Association of American Medical Colleges MINUTES OF THE PROCEEDINGS Sixty-Sixth Annual Meeting October 24·25·26, 1955 SWAMPSCOTT, MASSACHUSETTS a o <.l:1 DECEMBER 1955. VOL. 30, NO. 12 Office of the Secretary 185 N. Wabash Ave. Chicago I, liIinois 707
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Association of American Medical Colleges
MINUTES
OF THE PROCEEDINGS
Sixty-Sixth Annual Meeting
October 24·25·26, 1955
SWAMPSCOTT, MASSACHUSETTS
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DECEMBER 1955. VOL. 30, NO. 12
Office of the Secretary185 N. Wabash Ave.
Chicago I, liIinois
707
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OFFICERS OF THE ASSOCIATION
1955·56
Officers and Members of the Executive Council
President and Council Chairman: ROBERT A. MOORE University of Pittsburghpresident-Elect: JOHN B. yOuMANs . ..._Vanderbilt University
School of MedicineVice President: HAROLD S. DIEHL_. University of Minnesota Medical SchoolTreasurer: STOCKTON KIMBALL ..__University of Buffalo School of MedicineImmediate Past President: VERNON W. LIPPARD .__... ...-. yale University
School of MedicineSecretary: DEAN F. SMILEY 185 N. Wabash Ave., Chicago 1, Ill.
Executive Council, 1958: JOHN F. SHEEHAN_. .... .8tritch School of Medicineof Loyola University
Executive Council, 1958: JOHN Z. BOWERS__.. ._.. ...University of WisconsinMedical School
Executive Council, 1957: LOWELL T. COGGESHALL University of Chicago
Executive Council, 1957: THOMAS H. HUNTER.. ... University of VirginiaSchool of Medicine
Executive Council, 1956: GEORGE N. AAGAARD ..__University of WashingtonSchool of Medicine
Executive Council, 1956: WALTER R. BERRYHILL University of North CarolinaSchool of Medicine
Staff
DEAN F. SMILEY. . . . ..__Secretary; Editor, Medical EducationJ. EDWIN FOSTER . .. . Director, Medical Audio-Visual InstituteHELEN H. GEE .. . . . . . ..Director of ResearchWILLIAM N. HUBBARD JR. . . . . ..__Associate Secretary
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MONDAY, OCTOBER 24. 1955
October 24-25-26, 1955
New Ocean House, Swampscott, Mass.
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Sixty-Sixth Annual MeetingAssociation of American Medical Colleges
(President Vernon W. Lippard presiding)
Introduction of New Deans. . .
Presidential Address-Vernon W. Lippard
Naming of Nominating Committee .
Presentation of the Borden Award in the Medical Sciences... .....
Highlights of the Institute on the Teaching of Anatomy and Anthropology.
TUESDAY, OCTOBER 25. 1955
(President Vernon W. Lippard presiding)
Business Meeting of the Association
Roll CalL .
Approval of Minutes of the 65th Annual Meeting....
Report of the Chairman of the Executive Council-Vernon W. Lippard
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Report of the Secretary and Editor-Dean F. Smiley .
Report of the Treasurer-John B. youmans .
Report of the Director of the Medical Audio-Visual Institute-J. Edwin Foster.. .'
Reports and Recommendations of Committees
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Audiovisual Education-Wolfer A. Bloedorn....
Continuation Education-Norman B. Nelson .....
Editorial Board-John Z. Bowers _ .
Financing Medical Education-Joseph C. Hinsey...
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Internationol Relations in Medical Education-Richard H. Young
Internships and Residencies-Currier McEwen
Planning for National Emergency (MEND I-Stanley Olson
Licensure Problems-Charles A. Doan
Medical Care Plans-Dean A. Clark
Public Information-John L. Caughey _
Teaching Institutes and Special Studies-George Pader Berry
Veterans Administration-Medical School Relationships-Jaseph M. Hayman Jr.
Election of Officers
Presentation of Resolutions
Time and Place of 67th Annual Meeting_
Time and Place of 1957 Teaching Institute
Reports on Experiments in Medical EducaHon_
WEDNESDAY, OCTOBER 26, 1955
Symposium on Compensation of Faculties of Full-Time Departments
Instollation of Officers
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INTRODUCTION OF NEW DEANS
The following new deans were introduced:
Robert C. Berson, Medical College ofAlabama; F. Douglas Lawrason, University of Arkansas School of Medicine;Chester Scott Keefer, dean and director,Boston University School of Medicine;Harold A. Taggert (acting dean), Hahnemann Medical College; Robert S. Jason,Howard University College of Medicine;William S. Stone, University of Maryland School of Medicine; Donal Sheehan, New York Universlty (both collegeof medicine and postgraduate medicalschool); A. J. Gill, Southwestern Medical School; Howard W. Potter, StateUniversity of New York College of Medicine (N.Y.); Philip B. Price, (actingdean) University of Utah College ofMedicine; Oliver H. Lowry, WashingtonUniversity School of Medicine; and JohnZ. Bowers, University of Wisconsin Medical School.
NOMINATING COMMITTEE
The Nominating Committee wasnamed by President Vernon W. Lippardas follows: Granville A. Bennett, chairman; Donald G. Anderson; D. BaileyCalvin; Joseph M. Hayman; Richard H.Young; and James P. Tollman.
INSTITUTE HIGHLIGHTS
Reflections from the 1955 TeachingInstitute on Anatomy and Anthropologywere presented. Speakers and their subjects were:
George Packer Berry, dean of theHarvard Medical School and chairmanof the Committee on Teaching Institutesand Special Studies-The Association'sProgram of Teaching Institutes.
William U. Gardner, professor of anatomy, Yale University School of Medicine, and chairman of the 1955 Teaching Institute Planning CommitteePlanning the Anatomy and Anthropology Teaching Institute.
Normand L. Hoerr, professor of anatomy, Western Reserve University Schoolof Medicine-The Role of Anatomy in
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Medical Education.Arnold Lazarow, professor of anat
omy, University of Minnesota MedicalSchool-The Influences of Advances inMedical Science on Anatomical Teaching.
Gabriel Lasker, assistant professor ofanatomy, Wayne University College ofMedicine-Anthropology in Medical Education.
Sam L. Clark, professor of anatomy,Vanderbilt University School of Medicine-The Recruitment and Training ofTeachers of Anatomy.
OPEN HEARINGS ON ANNUALREPORTS OF COMMITTEES
1. Audiovisual Education-Walter A.Bloedorn, chairman; William J. Darby;Clarence E. de la Chapelle; William W.Frye; Theodore R. Van Dellen; W. ClarkWescoe; Tom Jones (consultant).
2. Continuation Education-NormanB. Nelson. chairman; Robert Boggs;Robert Howard; Samuel Proger; FrankRoberts; Thomas Sternberg; Grant Taylor; Douglas Vollan.
3. Editorial Board-John Z. Bowers,chairman; William B. Bean; Stanley E.Bradley; Alan Chesney; James M. Faulkner; Russell L. Holman; Chauncey D.Leake; Dean F. Smiley.
4. Financing Medical EducationJoseph C. Hinsey, chairman; Walter A.Bloedorn; Donald G. Anderson; RobertA. Moore; Norman Topping; John B.Youmans.
5. International Relations in MedicalEducation-Richard H. Young; FrancisScott Smyth; Coy C. Carpenter; E. GreyDimond; Maxwell E. Lapham; ElizabethT. Lam; Harold H. Loucks; Myron Wegman.
6. Internships, Residencies and Graduate Medical Education-Currier McEwen, chairman; Howard Armstrong;D. W. E. Baird; John Deitrick; ClarenceE. de la Chapelle; E. Hugh Luckey;Richard W. Vilter; George A. Wolf Jr.
