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APPENDIX VI

REPORT OF THE SECRETARY OF THE ITHACA DIVISION OF THE MEDICAL COLLEGE

To the President of the University:

SIR: I have the honor to submit herewith a brief report on some of the aspects of the work of the Ithaca Division of the Medical College for the year 1919-1920. The work of the year has progressed favorably and smoothly without any marked change in curriculum or procedure but with that gradual and progressive improvement in the various departments incident to normal growth.

The effects of the S. A. T. C. have nearly disappeared and most of the instructors who left to enter the army have returned.

FACULTY

The departments furnishing instruction in the Medical College at Ithaca are Anatomy, Histology and Embryology, Physiology including Biochemistry, and Organic Chemistry. These departments are small. Each has but one full professor. These are the permanent members of the staff. In the Department of Physiology there is an assistant professor in charge of biochemistry. The other teachers are instructors and assistants. These latter remain in the department but a short time. The result is that the heads of the departments must personally see to all the details of the administration and in addition must spend a considerable amount of time in training new assistants. Every good teacher welcomes the opportunity to guide the young men who are planning to devote themselves to this field of work, but when this time-consuming task is added to administrative duties, the elementary teaching of Arts, of medical students, and the graduate instruction, the amount of time and energy remaining for his own research and study is slight. I have pointed out repeatedly the need for more assistant professors who as semipermanent members of the staff shall share the above duties with the head of the department and relieve him to some extent of the smaller details. He can then devote himself with more enthusiasm and energy to teaching and research, but especially to the better training of more teachers in his subject.

The need of trained teachers of subjects taught in the first years of the medical course is greater today than ever before. This need is due not only to the lack of adequate salaries for the teachers in the medical colleges, which I have been emphasizing for over ten years, but it is also due to the fact that men cannot be found who are willing to spend the time necessary to obtain an adequate training. Something must be done to attract men of first-class ability to the teaching profession. Salaries large enough so that there shall not be constant worry and distraction because of financial matters will be a material help. In addition to this there must be, outside of the routine teaching and administrative duties, sufficient time for research and study to make the teaching career an attraction to real scholars. The right type of teachers will not be attracted by salaries beyond sufficient upon

which to live and provide for their families, but by the love of learning and the opportunities for study and research.

The Ithaca Division of the College has, I think, done its share in the training of young men and women for the teaching profession and provision must be made so that in addition to instruction of students this important work can be continued.

STUDENTS

A gradual increase in the number of medical students has been noted yearly for several years, as shown in the following table:

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Of the 37 students registered in the Medical College at Ithaca this year, 20 were men and 17 women; 12 entered from outside colleges and 25 from the College of Arts and Sciences of Cornell University. Of the 20 men, 5 were college graduates and 15 were seniors in the College of Arts and Sciences. Of the 17 women, II were college graduates and 6 were seniors in the College of Arts and Sciences.

In addition to the medical students, the various departments of the Medical College have given instruction to considerable numbers of students from other colleges of the University, as noted under the report from each department.

LIMITATION OF NUMBER OF STUDENTS

There was this year a greater proportionate increase in the number of medical students than in any year since 1913-1914. A similar large increase in number in the New York Division of the College precipitated a crisis and forced an immediate decision to limit the number of students. Since it was found that only about 60 students could be properly cared for in the last three years of the course, it was decided, after conference between committees from the Ithaca and New York Divisions of the College, to limit the number received in the first-year class to 75; of whom about 30 would be taken at Ithaca and 45 in New York. It was also decided to limit the number to be received from any other college than Cornell to five students, except under unusual circumstances.

As Cornell is equipped and prepared to give the highest quality of medical instruction, in limiting the number of students, it becomes increasingly important that only the best of the applicants should be selected. To this end, more detailed records of the academic work are to be required and direct information as to the special fitness of the candidates is to be requested from the instructors with whom they have taken the most of their pre-medical scientific work. Applications are to be received up to July 1 and only under exceptional circumstances after that. By July 10, it is hoped to notify all applicants, so that those who cannot be accepted may have ample time to apply elsewhere.

There can be no question of the wisdom of limiting the size of a class to the ability of a school to give adequate instruction. It is important, however, that the limitations in the first-class schools should not be so great that numbers of good students are forced to obtain their medical training in inferior institutions. From the reports of the Council on Medical Education of the American Medical Association, it would seem that the limitations have not yet reached the point where it is necessary for students to resort to any but the schools classified as A Class by the Association.

The need in America today is for increasing numbers of highly-trained medical practitioners. Cornell with her equipment and facilities has a duty to perform in supplying this need. We must first pick those best qualified to profit by the opportunities and then see to it that the quality of the instruction offered is of the best. It is extremely difficult to determine beforehand a student's fitness for medical study. In the medical profession perhaps more than in any other, there are factors other than scholastic ability that play an important role. To select, therefore, students who combine with scholastic ability these other qualities that are so essential must be our aim. And it must not be forgotten that the field is not limited to practice alone; ability for teaching and research are of the highest importance.

Whether or not by limiting the first-year class to a relatively small number, we shall be able to choose the best remains to be seen. There are some who feel that it would be an aid in picking those best qualified for a medical career to admit 90 or 100 students to the first-year class while still limiting the subsequent classes to 60 students; it being understood that only 60 of the best qualified first-year students would be advanced to the second year. During the first year of the medical course the Faculty would have an opportunity to judge of a student's fitness for a medical career. The Ithaca Division could, with but slight additions to the present equipment and staff, give adequate instruction to 40 or 50 students.

ADMISSION OF STUDENTS WITHOUT THE ARTS DEGREE

The Cornell University Medical College has admitted three classes of students, (1) graduates, (2) seniors in approved colleges, (3) persons who give evidence of equivalent training.

