 | University of Virginia record January 1, 1916 |  |
COURSES OF INSTRUCTION
In the following description of courses, the number of hours represents
the amount of time each student devotes to the course. In addition to
the hours scheduled in the third and fourth years of the course, each
student devotes a considerable amount of time to practical work which
does not appear in the schedule, but the satisfactory performance of which
is essential to graduation. Thus the taking of histories, the visits to his
cases in the hospital, assisting at operations, attendance upon cases of
labour, the employment of microscopical and chemical methods of diagnosis
in the hospital, require much time which it has not seemed possible
to record in a rigid schedule. It should, however, be stated that each
student in the fourth year gives at least two hundred hours to this required
but unscheduled practical work.
The session, exclusive of the time devoted to examination, is divided
into a fall term of twelve weeks, a winter term of ten weeks, and a spring
term of ten weeks.
FIRST YEAR
Anatomy 1.—Six hours weekly until November 1st; twelve hours weekly
from November 1st to the end of the winter term. This course begins with
a systematic study of the bones, on the completion of which a part (either
the head and neck with the upper extremity and thorax, or the lower
extremity and abdomen) is assigned to each student for dissection and
study; for this purpose each cadaver is considered as composed of four
parts. On the completion of this course and Anatomy 3 each student
has dissected a lateral half of the body. Emphasis is placed upon the
benefit to be derived by the student who obtains his knowledge at first
hand and by his own personal efforts. While practical dissection and
the consideration of topographical relations make up the essential features
of the course, there are occasional lectures and frequent recitations, followed
by a final written examination in March. The satisfactory
performance of the laboratory work is essential to a passing grade.
Dr. Whitehead.
Anatomy 2.—Six hours weekly during the spring term. This course
consists in a laboratory study of the anatomy of the central nervous
system carried out in considerable detail. The gross anatomy of the spinal
cord and brain is first considered, on the completion of which sections of
the more important regions are studied carefully with the aid of the
microscope. For the purposes of the course the laboratory is well
equipped. Fresh brains are obtained each year from the dissecting material
of the department; and several excellent series of sections of the cord
and brain both of infants and adults stained by the Weigert-Pal method
are thoroughly used. The laboratory work is supplemented by recitations
and occasional lectures. Dr. Whitehead.
Histology.—Three lectures or recitations and nine hours of laboratory
work weekly during the fall and winter terms. The student's record in
the course will depend upon his recitations, laboratory drawing books,
and final examinations, both written and practical. The course aims to
acquaint the student primarily with the microscopic structure of cells,
tissues, and organs. Cytogenesis and histogenesis are briefly considered
in the case of many tissues studied; and the relation of the whole subject
of histology to pathology is never lost sight of. The student is also given
opportunity to acquaint himself with the principles and practice of
histological technique. The laboratory is excellently equipped with
microscopes, paraffin baths, microtomes, a micropolariscope, a projectoscope
and other accessories essential to the most favorable presentation of this
course.
A record of seventy per cent. in this course is required for admission
to Physiology, and of eighty per cent. for admission to Pathology. Dr.
Jordan, assisted by Mr. Pagenstecher.
Embryology.—Nine hours weekly during the spring term. The laboratory
work (six hours weekly) is accompanied by lectures, recitations, and
the study of models and text-books. The course aims to give the student
a knowledge of developmental processes, in the light of which he may
the better understand the more abstruse normal conditions of adult
anatomy, as well as many anomalies and variations, neoplasms and maliormations.
The close correlation of obstetrics is recognized, and a correct
knowledge of the fetus and its membranes is taught from the embryological
approach. The course is made as practical as possible for the student and
practitioner of medicine. It begins with a consideration of maturation
phenomena, fertilization, segmentation, and the development of the germ-layers.
The study is made chiefly upon the ova and early stages of an
invertebrate, followed by a comparison in an amphibian. The chick is
used for the primary relations of the systems to one another; and this
is followed by the study of pig embryos, where each system is taken up
separately and the organology and histogenesis of its parts are studied.
Finally, the fetal membranes and their relations to the fetus and uterus
are studied in their variations among the amniota. Dr. Jordan, assisted by
Mr. Pagenstecher.
Organic Chemistry.—Lectures and recitations three hours weekly, laboratory
work six and eight hours weekly respectively during the fall and winter
terms. This course includes the systematic study of organic chemistry or
the chemistry of the compounds of carbon, with special reference to substances
of importance in their relation to medicine. The object of this
course of study is to familiarize the student with the more important
organic compounds and with the methods at present employed in chemical
synthesis and to lay the foundation for subsequent work in Physiological
Chemistry, Pharmacology, etc., etc.