7. Licensure Problems-Charles A.Doan; Charles L. Brown; Gordon E.Goodhart; John Hirschboeck; J. MurrayKinsman; Arthur W. Wright.
8. Medical Care Plans-Dean A. Clark,
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chairman; Frank R. Bradley; R. H.Kampmeier; Henry B. Mulholland; JohnF. Sheehan; Albert W. Snoke; MaxwellM. Wintrobe.
9. Planning for National EmergencyStanley W. Olson, chairman; Mark R.Everett; Thomas R. Forbes; StocktonKimball; John B. Truslow.
10. Public Information-John L.Caughey, chairman; Francis M. Forster;John D. Van Nuys; Harold C. Wiggers;Joseph B. Kelly; MIlton Murray; RalphRohweder (consultant); Raymond O.Torr (consultant); William N. HubbardJr.
11. Teaching Institutes and SpecialStudies-George Packer Berry, chairman; Philip Bard; D. Bailey Calvin;Thomas H. Hunter; Carlyle Jacobsen;Robert A. Moore; Robert Murray; Vernon W. Lippard; W. Clarke Wescoe;William R. Willard.
12. Veterans Administration-JosephHayman, chairman; George A. Bennett;Robert Berson; Gordon H. Scott; Francis R. Manlove.
ROLL CALL
All institutional members were represented except the University of California (S.F.), the University of NorthDakota, and Louisiana State University.
APPROVAL OF MINUTESOF 65TH ANNUAL MEETING
The minutes of the 65th Annual Meetting, October 18-20, 1954, at FrenchLick, Ind, were approved as published.
INDIVIDUAL MEMBERS
The Association voted in 376 newIndividual Members, and the first Sustaining Member, W. B. Saunders Co.The total individual membership in theAssociation is now 1465.
REPORT OF CHAIRMANOF EXECUTIVE COUNCIL
VERNON W. LIPPARD, chairman:ACTIONS TAKEN AT EXECUTIVE
COUNCIL MEETING OCTOBER 19,1954:
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BORDEN AWARD
The 1955 Borden Award in the Medical Sciences was presented to CharlesB. Huggins, director of the Ben MayLaboratory for Cancer Research. Theaward, consisting of $1,000 and a goldmedal, was presented by John H. McCain, of the Borden Company Foundation. Dr. Joseph Markee, of Duke University, made the nominating address.
Dr. Huggins award was based on hisoutstanding contribution in the field ofcancer research, partiCUlarly that portion of the field which deals with therelationships between the endocrineglands and cancer. It was Dr. Hugginswho first demonstrated that deprivationof the male hormone by castrationcurbed the activity of prostatic cancerand its metastases. He extended his workto show that by bilateral adrenalectomycertain tumors of the mammary glandwill be likewise halted in their furthergrowth. In recent work he has been ableto identify by examination of theirbasic cellular composition which of thevarious tumors will respond to thisnew type of treatment.
1. The Council elected Vernon W.Lippard chairman and appointed anadministrative committee to act for theCouncil between regular Council meetings. This committee was to consist ofVernon W. Lippard, Robert A. Mooreand Stanley E. Dorst.
2. A resolution recording the Association's appreciation and thanks for support received was passed and the Secretary was instructed to convey it toofficers of the John and Mary R. MarkleFoundation, the China Medical Board ofNew York, the National Heart Institute,the National Cancer Institute and theCommonwealth Fund.
3. Appointments to the Association'sstanding committees were made and theSecretary was instructed to inform theappointees.
Incorporation of Association:A mail vote of the Institutional Mem
bers in the Fall of 1954 showed that 76were in favor of incorporation, two weretentatively in favor, one did not re-
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spond, one was consulting legal adviceand one reserved vote for the meetingof Institutional Members.
The Articles of Incorporation werefiled in the office of the Secretary ofState of Illinois on January 20, 1955.
ACTIONS TAKEN AT THE FIRSTMEETING OF THE BOARD OF DIRECTORS (EXECUTIVE COUNCIL)OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES, INC., FEBRUARY 4, 1955.
1. A form of By-Laws was presentedand adopted.
2. A statement of "Procedures Approved by the Executive Council" waspresented and adopted.
3. The necessary bank resolutionswith respect to the designation andauthorization of depositaries of the Association's funds were duly adopted.
4. A form of seal for the Associationwas presented and adopted.
5. Joseph C. Hinsey reported that:(a) A building site on the southwest
corner of Ridge Ave. and Central St., Evanston, Ill. has beendeeded to the Association byNorthwestern University.
(b) The Sloan Foundation hadpledged the Association $75,000toward the construction of ahome office building.
(c) The China Medical Board ofNew York had given Northwestern University $125,000which is to be used for thebuilding of a national headquarters for the Association.
6. A resolution was adopted expressing the Association's appreciation forDr. Hinsey's laborious and perseveringefforts in obtaining the necessary grantsfor the new building.
ACTIONS TAKEN AT SPECIALMEETING OF REPRESENTATIVES OFINSTITUTIONAL MEMBERS-FEBRUARy 7, 1955:
1. President Lippard reported the results of the mail vote as overwhelminglyin favor of incorporation of the Association.
2. The group unanimously voted toadopt the By-Laws as presented andapproved by the Executive Council.
3. The President was authorized toappoint an ad hoc committee consistingof Stanley Dorst, George A. Bennett,Walter A. Bloedorn and John M. Stal-
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naker to review the By-Laws andrecommend possible changes whichcould be offered to the membership foraction at the regular annual meeting inOctober 1955.
4. A resolution was passed disapproving extension of the Doctor Draft Lawin the conviction that the effectivenessof the medical schools and their affiliatedteaching hospitals was being diminishectmore and more by the eroding effect ofthe present operation of that law.
ACTIONS TAKEN AT EXECUTIVECOUNCIL MEETING HELD JUNE 23,24, 1955:
1. A Building Committee consisting ofJoseph Hinsey, Lowell Coggeshall andDean Smiley was named.
2. A budget of $347,800 was approvedfor July 1, 1955 through June 30, 1956.
3. The Council voted to recommendto the Association that it approve:
(a) Increase of Institutional Membership dues from $500 to $1000a year.
The Association, at this point, votedapproval of this recommendation.
(b) Increase of Affiliate InstitutionalMembership dues from $125 to$250 a year.
The Association. at this point, votedapproval of this recommendation.
(c) It was unanimously recommended that the University of Montreal Faculty of Medicine be voted into Affiliate InstitutionalMembership.
The Association, at this point, votedapproval of this recommendation.
(d) Minor revisions of the By-Lawsin accordance with the recommendations of the ad hoc committee.
(Section 1. (e) Strike out "Any member not conforming to the articles ofIncorporation, By-Laws, or standards ofadmission and curriculum, as they maybe changed from time to time, shall besubJect to such discipline or penalty asthe Association may deem fit and properor may be dropped from membership."
Substitute "All members shall conform to the Articles of Incorporation,By-Laws and standards of admissionand curriculum, as they may be changedfrom time to time."
Section 6. (£) Strike out the word"fifth" and substitute the word "tenth"so that the paragraph will read "Meetings of the Council may be called by the
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Minutes of the 66th Annual Meeting
President or any two voting Councilmembers, and written notice thereof,unless waived, shall be mailed to eachCouncil member at his home or usualbusiness address not later than the tenthbusiness day before the meeting.")The Association, at this point, voted approval of this recommendation.
4. The council voted reduction of thenumber of free subscriptions to theJournal of MEDICAL EDUCATIONprovided by virtue of Institutional Membership from 50 to a maximum of 25per school.
5. The Council approved a Conferenceon Education of Physicians in Industry.Joseph Hinsey and Stanley Dorst wereappointed AAMC representatives to thccommittee planning the conference.
6. Approval was given to the idea ofthe Association sponsoring a conferenceof Visiting Fulbright Scholars in MedIcal and Allied Fields just previous tothe 1956 Annual Meeting of the Association. The President was authorized toappoint an ad hoc committee to implement this suggestion.
