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 and second terms. In this course
is given also instruction in electrotherapeutics. Dr. Davis.
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.
After review of the anatomic and histologic structure and physiology of the skin
the diseases commonly met with are discussed. Ward rounds once weekly for
one-half the year. The interesting cases seen in the out-patient department are
admitted to the hospital for detailed study. 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 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, Dr. Helvestine and
Dr. R. J.
Neff.
Orthopedics.—One hour weekly throughout 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. The student reviews pathological technique, and frozen
section work is emphasized. Dr. Bigger.
Obstetrics and Gynecology.—Continuation of practical work begun in third
year, throughout the first two terms. In the third term a course of three hours per
week in case analysis completes and rounds out the training in this branch.
Small groups of the class are also taught practical treatment by the ward round
method. 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
of this department. This includes the practical feeding of infants and the
preparation of the food. Dr. Royster and Dr. 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. 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 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. McCutchan.
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.