During the second term certain qualitative and quantitative work of
immediate importance in physiological chemistry is introduced into the
course. This includes, among other things, the reactions of carbohydrates,
the quantitative determination of sugar (Fehling and Benedict), total
methods), chlorids, and total acidity of urine (Folin).
A record of seventy per cent. on this course is required for admission
to Physiological Chemistry. Dr. Edgar and Dr. Pratt.
Physiological Chemistry.—Three lectures, three recitations and nine hours
of laboratory work weekly during the spring term. This course has for its
object to afford instruction in the fundamentals of physiological chemistry,
especially the chemical structure, properties, and reactions of the more
important compounds with which the student must deal in his subsequent
studies of physiology. The laboratory work, continuing that upon the
carbohydrates and the quantitative methods given in the laboratory of
Organic Chemistry, consists of the thorough study of the properties of the
fats, soaps, fatty acids, and proteins, and of the more important members
of each of these groups; the composition of blood, milk, and bile; the action
of the more important digestive enzymes and of the bile; and the
chemistry of the urine. Accurate quantitative determinations are required
of creatinin (Folin), creatin (Benedict), and of urea, ammonia, uric acid,
etc., by the microchemical methods of Folin. After this the class in
sections carries out analyses of 24-hour urines, these analyses including,
in duplicate, all the quantitative determinations which have previously
been learned.
A grade of seventy per cent. on this course is required for admission
to Physiology. Dr. Hough and assistant.
SECOND YEAR
Anatomy 3.—Ten hours weekly from October 1st through the fall and
winter terms. This course is the continuation of Anatomy 1, and consists
of the systematic dissection and study, by essentially the same methods,
of the parts not studied during the first year. Dr. Reeves.
Physiology.—Four hours weekly of lectures, recitations and demonstrations
throughout the year; six hours weekly of laboratory work in the fall
and winter terms. The physiology of muscle and nerve; blood and lymph;
the circulation; respiration; secretion; digestion and nutrition; excretion;
the sense organs; and the central nervous system. The laboratory is
equipped with kymographs, induction coils, signals, muscle and heart
levers, tambours, manometers, apparatus for gas analysis, etc., for thirty
men work at one time in pairs. The work of the laboratory closely follows
the lectures and is an integral part of the study of each subject. The
student becomes practically acquainted with the methods of modern physiological
investigation and is required to hand in tracings or other records,
together with full description of his experiments. The satisfactory completion
of the laboratory work is necessary to a clear record on the course,
as is the passing of the final examinations.
Open only to students who have obtained a grade of seventy per cent.
in Histology and in Physiological Chemistry. The satisfactory completion
of the laboratory work of this course is necessary for admission to
Pharmacology. Dr. Hough and Mr. Neff, assisted by Mr. Setzler.
Bacteriology and Pathology.—Twelve hours weekly throughout the year,
and two additional hours a week in the third term.
In Bacteriology the student is taught to prepare culture media and to
employ the usual methods necessary for the isolation and identification
of bacteria, and he studies the microörganisms concerned in the common
bacterial diseases.
After a few days have been spent in making culture media, sterilization,
etc., the general technique is learned by isolating the bacteria
from the air, soil, water and milk, and from exposed body surfaces.
Bacterial counts are made from water and milk. Following this, the
pathogenic bacteria are taken up serially. Those receiving special attention
are the bacteria concerned in wound infections, in respiratory and intestinal
diseases, and in tuberculosis. At intervals mixed cultures are given out
to the class and the students are required to isolate and identify the
bacteria in the mixtures.
Experimental work upon infection and immunity accompanies the
course in Bacteriology and Pathology. The students inoculate animals
with certain pathogenic bacteria and report to the class upon the course
of disease resulting from the inoculation. In fatal cases the students
perform autopsies upon the experimental animals and attempt to recover
the bacteria in cultures. Sections are made from the organs of the
animals which succumb to inoculation and are studied by the students.
Groups of students prepare vaccines and immunize animals. The
serum of these animals is employed by the class in studying the technique
of the more important immunity reactions. In this way the work in
Bacteriology is integrally combined with the work in Pathology, the two
courses overlapping.