7. The Council went on record assupporting a program for Traineeshipsin Medical Public Information as recommended by the Committee on PublicInformation.
8. Approval was given to the recommpndation of the Committee on Teaching Institutes and Special Studies that:
(a) The Teaching Institute originallyplanned to discuss medical ecology be abandoned in view ofthe coverage provided this subject in the first three Institutes.
(b) The fourth Teaching Institute, onClinical Teaching Including theInternship, be held in October1957 thus permitting two yearspreparation.
ACTION TAKEN AT EXECUTIVECOUNCIL MEETING OCT. 19, 20, 21,22, 1955:
1. The Council accepted an invitationfrom the AMA to appoint representatives to work with an AMA committeeto suggest a program for the SecondWorld Conference on Medical Educationto be held in the U.S., probably in 1959.
2. The Secretary was instructed toadvise Dean R. Hugh Wood, in answer tohis question, that the Association has noregulation, written or unwritten, "Thata student who is dropped from one medical school will not be accepted by an-
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other until the first school states thatit would itself be willing to readmit thatstudent." It is the feeling of the Councilthat the decision in such a case must bethe responsibility of the individualschool.
3. A schedule of visitation to 13 medical schools was approved for 1955-56.
4. A committee consistmg of John Z.Bowers, chairman, Robert Moore, Richard Young and William Willard wasappointed to meet with Dr. M. H. Trytton of the National Research Council toexplore the possibility that the Association sponsor a Conference of VisitingFulbright Scholars in the medical fieldin 1956.
REPORT OF THE SECRETARYAND EDITOR-1954-55
DEAN F. SMILEY, chairman:The past year has been an eventful
one for the Association. The ambitiousvisitation program including 19 schoolswas successfully completed and thewritten reports of the last two visitshave only recently been mailed. This isa matter of real satisfaction because itmarks the end of the backlog of postponed visitations occasioned by WorldWar II and means that henceforth,barring another war or catastrophe, amore leisurely school visitation programwill be possible and still each schoolwill be visited at least every 10 years.One school has already been visited onthe '55-'56 schedule. Twelve others arescheduled. It is a pleasure to reportthat almost everywhere in our visits wefind experimentation, change and progress in the curriculum, greatly increasedrecognition and appreciation of the artof teaching, and greatly improved correlation with subsequent lowering of thewalls between separate departments.Frequent references to the reports ofthe Teaching Institutes and the Objectives of Undergraduate Medical Education are evidence that these publications are being read and thought about.Laboratory exercises that have beenused without question for many yearsare being critically reviewed and not afew of them are being abandoned orconsiderably modified. Medical education is definitely in flux.
A number of staff changes have takenplace during the year. Most important
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among these was the loss of our Directorof Studies, John M. Stalnaker. As ofSeptember 1 he assumed the presidencyof the National Merit Scholarship Corporation with headquarters at Evanston,Ill. Going with Mr. Stalnaker to thenewly founded corporation were EdwardSmith and Mrs. Helen Morford. Dr.Roscoe Dykman, our Assistant Director of Studies, resigned as of September1 to accept an associate professorship inthe University of Arkansas School ofMedicine. Replacements include Dr.Helen Gee as Director of Research, JoanMcJoynt as Director of Operations ofthe National Intern Matching Program,Inc. and Helen McBride as Administrative Assistant to the Committee onTeaching Institutes & Special Studies.Dr. William Hubbard w111 continue another year to serve as part time Associate Secretary for the Association.
Progress toward the new central officebuilding has taken place slowly. Achange in the zoning laws permittingconstruction of our building at RidgeAve. and Central St., Evanston, Ill. wasfinally voted early m August and detailed plans for the building are nowbeing drawn by Holabird & Root &Burgee. It is expected that we will bemoving into the new buildmg early in1957.
Individual Membership growth hasbeen somewhat disappointing this year.Whl1e 376 new Individual Membershipswere procured, 174 individuals allowedtheir memberships to lapse. Thus though1,263 were voted into Individual Membership last October and 376 were votedin at thiS meeting, the total stands atonly 1,465.
It is a pleasure to announce our firstSustaining Membership, this honor goingto the W. B. Saunders Comany.
Our Institutional Membership nowstands at 81, our Affiliate InstitutionalMembership at 12. There are four potential Institutional Members in development-Miami, Einstein, Florida andSeton Hall, and there is one more potential Affiliate Institutional Member,Laval.
In the course of the year 17 questionnaires were submitted to the centraloffice for advice. In eight of these,cooperation was advised, in nine rejection was advised. In most instancesof rejection it was because information
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on the subject was already available.It may be of interest that the Association's questionnaire file now includesrecords of 117 different questionnairesthat have been directed to the medicalschools since November 28, 1949.
The interest of foreign physicians incoming to the U. S. for advanced training in medicine continues unabated.During the past year 135 foreign medicalgraduates made inquiry of our officeabout advanced training and receivedbooklets either from our office or theCouncil on Medical Education and Hospitals of the American Medical ASSOCiation. In the few instances in which theforeign physician wished training inorder to return to his own country toteach, the inquiry was referred to ourCommittee on International RelatIOns inMedical Education. It should be pointedout that Dr. Francis Scott Smyth, aftermany years of service as chairman ofthe Committee on International Relations in Medical Education, has felt compelled to resign that post. The interimappointee as chairman is Dr. RichardYoung of Northwestern University. Dr.Smyth will, however, contmue to serveas a member of the Committee.
The Journal of MEDICAL EDUCATION has enjoyed an espeCially goodyear of growth. Due to the energeticefforts of our Editorial Board steadilyincreasing numbers of solicited articlesare coming in. With a backlog of over50 articles already approved by theBoard the publication schedule has beenspeeded up to include approximatelysix articles in each issue. This has beendone with some loss to the news, audiovisual and book review sections. Weapologize for the number of college newsitems we just do not have the space toprint and hope that we can increase ouradvertising pages sufficiently to makefeasible the addition of another 4 pagesfor news and related sections. A greatdeal of effort has gone this last yearinto checking and rectifying our list ofsubscribers and the average figure forthe last 10 months is 6,848. With monthlypublication, a 72-page format, and theusual supplements, it is easy to see whywe have been forced to ask you to votea reduction in the number of free subscriptions from 50 to 25 per InstitutionalMember. Efforts to increase our circulation have been to date more successfulthan efforts to increase our advertising
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We have examined the statement of financial condition of the Associationof American Medical Colleges as at June 30, 1955 and the related statements ofcurrent receipts, disbursements, and balances for the fiscal year then ended. Ourexamination was made in accordance with generally accepted auditing standardsand accordingly included such tests of the accounting records and such otherauditing procedures as we considered neces~ary in the circumstances.
On January 20, 1955 the Association of American Medical Colleges,(then not incorporated,) was incorporated under the Illinois General Not For ProfitCorporation Act. Since the Association has continued under the same governingpolicies, and accounting records, the results for the entire fiscal year from July 1,1954 to June 30, 1955 are shown in Exhibt B.
In our opinion, the accompanying statement of financial conditionand the statements of receipts, disbursements, and balances present fairly thefinancial position of the Association of American Medical Colleges as at June 30, 1955and the results of its operations for the period from July 1, 1954 to June 30, 1955in conformity with generally accepted accounting principles.
Very truly yours,
Horwath & Horwath
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pages. It is our hope, however, that advertising promotion efforts currentlybeing made will begin to payoff in thecoming year.
The distribution of our publicationshas been at an all time high. In the pastyear we have sold over 20,000 of ourleaflet "Objectives of UndergraduateMedical Education," over 7,400 of ourbooklet "Admission Requirements ofAmerican Medical Colleges," over 3,000of our "Directory." We also sold over10,000 copies of the Public Affairs Pamphlet "The Challenge to Medical Education." The demand for the reports ofour first two Teaching Institutes has notbeen large and we are hoping to be ableto provide each new Individual Member coming in during 1955-56 withcopies of these reports without cost.