Only seniors and graduates have been admitted to the Ithaca Division and but one student of the other class in New York City. The necessity for limitation of numbers has raised the question as to whether it might not be desirable to discontinue the admission of seniors and in the future admit to the Medical College only graduates of approved colleges.

On comparing the standings of the students who were admitted as seniors with those of the students who had finished their college course before admission, it was found that on the whole the records made by the seniors were fully as satisfactory as those made by the graduates.

It was found also that the majority of the seniors were students in the College of Arts and Sciences of Cornell University, there having been 20 such students in 1918-1919 and 21 in 1919–1920, while there were but five students in 1918-1919 and four students in 1919-1920 who were already graduates of Cornell University, and there were six students in 1918-1919 and 12 in 1919-1920 who were graduates

from institutions other than Cornell. The senior students from Cornell have proved to be a most desirable class and are welcome additions to the Medical College.

It is no doubt true that some of the seniors are attracted to the College of Arts and Sciences because of the possibility of combining their Arts and Medical work and thus completing the combined course in seven rather than eight years. In most cases this shortening of the course by one year is very desirable.

The majority of the medical colleges of the country require only two years of college work for admission. The Cornell Faculty believes that this is too short a time and that three years of college work are the least amount of time in which a student can adequately prepare for the medical course.

The age at which medical students complete their course and hospital and begin their life work has been steadily increasing for some time. It is clear that the medical course cannot be shortened and it does not seem wise for us to decrease the Arts training to less than three years. If students then are to start their medical practice earlier the solution must be found in a school system which will make it possible for a student to enter college at a younger age.

While the Faculty has limited the number of students to not more than five from any one outside college, students from the other colleges of Cornell University who fulfill the requirements, are especially welcome, since they come from various parts of the country and bring to the Medical College in New York City the spirit and traditions of Cornell University thus helping to cement more firmly the Medical College in New York City to the University at Ithaca. These students are the majority of them seniors and some of them at least would not come to or continue in Cornell if the combined seven-year privilege were abolished. As the Medical College is an integral part of the University, everything which helps to bridge the geographic separation is to be encouraged.

After a careful consideration of the above and other points by a committee composed of members of both the New York and Ithaca Faculties, it was decided to continue accepting seniors.

CHANGES IN THE ENTRANCE REQUIREMENTS

No especial changes have been made in the requirements for admission for some years. To bring our requirements in Chemistry into conformity with the recommendations of the Association of American Medical Colleges, the Council on Medical Education of the American Medical Association, and the present requirements of the Education Department in this state, the Organic Chemistry which has heretofore been given in the first year is now required for admission. This will be an addition of at least thirty-six hours of lecture or recitation and eighty actual hours of laboratory work. The time formerly devoted to Organic Chemistry in the medical course will be given to those special phases of organic and physical chemistry most important for the subsequent work of the medical student. This will bridge the gap between organic chemistry and the biochemistry of the medical

course.

ADMISSION OF WOMEN TO THE FIRST YEAR IN NEW YORK

Women have heretofore been required to take the first year of their medical work at Ithaca.

The question of their admission to the first-year class in New

York City has been before the Faculty repeatedly for consiueration. The Ithaca Faculty indicated its willingness some years ago to concur in any action the New York Faculty desired to take in this matter, and this year the New York Faculty voted to admit women to the first-year class in New York City.

CO-ORDINATION OF WORK IN ITHACA AND NEW YORK CITY

In order that the work of the two divisions of the College should be properly correlated, the Secretary of the Ithaca Division of the Medical College, in addition to the President, attends regularly the meetings of the Faculty of the Medical College in New York City. In addition to this, Dean Niles has made one visit to Ithaca this year to confer with the members of the Faculty here and the Professor of Chemistry, Dr. Stanley Benedict, also came to the University for a conference in regard to the courses in chemistry. The Professor of Physiology, Dr. Sutherland Simpson, and the Professor of Histology and Embryology, Dr. Benjamin F. Kingsbury, made one trip to New York City to attend a committee meeting there and to be present at the meeting of the Faculty. These conferences between members of the two Faculties are mutually helpful both in promoting closer union of the two divisions of the College and in helping in a better co-ordination of the teaching work. More frequent conferences of this kind are desirable.

ANATOMY

The Department of Anatomy has consisted of one professor, one half-time instructor for neurology, three assistants, and a half-time assistant. The laboratory was open during the first term from 8 A. M. to 5 P. M. every week day except Saturday when it closed at I P. M. In addition to the 37 medical students, instruction in anatomical methods was given to 43 Arts students. During the first term a lecture demonstration course was given to Arts and Agricultural students on elementary human anatomy.

The work on the anatomy of the nervous system was given most admirably under the direction of Instructor Stewart who also had charge of the work on the histology and embryology of the nervous system. A part of the neurological collection assembled by Emeritus Professor Burt G. Wilder was transferred from the Department of Zoology to the Department of Anatomy. It is planned that the remainder of the collection be transferred in the near future, as authorized by the trustees. It is desirable that this collection should be kept together, and should be properly cared for and extensively used. It seemed probable that this would be accomplished best in Stimson Hall where courses are now given in the anatomy, in the histology, in the embryology, and in the physiology of the nervous system. Instructor Stewart is leaving at the end of this term to continue his medical studies in Paris under one of the fellowships recently established for American students in France. It is desirable that as soon as possible some other member of the staff of the Medical College should be devoting much of his time to neurology, and ultimately there should be a Professor of Neurology, as there is in a number of other first-class medical colleges.

The instructor and assistants have been most efficient and industrious and have given to the work of instruction far more time than was required of them. They have rendered a valuable service to the Department.

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