University of Virginia Library

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.

Dermatology and Syphilology.—One lecture weekly during the fall and
winter terms. The importance, etiology, prophylaxis, pathology, clinical
history, diagnosis and treatment of syphilis are discussed. After a review
of the anatomic and the histologic structure and the physiology of the
skin, the diseases commonly met with are discussed. The available outpatient
material is utilized by the third year students; selected cases, admitted
to the hospital, are studied by the fourth year students. Dr. Smith.

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; 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. 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 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 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, and Dr. Setzler.

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.—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, 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 care 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. Klotz.

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.