I cannot close this report withoutexpressing the appreciation of the central office staff for the fine cooperationyou and your institutions have given usthis past year in meeting our requestsfor needed information and help. Particularly appreciated are the reportsreturned to us just previous to a schoolvisitation. They are laborious and time-
Association of American Medical Colleges185 North Wabash AvenueChicago 1, Illinois
Gentlemen:
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consuming and must try your patience.May I point out though how important itis that these detailed reports be available in our offices when inquiries occurfrom secretaries of State Boards of Medical Examiners who depend upon ourAssociation and the Council on MedicalEducation and Hospitals almost implicitly for evaluation of our medical schools?The Association exists to serve andpromote medical education. If there areadditional ways in which the centraloffice can serve you, please do nothesitate to call upon us.
REPORT OF THE TREASURER
JOHN B. YOUMANS, treasurer:As of June 30th, the close of the fiscal
year of the Association, the financialstatus was as follows:
General income for the year, includinggifts and grants assigned to the generaloperation of the Association, but excluding special restricted grants, totaled$190,637.05 compared with $220,713.22the previous year. The difference is inthe amount of unrestricted gifts the previous year.
DisbursementsSalariesAnnuities .Payroll taxesContracted services and equipmentOffice supplies, telephene and postageRent and house expensesFurniture and equipmentTravelingAnnual meetingInsurance .PublicationsAdvertising and circulation promotionMailing and engraving
Balances-July 1, 1954 ...••
ReceiptsMembership dues-institutional-Schedule B-1.Membership dues-individualInterest on investmentsPublications . .Subscriptians .Advertising . .Film sales and rentalsEducational Testing Service, Inc.China Medical Board .John and Mary R. Markle Faundation .Alfred P. Sloan FoundationThe Cammonwealth Fund •Abboll Laboratories . .Pfizer Laboratories •Notional Heart InstituteOverhead on projectsOther •••...
Total receiptsOther additions
Budget allotment traasfers .Transfers from other funds
Totals brought forward .Committee on internships and residenciesSpecial projects-foreign subscriptionsLegal feesInterest tests . . . . .Restricted funds • . . .Film costs and expenses.
Total disbursements and transfers
Balances-June 30, 1955 •
Total disbursementsOther deductions
Budget allotment transfersTransfers to other funds .
Excess or (deficiency) 01 receipts over disbursements for fiscal yearended June 30, 1955
Transfers of unexpended balances to general fund.
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Disbursements for general operationstotaled $269,999.70 resulting in a difference of $79,362.65 which was met bygrants and gifts, leaving a net operatingbalance of $32,454.38 which was addedto the general fund.
The general fund totaled $185,507.75compared with $153,053.37 the previousyear.
Receipts for special restricted projectsand for the building fund totaled $357,562.97.
The balance sheet revealed total assets, including restricted funds and especially the building fund, of $542,956.51compared with $320,173.48 the year before, the greatest part of the increasebeing in the building fund.
Budgets for the current fiscal yearincluding the Journal of Medical Educa~tion, Special Studies and the MedicalAudio-Visual Institute total $300300 ofwhich $108,000 is to be provided by giftsand grants and $192,300 from basic income.
The report of the auditors, Horwathand Horwath, gives the details of thefinances.
I wish again to thank the staff and allthe others who have assisted me in discharging my duties as treasurer.
REPORT OF THE DIRECTOR OF THEMEDICAL AUDIO·VISUAL INSTITUTE
J. EDWIN FOSTER:
The program and activities of theMedical Audio-Visual Institute are theconcern of the Committee on Audiovisual Education. The Committee hasdirected emphasis to the problems ofutilization and distribution as they relate or contribute to the better use ofaudiovisual materials. This report seeksto indicate how the Medical AudioVisual Institute has interpreted andexecuted this directive during the pastyear. Further, this report should beconsidered as supplementing that of thechairman of the Committee on Audiovisual Education.
Last year the Committee recommended a basic film library operatedon a self-supporting basis by means ofa realistic service charge. Pfizer Laboratories, a division of Chas. Pfizer & Co.,has come forward with a sum of $10 000to initiate the library. Film purcha~ingand renting has begun and last month
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the first film catalog of the Associationof American Medical Colleges was published.
The Medical Audio-Visual Institutehas for the past three years made certain AV materials available to theschools in much the manner of a university press. We have assisted indiViduals or departments in completingcertain films and had them publishedfor use by the medical colleges on arental or sale basis. During the pastfiscal year the MAVI spent $7,154 forthis purpose. During the same period150 prints of these films were sold and119 rentals made. The income fromthese sales and rentals was $7,768. Thisexperience will assist a great deal inoperating the medical college film library.
The Audio-Visual Preview Circuitsfor Medical Colleges were continued thisyear. Sixty colleges participated. Eachschool received eight programs and fulladvance information relative to the material and where it could be procuredfor later use if desired. A total of 3,394faculty previewers were reported anda total of 10,902 student viewers werereported.
Abbott Laboratories of North Chicagois giving financial assistance to theeditmg and narrating of short filmsusing the research footage held by Dr.C. M. Pomerat of the Tissue CultureLaboratory at the University of Texas-Medical Branch. The purpose is tomake a minimum of five films showingthe living anatomy and function of tissue cells, to be used as a teaching supplement to the gross specimen and thestained section. It is too early to givea concrete progress report but Abbotthas granted $30,000 over a three-yearperiod. During the first half year $2,000has been spent to classify existing footage. The first film is expected in February.
The present staff of the MedicalAudio-Visual Institute includes two people, the director and a competent secretary-librarian-accountant-cataloger, Audrey Skaife. A large portion of staff timeis spent in answering inquiries andmaintaining files in preparation for inquiries.
During the year the director visited31 medical colleges. These visits werescheduled but in most cases were in-
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formal and with the purpose of learningAV problems and helping to solve them.
In August 1954 the Medical AudioVisual Institute sponsored a Conferenceof Midwestern Medical School AV Coordinators. On April 18 of this year asimilar conference was held in LosAngeles with participants from theschools west of Denver, with the purpose of solving common medical schoolproblems of getting and using suitableAV teaching materials.
The Medical Audio-Visual Instituteis an active participant in the AudioVisual Conference of Medical andAllied Sciences. This conference hasrepresentation from 15 national associations having AV responsibilities in theUnited States and Canada. The thirdannual conference was held in Chicagoin July at the time of the National Audio-Visual Trade Show and Convention.The purpose of the conference is toexchange information and to workjointly on AV problems which are common to all the professional groups usingteaching materials.
Assistance was given to the 1954 and1955 Teaching Institute Committeeswherever service could be rendered.
The Journal of Medical Educationcontinues to provide space for Audio-
REPORT OF THE COMMITTEE ONAUDIOVISUAL EDUCATION
WALTER A. BLOEDORN, chairman:
The program and activities of the Medical Audio-Visual Institute are the concern of the Committee on AudiovisualEducation. The Committee has directedemphasis to the problems of utilizationand distribution as they relate or contribute to the better use of audiovisualmaterials. The major services providedto the medical schools throughout theyear reaffirm this emphasis. The following report has been prepared under thedirection of the chairman by the director of the Medical Audio-Visual Institute.
Film Library for Medical Colleges:Last year the Committee recommendeda basic medical teaching film library
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visual News. This section is devoted tonew AV materials, equipment and techniques.
