The Integration of Clinical Medicine with the Preclinical Sciences 1937

I think it may be taken as a truism that the majority of young men and women who enter medical school do so with the intention of eventually pursuing the practice of medicine. The reasons that prompt them to this end are undoubtedly manifold; but, in the final analysis, they are most influenced to do so as it seems a respectable and pleasant way of making a living. …A few enter on the study of medicine through pure love of pursuing a biological science. To these students the study of anatomy, physiology and biochemistry is an intellectual joy, and they are even more exhilarated when they enter on the intricate and often uncharted seas of pathology, immunology and scientific medicine. But these individuals are comparatively few in number. The majority who approach their medical studies with a utilitarian objectiveness naturally think of the individual patient and his illness as the important goal. Therefore, they are inclined to find the meticulous study of anatomy, physiology and biochemistry rather boring, and they are impatient, as they think their study a waste of time. …Now, these may be hard words, but there is much truth in them. It can with equal justice be asked, “To what extent has the teacher of medicine or surgery or gynecology and obstetrics employed the knowledge, language and technique of these subjects in the teaching of his own subject?” It is of little future use for one to blame the other for the faults of the past, particularly as the problem is easier of criticism than of solution. Nor is a ready answer to be found unless there be a desire on the part of all teachers to coordinate and cooperate. There are, however, to my mind, certain primary principles that should be accepted. The first of these is to introduce the student to the sick person as early in his curriculum as possible. The interpretation of the function of “possible” will vary considerably in different minds. It might mean the first week of the medical student’s first year, or it might be deferred, as at present, to the end of his second or the beginning of his third year. …A proper integration of all these subjects toward themselves as well as toward medicine, surgery and obstetrics, is the ideal to be attained…Anatomy and physiology would not be first year subjects nor medicine and surgery final year subjects. They would all start together and end together. …This conception of the teaching of medicine may seem to you bizarre and heretical; but, there has been much searching of heart in the body medical of how the teaching of this subject might be brought into line with its practice…I am bold enough to believe that the medical faculty which first adopts such a general plan for their curriculum will blaze a trail which all will eventually be forced to follow. J. C. Meakins McGill University Faculty of Medicine

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