The lectures and quizzes which accompany the laboratory work are
designed to set forth clearly the relations existing between bacteria and
disease and to give a knowledge of the fundamental facts and theories of
immunity and of the important principles of preventive medicine.
The course in Pathology extends from January to June. The greater
part of the practical work is devoted to the study of the microscopic
changes occurring in disease. This is supplemented by the study of
autopsy material and museum specimens. Selected types of diseases are
studied experimentally. The practical work includes the consideration
of the vascular disturbances, degeneration, inflammation, regeneration,
and of benign and malignant tumors. The diseases produced by animal
parasites are considered briefly. During the course the student has an
opportunity to learn the standard methods employed in preparing tissues
for examination, and he is called upon to witness and assist in the
autopsies.
Both in Bacteriology and Pathology frequent recitations are held and
the standing of the student is determined largely upon these and from the
character of his daily practical work.
In addition to the regular course outlined above, opportunity is
afforded for qualified students and doctors to engage in advanced work.
A special room is reserved for this purpose.
The work in Pathology is open only to students who have obtained
a record of eighty per cent. in Histology. Dr. Marshall and Dr. Haralson,
assisted by Mr. Moore and Mr. Gilmore.
Pharmacology.—Five hours of lectures, recitations, and demonstrations
and six hours of laboratory work during the third term. In this course a
study is made of the chemical characteristics and physiological action of
representative drugs from the different pharmacological groups. An average
grade of seventy per cent on the first two terms of Physiology together
with the satisfactory completion of the laboratory work of Physiology is
required for admission to the course. Dr. Waddell and Mr. Neff.
Journals.—In connection with the work in Physiology, Pathology, and
Pharmacology the second-year students meet with their instructors for
one hour each week from the first of December to the end of the session
for reports and discussion of the current literature of the above sciences.
Three reports are made at each meeting by the students.
Physical Diagnosis.—Four hours weekly during the spring term. Instruction
is given in the principles and methods of physical examination.
Attention is especially given to study of the normal subject. Dr. Flippin.
THIRD YEAR
Materia Medica.—Three hours of lectures and recitations and four hours
of laboratory work weekly during the first half of the third year. The more
important drugs and preparations of the Pharmacopeia, together with newer
non-official remedies which bid fair to attain or have attained considerable
use, form the subject of study. In the laboratory the student becomes
familiar with the peculiarities and methods of preparation of the different
preparations of the pharmacopeia, as well as with the solubilities and other
characteristics of the more important drugs. Especial attention is paid to
chemical and pharmaceutical incompatibility. Prescription writing is dealt
with by lecture and frequent practical exercises. Dr. Waddeli. and Mr.
Faris.
Toxicology.—Three hours of lectures and recitation and three hours of
laboratory work weekly during the last half of the second term.
This course is, to a considerable extent, a review of the pharmacological actions
of poisons and their antagonists. The treatment of poisoning is dealt
with in detail. Some attention is given to the methods of separation and
identification. Dr. Waddell and Mr. Faris.
Clinical Diagnosis.—Six hours weekly during the fall and winter terms.
In this course the student is made familiar with those modern laboratory
methods which are practically helpful in the diagnosis of disease. These
include, among others, the systematic examination of blood, sputum, urine,
gastric contents, feces, exudates, transudates, and milk. The student is not
only required to understand the methods employed in such examinations,
but by practice to acquire the skill necessary for accurate results. The instruction
is given in the Clinical Laboratory, situated in the north wing of
and the wards of the Hospital furnish ample material for the
proper presentation of the subject. Dr. Bray and Dr. Duggins.
Theory and Practice of Medicine.—Three hours weekly of lectures and
recitations throughout the year; nine hours weekly in the clinics for one-half
the session. A systematic course of lectures, supplemented by work in the
dispensary and hospital. The class is divided into two sections, each of
which devotes itself for half the year to the medical service in the dispensary
and also twice a week receives instruction on selected cases in the wards of
the hospital. There is a general medical clinic once a week in the hospital
amphitheater for the third- and fourth-year students. Dr. Davis, Dr. Flippin,
Dr. Magruder, and Dr. Nelson.
Surgery and Gynecology.—Five hours weekly of lectures and recitations,
and two hours weekly of surgical clinic throughout the session, with six hours
weekly in the dispensary for one-half the session.
The study of surgery begins in the third year and continues through
the fourth year. In the third year the classroom work consists of lectures
and recitations, as arranged in the schedule, in which the Principles and
Practice of Surgery, Surgical Diseases, Surgical Diagnosis, etc., are thoroughly
discussed. This also includes the surgical specialties, Orthopedics,
Genito-urinary Surgery, etc.