Considerable time has been devotedto the problems of the teaching or learning environment. A committee member,Tom Jones, has participated in a number of informal planning conferences.It is hoped that a brochure can be published covering the design of medicalschool classrooms, laboratories and corridors for the effective use of teachingmaterials. Dr. D. B. Harmon, a wellknown consultant on the learning environment has been very helpful, and,further, he has proposed to manufacturers of materials and equipment thatthey supply these materials and equipment for a prototype teaching area forexperimental use in one of the medicalschools. This they have informally accepted. This classroom or teaching areawould be built and equipped for thefacile use of all materials and methods.Building materials and equipment wouldbe supplied by the manufacturers withinstallation costs borne by the school.
Finance: The Medical Audio-VisualInstitute has operated on a budget of$18,000, exclusive of the film operationsand the grants from Abbott and Pfizerreported above.
operated by the Association for the medical colleges and financed on a selfsupporting basis by means of realisticservice charges. Pfizer Laboratories, adivision of Chas. Pfizer and Co., hascome forward with a sum of $10,000to initiate the library. Over 40 filmshave been added to date and the firstcatalog has been printed.
Preview Circuits for Medical Colleges:The preview circuits were continued.
This provided the medical colleges witha means whereby they saw new materials and received full information asto where these materials might be borrowed or purchased if suitable for usein the curriculum.
Conferences: The Medical AudioVisual Institute sponsored a Conferenceof Western Medical School AV Coordinators in Los Angeles on April 18, with
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the purpose of solving common medicalschool problems of getting and usingsuitable AV teaching materials.
The Medical Audio-Visual Instituteis an active participant in the AudioVisual Conference of Medical and AlliedSciences. This conference has representation from 15 national associations having AV responsibilities in the UnitedStates and Canada. The Third AnnualConference was held in Chicago onJuly 26.
Assistance was given to the 1954 and1955 Teaching Institute Committeeswherever service could be rendered.
Journal of Medical Education. TheJournal continues to provide space forAudiovisual News. This section is devoted to new AV materials, equipmentand techniques.
Living Tissue Short Films: AbbottLaboratories has given financial assistance for the editing and sounding ofshort films using research footage heldby Dr. C. M. Pomerat of the Tissue Culture Laboratory at the University ofTexas Medical Branch. The purpose isto make four or five short films showingthe living anatomy and function oftissue cells, to be used as a supplement tothe gross specimen and the stained section. The films will be produced overa period of three years using the resources of Dr. Pomerat as available.
Finance: The Medical Audio-VisualInstitute has operated on a budget of$18,000. In addition, $7,768 was receivedfrom film services including rentals andsales; the expense of providing theseservices was $7,154. The special grantsfrom Abbott Laboratories and PfizerLaboratories were reported above. TheCommittee recognizes wlth appreciationthe value of the support received fromthese two houses.
Plans: The Committee recommendsthe continuation of the reported activities as they contribute to easierdistribution and the better use of audiovisual materials, and also as they maystimulate greater employment or usageof such materials.
It is intended that a brochure will bepublished covering the design of medical school classrooms, laboratories andcorridors for the effective use of teaching materials. A committee member,Professor Jones, has participated in anumber of informal planning conferences. Dr. D. B. Harmon, a well-known
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consultant on the learning environmenthas been very helpful and as an outgrowth of these discussions, consideration is being given to the constructionof a prototype teaching area for experimental use in one of the medicalschools. This classroom or teaching areawould be built and equipped for thefacile use of all materials of instruction. Building materials and equipmentwould be supplied by the manufacturers with installation costs borne bythe school.
REPORT OF THE COMMITTEE ONCONTINUATION EDUCATION
NORMAN B. NELSON, chairman:
The Committee on Continuation Education has commended the Academy ofGeneral Practice on their trend to lookto colleges of medicine for guidance intheir educational program, and invitedrepresentatives to attend the annualmeeting of the Association of AmericanMedical Colleges.
The Committee feels that the Association should investigate the increasing entrance of pharmaceutical housesinto the field of medical education. Theimpact of this movement on medicaleducation should be carefully surveyedby the Association.
REPORT OF THE EDITORIAL BOARD
JOHN Z. BOWERS, chairman:
The Journal of MEDICAL EDUCATIONstands as the only journal in the worldexclusively devoted to problems of medical education. The past year has seenreal growth of this position.
The Editorial Board has held twomeetings and has been active in its efforts to continue the development ofthe Journal of Medical Education. TheEditorial Board met in Chicago on Sunday, February 6, 1955, and considereda number of problems.
The Editorial Board has continued toemphasize the solicitation of manuscriptsand feels that this effort is paying off.As of this date, we have at hand enoughfirst class manuscripts to cover eightnumbers of the Journal.
A section on the History of MedicalEducation, which will include profilesof renowned medical educators and ofmedical schools that epitomized broaddevelopments in the field has been 01'-
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ganized by Dr. Erwin H. Ackerknecht.The global development of the Journal
has been implemented by the appointment of correspondents in other countries. They have been requested to submit an annual communication to thechairman of the Editorial Board pointing out significant developments orproblems in their country. A series ofarticles on medical education in Englandis projected; articles on medical education in Japan, India and France are inpress.
Relations between medical schools andtheir parent universities represent animportant problem in the further development and growth of medical education. The Editorial Board is now readyto embark on this phase of its program.
Symposia on "Medical Libraries,""Graduate Medical Education," and"Students" have appeared or will appearin the very near future.
Each medical school has designateda faculty member to serve as correspondent to the Journal of Medical Education. Thus far, the major activities ofthese correspondents have been in relation to the transmittal of news items forthe Journal. It is hoped that correspondents will become increasingly active insoliciting manuscripts for considerationby the Editorial Board.
The Editorial Board would like tohave more critical comments from thesubscribers to the Journal of MedicalEducation. Unquestionably, there arenumerous areas in which we can improve this important publication and itis only by forthright comments f;om oursubscribers that such improvements canbe achieved. We hope that you will always be ready to speak up on issues oractivities which you feel deserve furthercoverage in the Journal of Medical Education.
As of September 1, 1955 the circulation of the Journal was 6,409 made upas follows:
1. Institutional and Affiliate Institutional Membership subscrip-tions 3,586
2. Individual Membership sub-scriptions 1,435
3. Foreign medical schools:(a) Paid by China MedicalBoard 399(b) Paid by individualschool.................................... 88
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4. Libraries (paid by individuallibrary) 119
5. Exchange subscriptions............ 1546. Paid subscriptions other than
libraries, foreign and members...... 3517. Potential advertisers................ 337
6,409
REPORT OF THE COMMITTEE ONFINANCING MEDICAL EDUCATION
JOSEPH C. HINSEY, chairman:
December 4, 1954: Meeting in Washington, D. C. with Sen. Lister Hill, andCharles S. Brewton.
January 8, 1955: Meeting at New YorkHospital-Cornell Medical Center. Drewup a resolution to send to Sen. ListerHill for the writing of S. 1323.
January 14, 1955: Chairman receivedfirst draft of Bill S. 1323.
January 24, 1955: Hinsey and Lippardmet with president and vice presidentof an important foundation to requestthem to bring together a group representing the large voluntary foundations to talk over the possibility of thesefoundations contributing five or 10 percent of their net income to the NationalFund for Medical Education. We wereassured that consideration would begiven to this possibility but as yet ananswer has not been forthcoming. TheJournal of Medical Education carried aneditorial on this subject in its January1954 number.
The following is an excerpt from:Medical Economics, November 1954Vol. 32, No.2.
"$1 Billion for Health: How muchare medical philanthropies collectingthese days? According to the latest figures, health and welfare causes receivedsome 25 per cent of the $4.5 billion donated to charity last year. (The onlycause that did even better was religionwhich garnered 50 per cent of aU con~tributed funds.)
