On the Medical Curriculum

Nature (November 1873)

[21] In a recent number of this journal (Nature, Oct. 2, 1873) we made some remarks on medical studies, which were intended more for students themselves than in any way to bear on the principles of medical education. To the latter subject special attention has just been directed by Prof. Huxley, who, as Lord Rector of the University of Aberdeen, has drawn up a series of propositions for the consideration of the Court at the next meeting in February or March, on which occasion he will deliver his inaugural address.

The following are the motions that the Lord Rector will propose:–

"I. That, in view of the amount and diversity of the knowledge which must be acquired by the student who aspires to become a properly qualified graduate in medicine; of the need recognised by all earnest teachers and students for the devotion of much time to practical discipline in the sciences of chemistry, anatomy, physiology, therapeutics, and pathology, which constitute the foundation of all rational medical practice; and of the relatively short period over which the medical curriculum extends–it is desirable to relieve that curriculum of everything which does not directly tend to prepare the student for the discharge of those highly responsible duties, his fitness for the performance of which is certified to the public by the diploma granted by the University.

II. That it would be of great service to the student of medicine to have obtained. in the course of his preliminary education, a practical acquaintance with the methods and leading facts of the sciences comprehended by botany and natural history in the medical curriculum, but that, as the medical curriculum is at present arranged, the attendance of lectures upon, and the passing of examinations in, these subjects occupy time and energy which he has no right to withdraw from work which tends more directly to his proficiency in medicine.

III. That it is desirable to revoke or alter ordinance No. 16 in so far as it requires a candidate for a degree in medicine to pass an examination in botany and zoology as part of the professional examination; and to provide, in lieu thereof, that the examination on these subjects shall as far as possible, take place before the candidate has entered upon his medical curriculum.

IV. That it is desirable to revoke or alter said ordinance No. 16, in so far as it requires candidates for the degree of doctor of medicine to have passed an examination in Greek, and that, in lieu thereof, either German or French be made a compulsory subject of examination for said degree, Greek remaining as one of the optional subjects."

In considering these points a review of the method by which the present position of the medical curriculum has been arrived at, will throw considerable light on the steps which ought to be taken for its improvement, and will show how subjects which have but an indirect bearing, or none at all, on medicine proper have been gradually made to form an element of the course of study, without any question having been asked as to whether their introduction does not bring its concomitant disadvantages.

The influence of Materia Medica seems to have been great in bringing about the present state of affairs. When Dr. Anthony Todd Thomson and Dr. Pereira, in their enthusiasm for their favourite subject, extended its limits so as to include a full account of the source and history of every one of the articles which were mentioned in the Pharmacopœia, and went so far as to give a full description of Gallus bankiva, together with all the steps in the development of its egg, simply because Ovi vitellus is an antidote against poisoning by corrosive sublimate, and is employed in the preparation of Mistura Spiritus Vini Gallici (egg flip), it is evident that as the sciences of zoology and botany became more profound, Materia Medica as a subject would proportionately expand. At last a time came when separate lectures had to be given on the above-mentioned kindred subjects, in order that those on Materia Medica might be more easily comprehended by the student; and, as might be expected, these independent lectures on zoology and botany, as those on chemistry had done before, became so complete in themselves, as to reduce the subject which had given rise to their introduction, to a simple formulary for the chemist, with references to the sources of the necessary scientific information. The introduction, however, of zoology and botany as separate independent elements of the curriculum, brought into the medical education a large mass of matter, which is very valuable no doubt in itself, but to the student entirely irrelevant; and as in the short pupilage of three or four years there is a much larger amount that ought to be learned than can be properly acquired in the time, it becomes a matter worth serious consideration, whether subjects which are not indispensable to a thorough training should be still taught and be required by the examining bodies. The question therefore resolves itself into the determination of whether the loss of time necessary for obtaining a superficial knowledge of a couple of sciences, is counteracted by the advantages of those sciences as a mental training and a basis for higher work? In an Introductory Lecture delivered some time ago at University College, Prof. Huxley throws the weight of his opinion in the scale against retaining the subjects which must be to him most dear, in the medical curriculum; and most will agree with him, notwithstanding the many difficulties in the way of an improved programme.

With regard to Prof. Huxley's fourth proposition, in which it is considered desirable to omit Greek from the preliminary examination, and substitute German or French in its place, the interest will not be so great to most, as that relating to the scientific qualifications that are necessary. The same conservative spirit which has prevented any reduction in the overloaded Biological portion of the curriculum, has, without question of any kind being asked, never even hinted at any change in the long-established and well-tried school-course, in which the at one time practically valuable and indispensable Greek and Latin are still retained, though of less importance at the present day. How many of our scientific men find that nothing deters them in every step of their work, more than a want of knowledge of the German language, now that the scientific activity of that country is so considerable and so rapidly increasing. There must be a change with the times, even in primary education, and we hardly think that in his introductory address to the King's College Medical Society on the 23rd of last month, Prof. Curnow put the case fairly when he disapproved of the substitution of German for Greek, because the one could be [22] mastered by a few months' residence in a neighbouring country, whilst the other had done more to develop true culture than almost all other writings since. It is not proposed simply to substitute German or French for Greek, the advantages to be derived from which are not fully absorbed into the spirit of the nation, but, by the change, to leave a sufficient time, in addition to the education in modern languages, for the study of the Natural Sciences during the school-boy period. That the dead languages form an excellent mental training no one doubts, but that Physics and Chemistry do the same is daily becoming more certain; and the time is not far hence when the facts and methods of Physiology and Comparative Anatomy will be so well known and assorted, that they may be placed in the same category.


C. Blinderman & D. Joyce
Clark University