pendence of modern medicine on the physical and biological sciences, already adverted to,[1] will hereafter become increasingly obvious in the wealth of the curricula based upon them, and no less in the poverty of those constructed without them. But the practical importance of scientific method as such to the general practitioner is by no means so generally conceded. Its function in investigation is granted: there it is justified by its own fruits. But what has this to do with the education or the daily routine of the family doctor?
The question raised is fundamental; the answer decides the sort of medical education that we shall seek generally to provide. If, in a word, scientific method and interest are of slight or no importance to the ordinary practitioner of medicine,[2] we shall permanently establish two types of school,—the scientific type, in which enlightened and progressive men may be trained; the routine type, in which "family doctors" may be ground out wholesale. If, on the other hand, scientific method is just as valuable to the practitioner as to the investigator, it may indeed be expedient partly, or even in some instances altogether, to set aside gifted individuals as teachers or investigators and to guard the undergraduate student against original work prematurely undertaken. But this will not be construed to involve the abrupt and total segregation of medical education from medical research. Much of the educator's duty may consist in traversing a well known path; but if otherwise he is progressively busy, the well known path will never look exactly the same twice. The medical school will in that case be more than the undergraduate curriculum. Activities will be in progress that at every point run beyond the undergraduate's capacity and interest at the moment. But the undergraduate curriculum will not differ in spirit, method, or aspiration from the interests that transcend it.
The conservative in medical education makes much of what he conceives to be a fundamental opposition between medical practice and medical science; occasionally a despairing progressive accepts it. The family doctor represents the former type. One can ask of him—so the conservative thinks—only that he be more or less well grounded in things as they are when he gets his degree. The momentum with which he is propelled from the medical school must carry him to the end of his days,—on a gradually declining curve; but that cannot be helped. The other type—the scientific doctor—either himself "investigates," or has a turn for picking up increases due to others. How profound is the opposition here depicted? Opposition of course there is between all things in respect to time and energy. The doctor who puts on his hat and goes out to see a sick baby cannot just then be making an autopsy on a guinea-pig dead of experimental dysentery. But does the opposition go any deeper? Is there any logical incompatibility between the science and the practice of medicine?