"Following are the top 12 money-getters in the medical field, with receiptslisted for the last calendar or fiscal year:
MillionNational Foundation for Infantile
Paralysis $51.5National Tuberculosis Association 23.9American Cancer Society................ 19.8National Heart Association............ 10.5National Society for Crippled
Children and Adults.................... 7.8
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United Cerebral Palsy.................... 6.4Muscular Dystrophy Associations 4.0Sister Elizabeth Kenny
Foundation . . 3.4National Fund for Medical
Education 2.5Arthritis and Rheumatism
Foundation 1.4Damon Runyon Memorial Fund
for Cancer Research........... 1.2Planned Parenthood Foundation
of America 1.1"January 18, 1955: Hinsey wrote to
Dr. Alan T. Waterman, of NationalScience Foundation, for the Committee,pleading for an increase from eight percent "overhead" on USPHS grants to 15per cent "overhead." This was grantedsome months later.
March 4, 1955: S. 1323 was introducedby Senator Lister Hill and others.
March 9, 1955: Committee meeting inNew York City to plan for hearings onS. 1323.
March 11, 1955: Bill S. 1323 was sentto the dean of each school and certaininformation was requested.
April 20, 1955: A memorandum wassent to each dean giving the results ofthe poll and asking for help from eachschool on support of it. The Senate Bill1323 has a companion House Bill 4743.(Deans received names of the two committees on July 18, 1955).
May 5 and 6, 1955: Hearings were heldbefore the subcommittee on health ofthe Committee on Labor and Public Welfare of United States Senate. (Publishedby U. S. Printing Office.)
May 23, 1955: Memorandum to eachdean reporting on hearings.
June 17, 1955: Hearing on H. B. 4743.Congress recessed without bringing
these bills out of committees. However,they will be brought out during thenext session.
July 13, 1955: Hinsey and Lippard metwith Sloan Colt, Dr. Devereaux Josephs,and Colby Chester to discuss some matters pertaining to the National Fund forMedical Education. The results of thismeeting will be presented at the business meeting of the Association ofAmerican Medical Colleges on October25, 1955.
To summarize, your committee hasbeen concerned with:
1) development of legislation.2) obtaining increase in "overhead"
allowance from federal agencies.
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3) development of possibilities ofhelp from voluntary foundations.
4) have done little with possibilIty ofhelp from state governments for privateinstitutions.
REPORT OF THE COMMITTEE ONINTERNATIONAL RELATIONS INMEDICAL EDUCATION
RICHARD H. YOUNG, chairman:This Committee was created in 1949
to orient members of the Associationto the opportunities and responsibilitiesinvolved in international relations in thefield of medical education. The Committee has, also, acted in an advisory andconsulting capacity to the ExecutiveCouncil of the Association itself and toits Executive Secretary.
The problems, being complex and involving diversified levels of medicaleducation, necessitated subsequently theappointment by the Association of representatives to related organizations,such as a Medical Advisory Committeeon Institute of International Education,a Committee on Evaluation of ForeignCredentials and a Cooperating Committee on Graduates of Foreign MedicalSchools. These latter committees havehad to be concerned largely with problems involving evaluation of professional competency of physicians trained inforeign medical schools and efforts toset up some adequate screening mechanism whereby candidates could be certified to medical schools for admissionas undergraduates, to hospitals for internships or residencies and to statelicensing boards for eligibilty to taketheir examinations.
The Committee on International Relations in Medical Education has beenconcerned chiefly with problems involving the advanced scholar or medicaleducator who has an established position in teaching or research on the faculty of a foreign medical school. TheCommittee, therefore, acted in an advisory capacity to the Committee onInternational Exchange of the Conference Board of Associated ResearchCouncils, which deals with the advancedFulbright scholars, to the division ofeducation and training of the Pan American Sanitary Bureau, which deals withscholars from Latin American countriesand maintains a medical education information center, to the branch of education and training of the division of
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international health of the Public HealthService, to the China Medical Board, andother agencies, such as Kellogg andRockefeller Foundations, interested inthe advanced training of the foreignphysician. In turn, representatives ofthese agencies have been consultants tothe Committee. The objective has beenthe development of an effective and coordinated program for the foreignscholar.
As the problems are highly individualboth as to the persons and the medicalschools involved, the communicationshave been almost entirely between thechairman of this Committee and theexecutive secretaries of the above-mentioned groups. Francis Scott Smyth unfortunately found it necessary to resignthe chairmanship of this Committee inJune of this year and was unable to behere as he is at present in Indonesiadeeply involved in a contractual programbetween the faculty of medicine in Indonesia and the University of CaliforniaSchool of Medicine. This Committee hasnot only been interested in the advancedscholar trainmg in this country, but,also, in gathering information in regardto individual medical school contractualprograms with foreign medical schools.Such programs contemplated or in effecthave been those between WashingtonUniversity (St. Louis) and Thailand,University of Minnesota and Korea, University of California and Indonesia,University of Pennsylvania and Burma,Tulane University and Colombia and theUniversity of Virginia and Paraguay.
There are many problems arising outof such agreements;"and Dr. Smyth haswritten, "I do have some definite ideaswith regard to the nature of such contracts and the need for concerted actionby our educational institutions if the objectives and purposes are to be reached.
"I. I refer to the confused and restrictive rules of Federal agencies whichfrequently frustrate the present administration of such contracts. It is quite obvious that for educational programs ofany concentrated and special type (suchas the University of California-University of Indonesia affiliation) the Federalbureaus are not properly endowed tocarry them out. By that token the American colleges and universities are thelogical agencies.
"Hence I maintain that such budgetsas are provided by the Federal government, given to the contracting American
722
institution, should be admimstered bythat educational body, by their rules,regulations and policies. For example,the salary status, appointments, etc. ofour program at the University of California, should be independent of therules governing Federal employment butentirely entrusted to University of California audit, etc. I believe such university policies are easily defended on Capitol Hill, while the continued challengeby Federal auditors leads to inequities,delays and inefficient (often expensive)administration. American schools andcolleges should not be called on as simple 'employment agencies' for the government.
"I could enlarge and illustrate frommy experience the need for giving thecooperating or contracting Americanuniversity the full authority if a realeducational program is to be more thana 'flash' or 'impact phenomenon.'''
It would be well for this Committeeto gather further information on contractual problems and opinions as tofundamental educational "impact" ofprograms as noted above.
It has been suggested by Dr. M. H.Trytton of the National Research Council and chairman of the Committee onInternational Exchange of Persons ofConference Board of Associated Research Councils that the Association ofAmerican Medical Colleges foster a conference for advanced Fulbright scholarsand advanced scholars sponsored byother agencies. This conference wouldafford incoming scholars and educatorsan opportunity "to become acquaintedwith the broader issues of Americanmedical education and its distinctive developments or to discuss medical education problems of mutual interest withAmerican medical educators."
Problems of financing such a conference, the advisability of repeating annually such orientation, and the advantages and disadvantages of national,regional and local conferences were discussed. It was, also, suggested that apilot regional conference be fostered byan interested foundation and that consideration be given by the ProgramCommittee of the Association to devoting a session of the next annual meetingto the problems of the foreign-trainedphysician, encompassing all levels ofeducation and all committees of the Association dealing with the problems ofthe foreign physicians.
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REPORT OF THECOMMITTEE ON INTERNSHIPS,RESIDENCIES AND GRADUATEMEDICAL EDUCATION
CURRIER McEwEN, chairman:
In the report submitted a year ago,this Committee considered it inadvisable to undertake another general survey of the internships and residencieson a national basis. In subsequent meetings, however, held at the time of themeetings of our Association in October1954 and February 1955, the Committeecame to the conclusion that it wouldbe desirable for the Association to undertake a more limited study of internships and residencies in the majorteaching hospitals affiliated with themember colleges.