The dispensary course in the third year gives opportunities for diagnosis
and treatment of clinical cases under close personal supervision. Experience
in dressings, bandaging, anesthesia, and minor surgery is afforded.
Surgical appliances and technique are demonstrated to the students, divided
into small groups.
The work in gynecology follows closely the outlines already described
for surgery. The general principles of gynecology are taken up in lectures
and recitations. In addition, the dispensary affords practice in palpation,
diagnosis, and treatment. Dr. Watts and Dr. Goodwin.
Obstetrics.—Three hours weekly of lectures, recitations, and manikin demonstrations
during the year, supplemented by work with living subjects in
the wards of the hospital.
The class is divided into sections of five for manikin instruction and for
examination of patients in the hospital. The manikin course forms an important
part of the work, not only for teaching presentation, position, and
posture, but also the mechanism of normal and abnormal labor and the application
of forceps. When the section is taken into the wards of the hospital,
the methods of examination, particularly abdominal palpation, are
practiced on the living subject. Dr. Macon.
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
division. The records thus obtained are kept up by the student assigned to
the case, which he is expected to follow until its discharge. The accuracy
and completeness with which this is done constitutes a large element in the
determination of fitness for graduation.
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 fall 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 winter 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. Instruction in the practical details of the
subject is given by the work at the dispensary and in the wards of the hospital.
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.
After a brief review of the anatomic and histologic structure and of
the physiology of the skin, the diseases most commonly met with are discussed.
The clinical material available at the University Dispensary is utilized
to the best advantage to give the students a practical working knowledge
of the diagnosis and treatment of affections of the skin. Dr. Davis and Dr.
Rea.
Case Teaching, Medical Ethics and Economics, and Insurance Exam-
inations.—Two hours weekly during the spring term. Dr. Davis.
Therapeutics.—Two lectures weekly during the fall and winter terms, with
five hours weekly of ward rounds for one-half the session.
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 clinical side of the teaching of this subject,
the student being required to suggest treatment for cases assigned to
him and to follow closely and make a record of the results of the therapeutic
agents employed throughout the course of the disease.
The course includes a discussion of the preparation of food for the
sick; demonstrations of the preparation of stupes, plasters, and poultices;
and the methods of giving therapeutic baths, electric treatment, massage,
and other therapeutic measures. 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, 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, complication,
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 offer 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 recording 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 and Dr. Goodwin.
In addition to the above course, required of all students, the following
elective course is offered in the Department of Surgery.
Surgical Pathology.—Two hours weekly during one-half of the year. The
work in this course comprises lectures upon the pathology of surgical lesions,
with especial emphasis upon the clinical diagnosis of tumors and inflammations,
the examination of microscopic sections, and the study of fresh
tissues in the gross, obtained from the operating room. The purpose of
the course is to supplement the general courses in pathology and surgery,
and to acquaint the student with the appearance of fresh pathological material
from surgical cases. Dr. Goodwin.
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, 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 the term of the fourth
year. Dr. Waddell.
Diseases of the Eye, Ear, Nose and Throat.—Two lectures weekly from
the beginning of the session to the first of March, supplemented by regular
clinics twice weekly throughout the year and clinical lectures to sections of the
class as suitable cases occur.
No attempt is made to train specialists, but every effort is made to render
the class familiar with such common diseases of the eye, ear, nose and
throat as the general practitioner meets in his daily work. To this end 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.
At the operations in the hospital only as many students are allowed to
be present as can really see and appreciate what is being done.
Valuable work is also given in the dissecting room, where the technic
of operative work is shown in a way that can not be employed with the living
patient. Students do this work as far as possible for themselves, especially
in tracheotomy and intubation of the larynx.
Finally the attempt is made so to ground the student in the anatomy,
physiology, general pathology, and in methods of examination and treatment
that he may diagnose and treat intelligently many of the cases that
can not afford to go to a perhaps distant specialist; that he may treat successfully
that large class of emergency cases that first come to the general
practitioner and in which immediate treatment is imperative; and, lastly,
that he may recognize and intelligently refer those cases that need the
services of one especially trained to this branch of work. Dr. Hedges and Dr.
Compton.
Hygiene.—Three hours weekly throughout the year.
The course begins with a historical sketch of the development 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.
| University of Virginia record January 1, 1916 | |