith.

Surgery and Gynecology.—One hour weekly of surgical clinic throughout
the session; five hours weekly of ward classes, supplemented by clinic 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 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. J. H. Neff, Dr. Voshell, Dr. Bigger and Dr. R. J. Neff.

Orthopedics.—One hour weekly throughout one-half the year for ward
rounds. Dr. Voshell.

Surgical Pathology.—Two hours weekly during one-fourth 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. Dr. Bigger.

Obstetrics and Gynecology.—In small groups throughout the year instruction
is given in the practical observation of, and participation in, the care of the
pregnant and parturient woman, in the Hospital wards and labor room. Ward
rounds, and mannequin demonstrations and practice by the individual student.
Dr. Calkins and Associates.

Entire class throughout the year, one hour weekly. Case analysis, and
discussion of special problems complete the training in these subjects. Dr.
Calkins and Associates.

Pediatrics.—Students are instructed in the wards of the hospital twice a
week in ward rounds. In addition all students serve as clinical clerks and have
cases assigned to them for their personal care under the direction of the professor
or instructor. Frequent clinics are held in the mountains, the students
of the fourth year class being used as assistants in this work. Students are also
required to go into the milk laboratory and acquire a knowledge of the preparation
of formulae by practical experience. Dr. Royster and Dr. W. W. Waddell.

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. J. A. 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 three
times a week 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. Woodward.

Hygiene and Preventive Medicine.—Two 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 and Dr. Young.