Although there is no generally acceptable definition of a teaching hospital, according to the one used by theCouncil on Medical Education and Hospitals and applied by Stalnaker to theresults of the matching plan, approximately one-third of the "major teachinghospitals" filled less than two-thirds oftheir available internships, and onequarter filled less than one-third. Suchfigures as these suggest the need formore precise information about thevarious services in the hospitals in whichmedical students are receiving theirearly clinical experience. It wouldseem advisable also to examine thevarious ways in which undergraduatemedical students are serving in lieu ofinterns in some schools. Indeed thewhole service for the optimal benefitof students, interns, residents, postgraduate students and patients is one ofgreat current importance.
The Committee also believes it highlydesirable to obtain more precise information regarding the types of relationships which exist between the schoolsand the individual affiliated hospitals.
In considering the means of carryingout such a stUdy, the Committee wasconscious of the reluctance of most medical college faculties to participate insurveys, and of the special antipathywith which this particular surveymight be received by the staffs of clinicaldepartments. It is therefore recommended that the desired information beobtained not by a special, intensivesurvey, but by means of other studiesalready arranged.
Future Teaching Institutes planned by
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the Association will be concerned withclinical instruction. If representatives ofthe Committee on Internships, Residencies and Graduate Medical Educationare included in the working committeeof these institutions they will be ableto help obtain the answers to some ofthe questions raised in this report.Furthermore, it is suggested that in future, official inspections which representatives of our Association make ofmedical schools, attention be directedto the affiliated teaching hospitals aswell as to the schools themselves. Preparatory to this the Committee will beglad to draw up the draft of a separatequestionnaire on the hospitals to be included in the forms which the schoolsare now required to submit prior to inspection.
REPORT OF THE SUBCOMMITTEEON MEDICAL EDUCATION FORNATIONAL DEFENSE*
STANLEY W. OLSON, chairman:
Following the last Annual Meeting ofthe Association of American MedicalColleges, the MEND Subcommittee increased its affiliation to include the following 10 schools: Tufts, Pennsylvania,Georgetown, Medical College of Virginia,Emory, Ohio State, Baylor, Wisconsin,Colorado and Washington (Seattle).These schools formally began a processof orientation on January 1, 1955 andstarted actual teaching activities withthe 1955-56 academic session. A 10day trip and orientation session washeld in March for some 30 deans andcoordinators, with visits to the Submarine Base, New London, Conn.; Edgewood Arsenal, Md.; the Armed ForcesInstitute of Pathology, Army MedicalService Graduate School, Naval MedicalResearch Institute, and National Institutes of Health in Washington; BrookeArmy Medical Center, Medical ServiceField School, and School of AviationMedicine, Randolph Field, San AntonioTexas. Each of the new schools wasvisited by a dean and a coordinatorfrom one of the five pilot schools; (Cornell, Buffalo, Vanderbilt, Illinois andCalifornia, San Francisco) for the purpose of holding discussions with facultygroups, department heads, and administrative officials in regard to the MEND
·This is a subcommittee of the Joint Committe. onMedical Education in Time of Nallonal Emerllency.
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philosophy.The Department of Defense continued
its support of the MEND program andarranged a contract ~ith each school foran average of $11,000 to include $5,000part salary for the local coordinator,the remainder to be used for purchaseor rental of teaching materials and forfaculty travel.
In May 1955 the Public Health Service increased its support of MEND byassigning one of its reserve officers, Dr.James R. Schofield, on military leave asassistant dean at Baylor, to work fulltime for the MEND Committee as itsnational coordinator. An office has beenestablished in the Potomac Annex, Bureau of Medicine and Surgery, Department of the Navy, Washington, D. C.Dr. Schofield's duties are to establishcontact with the numerous Federalagencies and installations and to accelerate the flow of teaching materialsfrom those agencies to the affiliatedschools.
During February-March 1955 theMEND program sponsored symposia onthe following subjects: "Psychiatry inMass Casualty Care," and "Blood andBlood Substitutes." MEND-affiliatedfaculty members attended the ArmyMedical Service Graduate School coursein "Medical Care of Mass Casualties."
The National Coordinator and Dr.John L. Shapiro, department of pathology, Vanderbilt, began the development of a collection of teaching materials on the subject of "Pathology ofAgents of Warfare," to include subtopics on radiation injury (systemicand fall-out) cold injury, thermal burns,missile injuries, blast injuries (atmospheric and underwater). The collectionof some 350 slides is being duplicatedand will be made available at cost tothe schools. The materials are derivedfrom the Armed Forces Institute of Pathology and a number of other militaryinstallations.
The affiliated schools are increasingtheir use of visiting speakers as a partof the MEND program. A speakers' bureau consisting of outstanding researchers and clinicians in military servicehas been prepared for the use of localcoordinators and committees in planningpresentations to student groups.
The MEND program from the firsthas encouraged and given financialsupport to faculty travel to the Fed-
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eral research-teaching establishments. Alarge number of installations has beenvisited by members of the several faculties in order to learn of researchresults and to establish personal contactswith military medical officers. Opportunities for travel are increasing as interest in this activity has developed onthe part of the Federal services.
Further expansion of the MEND program is presently projected as a yearlyincrement of 10 schools until all whodesire affiliation have been given thatopportunity. The next group of 10schools is being selected by the MENDCommittee during these sessions. Selections will again be made on the basisof interest, geographic location and typeof support of the school.
While financial support of the MENDprogram is limited to 10 new schoolseach year, voluntary affiliation is available to any school interested in the program. In May 1955, Michigan requestedaffiliation on a local support basis andwas welcomed to full participation. Acoordinator was appointed and a facultycommittee began making plans to include items of the MEND program inthe curriculum. This same pattern ofvoluntary affiliation has been recommended by the MEND Committee andapproved by the Executive Council ofthe Association of American MedicalColleges. The schools have only to request it.
As the years have gone by, it seemsapparent that the faculties of medicinedo accept the concepts of MEND andare interested in altering the curriculato include necessary information provided through the MEND affiliation.
REPORT OF JOINT COMMITTEE ONLICENSURE PROBLEMS
CHARLES A. DOAN, chairman:
Created by the Executive Council ofthe Association of American MedicalColleges as one of its permanent standing committees in February 1952, theCommittee on Licensure Problems during its first year of deliberations becamea joint committee with representativesfrom the Federation of State MedicalBoards, and the American Medical Association Council on Medical Educationand Hospitals, each at their own request. All subsequent discussions andrecommendations, including the current
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Swampscott meetings, have been withthe full representation of the combinedgroups in attendance.
1. One of the major problems, whichhas been before this Committee sinceits inception, is that of the licensing ofgraduates from foreign medical schools.The unanimous committee recommendatIon made two years ago to this Association, was modified by an ad hoc subcommittee of the Association's Executive Council, and later submitted to anewly created Cooperating Committeesponsored by the AMA. Donald Anderson was elected chairman, and WalterS. Wiggins, secretary, by representatives from the three associations alreadymentioned, plus the American HospitalAssociation. A plan, the details of whichneed not be reviewed at this time, isnow pending before the legal department of the AMA, and will be considered by the house of delegates at thenext interim meeting of the AMA inBoston in December. Suffice it to say atthis time that the handling of the foreigntrained medical graduate remains oneof the most challenging problems forevery segment of the medical professionand lay public, and the solution shouldcontinue to be earnestly sought by thisAssociation in cooperation with otherinterested groups.
2. The interest of this Committee ina Uniform Medical Practice Act is asstrong now as previously reported tothis Association, and we are informedthat a two-year study undertaken by aduly appomted committee from the Federation of State Medical Boards, originally under the chairmanship of BruceUnderwood of Kentucky, and now directed by George Buck of Colorado, willbe ready for consideration by the Federation at its next meeting in Chicagoin February 1956. It is urged by thisCommittee that attention be focused inany new model Medical Practice Acton some attempted answer at the stateboard level to (a) the foreign medicalgraduate problem, (b) the desirability ofincluding provisions for a temporary"educational permit" or limited licenseto cover the hospital training period forinterns and residents, so that insurancecoverage may be obtained, and (c)wider and simpler and more uniforminterstate reciprocity provisions for basically qualified physicians.
