University of Virginia Library

FACILITIES FOR AND METHODS OF INSTRUCTION.

There are well-equipped laboratories for the study of organic chemistry,
biochemistry, gross anatomy, histology and embryology, bacteriology
and pathology, physiology, pharmacology, materia medica, and clinical
diagnosis. These laboratories are all presided over by trained teachers, to
whom teaching and investigation are primary considerations. The number
of hours assigned to laboratory subjects is quite large and affords ample
time for thorough study of the best methods. The student is brought into
close contact with teachers who are both willing and able to guide him; he
gains a very large part of his knowledge at first hand and by his own exertions,
and thus acquires the habit of working out things for himself; he

becomes self-reliant, a quality essential to the practice of his difficult profession.
Trained in this manner, he acquires an understanding of the medical
sciences and the ability to apply the facts of these sciences to the subsequent
study of disease. For these reasons the great fundamental sciences
receive the utmost consideration, constituting the entire work of the first
two years.

The methods of clinical instruction are based upon the belief that no
clinical teaching is efficient which is not governed by essentially the same
principles as those which govern the best laboratory teaching. This instruction
is accordingly designed to enforce with the individual student a
careful, thorough, face-to-face study of disease and its management. The
facilities afforded by the University Hospital and Out-Patient Department
are described on a subsequent page. After two sessions devoted to laboratory
training, the student is introduced in the third year to the study of
disease in living persons. In the Out-Patient Department and in the Hospital
he learns the methods of examining patients, of diagnosing their
diseases, and of instituting rational treatment; and he learns these things
in much the same way as he studied in the laboratory, that is to say, by
doing them himself under the direction and criticism of the instructors. This
practical training is accompanied by a systematic study of the various subjects
by means of lectures, textbooks, and recitations. With this preparation
the student is ready to enter upon the hospital work in his fourth year.
Here he has advantages for clinical training similar to those enjoyed by
internes. Each clinical patient on admission to the hospital is assigned to
a student, and that patient is regarded as his "case." The student conducts
a complete examination, records his observations in a scientific manner,
makes a diagnosis, states his view as to the treatment indicated, and keeps
a complete record of the case, all under the advice and criticism of the
physician or surgeon in charge. He is expected to keep himself informed
of the progress of the case throughout its course. If it is one requiring
surgical treatment, he assists at the operation, and thus is able to follow
all the procedures of the operator at close range. In addition, students
make frequent visits to the wards with the attending physicians and surgeons,
during which visits the nature, treatment, and progress of various
cases are gone over in detail. To carry out this method of clinical instruction
the hospital had last year over 3,000 cases. Since the number of students
in each class is relatively small, it is clear that the department offers capable
young men clinical advantages which are distinctly exceptional.

The Blue Ridge Sanatorium of the State Board of Health, situated a
mile east of Charlottesville, will open in the spring of 1920 for the treatment
of tuberculosis. Three pavilions have been erected, each with accommodations
for forty patients, and it is expected that the Sanatorium
will be enlarged within a year or two. The State Board of Health and the
University have agreed upon a plan of coöperation by which the medical
students of the third and fourth years are to receive instruction and to
act as clinical clerks in the Sanatorium. By arrangement with the State
Board of Health the Medical Director of the Sanatorium teaches his special

subject in the Medical School of the University of Virginia, and both
students and nurses have the opportunity of learning at first hand the
methods of diagnosis and treatment of tuberculosis by actual experience
in the Sanatorium. This affiliation of the Sanatorium and the Medical
School offers an almost unique opportunity in the country for the medical
student to become thoroughly familiar with the diagnosis and treatment
of this most important disease.

Opportunities are offered in the third and fourth years for more extended
training in certain subjects with a view toward possible specialization
after graduation.

At the meetings of the Medical Journal Club reviews of important articles
and results of original research are presented by the instructors and
by invited guests. These meetings are open to the students.