3. Toward the objective of resolving
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problems between the state boards andthe National Board of Medical Examiners, the following progress may benoted:
(a) Three state boards, which hadwithdrawn acceptance of national boardcertification during the transition fromessay examinations to the multiple choice'form of examination, have restoredacceptance of national board certification. These three states, are Kansas,Nebraska and South Carolina;
(b) In order that state boards mayhave a thorough understanding of thenature and content of the national boardexaminations, members of state boardshave been invIted to attend the meetingsof the national board committees, whichare responsible for the preparation ofthe individual tests. These committeesmeet regularly at the national boardoffices in Philadelphia to prepare examinations, each of whIch contains onlynew, previously unused questions;
(c) All national board examinationquestions are available for review byany state board;
(d) Several state boards and somemedical schools have requested the national board to provide examinationsin individual subjects, which are thenused by the state board or medicalschool for their own purposes, or if requested by a state board, a foreigntrained physician may be admitted tonational board examinations for purposes of screening and evaluation. Insuch cases, the grades are reported bythe national board only to the stateboard or medIcal school, and not to themdlvidual taking the examinatIon. Forthese examinations, the national boardd'Jes not set the passmg level. Individualsexamined in this manner are not candidates of the natIonal board, and hencethey receive no credit toward natIonalboard certification. It is gratifying tothe Committee to be able to make these'changes in national board practice amatter of record for the members ofthis Assoication, and to note the betterrelationship which seems to be developiog bdween the natIOnal board and theFederation of State Medical Boards.
4. The existence of this Committeereflecting the interest of this Association in Licensure Problems during thepast four years-serving as a focal pointfor joint discussions and cooperatingwith other official agencies in exploring
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new and better answers to the complexsocial and legal problems which surround the present day practice of medicine--has been a salutary influence, webelieve. With continued patience andfresh insight, the right answers to theseproblems, must and will be found.
REPORT OF THE COMMITTEE ONMEDICAL CARE PLANS
DEAN A. CLARK, chairman:
The Committee on Medical Care Plansregrets that it was not able to completethe survey of teaching hospitals projected in last year's report. There were several reasons for this failure which bearupon the principal task of the Committee, which is to study the effect, if any,of medical care plans on the teaching ofundergraduate medical students, internsand residents.
The first difficulty was to define a"teaching hospital," particularly as thisconcerns hospitals which have no undergraduate medical students but dohave interns or residents. It proved tobe almost impossible to draw a line onany rational basis and yet to include every hospital approved for internship orresidency training would have involvedsuch large numbers that analysis of responses to any questionnaire would havebeen impossible for the Committee.
The second difficulty was to devise aquestionnaire which would truly distinguish the effects of medical care planson the education of these groups fromthe effects of all other factors. Severalattempts were made and tried out on individual hospitals but the results werenot precise enough to encourage theCommittee to send out a nationwidequestionnaire.
After an open hearing, the Committeedecided that the matter was extremelyurgent and of real concern to all whospoke to us, and, therefore, that anotherattempt should be made to gather information from teaching hospitals aboutany effects that medical care plans mayhave had on teaching. Consequently, theCommittee proposes to try again, starting with as simple a questionnaire aspossible and defining teaching hospitalsarbitrarily as those which have undergraduate medical students or perhapsthese plus any hospitals which have asmany as 25 residents, even though they
726
may not have undergraduates.It is felt that such a limited approach
might yield useful leads which couldthen be followed up on a larger or moreintense basis if indicated.
Certainly it is the Committee's opinionthat the rapid growth of medical careplans that has already occurred and isin prospect will tax our ingenuity to devise ways of teaching students, internsand residents with the use of private,insured patients in all programs. We believe this is inevitable and, in manyways, dcsirable; but we also believe newmethods must be worked out quickly orwe will find ourselves faced with an impossible situation.
The Committee therefore desires tomake another attempt to make a studyand hopes to have some beginning findings by next year.
REPORT OF THE COMMITTEEON PUBLIC INFORMATION
JOHN L. CAUGHEY JR.:
1. At its meeting on October 19, 1954,in French Lick, the committee gavetentative approval to a proposal, prepared by Milton Murray, that the Association assist in the development of"Traineeships in Medical Public Information." It was felt that such traineeships would help alleviate the acuteshortage of personnel in this field.
2. On February 6, 1955, at a meetingin the Palmer House, Chicago, the committee gave further support to this proposal. A final draft, approved by thecommittee, was submitted to the Executive Council of the AAMC on March1955, with the request that the Councilapprove it for transmission to the National Foundation for Infantile Paralysis. It was proposed that the Foundation be asked to add such a traineeshipprogram to its already extensive activities in the field of professional education. At its meeting of June 23-24, 1955,the Council voted to support the program for traineeships in medical public information as proposed by thecommittee. The plan was forwarded tothe division of professional educationof the Foundation for its consideration,but no action has been taken on it yet.
One year ago, the committee was informed that Dr. Hubbard, recently appointed associate secretary of the Asso-
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ciation, would serve as secretary for thecommittee. In February, it became clearthat Dr. Hubbard would not be ableat present to devote any significantamount of time to the committee's fieldof interest. In spite of this the committee felt it might serve a useful advisorypurpose if it reviewed the present efforts of the AAMC in the public information field and attempted to evaluatethese and make suggestions for moreeffective use of the available personnel,funds and facilities. This would includenot only a study of the Association'smethods of communication with thepublic, but also the ways it presentlydoes, or does not, attain satisfactorycommunication with medical schools,colleges and other medical and healthagencies. For example, it was pointedout that a large amount of AAMC literature going to medical schools is wastedbecause it all goes to the dean's officeand gets filed without even reachingthe faculty persons who would be interested in it. As a result of this discussion, it was suggested that Dr. Hubbard, insofar as his time will permit,should collect information about presentactivities of the AAMC and present tothe committee data which might permitit to make constructive suggestions aboutpublic relations and communicationsproblems. Unfortunately, it has not beenpossible for Dr. Hubbard to give thetime necessary to work with the committee on this.
4. For three years the Committee hasworked with the generous cooperationof the Medical Section of the AmericanCollege Public Relations Association, touse the Annual Meeting as a means ofinforming the public about activities ofthe Association. Newspaper coverage atAtlantic City was good, but not muchwas accomplished at French Lick.
In the absence of a continuing program of public information during theyear, the efforts at the Annual Meetingare costly of the time of the volunteerswho attempt to do the job under difficult conditions.
REPORT OF THE COMMITTEEON TEACHING INSTITUTES ANDSPECIAL STUDIES
GEORGE PACKER BERRY, Chairman:
Organization and AdministrativeChanges: The Committee on Teaching
DECEMBER 1955, VOL. 30, NO. 12
Minutes of the 66th Annual Meeting
Institutes and Special Studies wasformed in October 1953 at the 64thAnnual Meeting of the Association atAtlantic City, by combining two existing committees, the Committee on Student Personnel Practices and the Committee on Teaching Institutes. Thepresent report is the second to be submitted by this new Committee. It hasbeen prepared for the members by thechairman and the Director of Research,who serves as the Committee's secretary.To insure that the many activities ofthis Committee are carried on in closeintegration with the Association's otherworks, the President, the PresidentElect and the Chairman of the Executive Council serve as members.
Until his resignation on September 1,1955, to become president of the National Merit Scholarship Corporation,John M. Stalnaker in his role as Director of Studies for the Association wasthe Committee's secretary and directedthe manifold research studies and service activities with which the Committeehas been concerned. During the six yearssince Mr. Stalnaker joined the Association in 1949, his imaginative and vigorous leadership has been responsible formany of the Association's most important services to the member colleges. TheCommittee's best wishes go with him ashe embraces his new opportunities toimplement his program for an improvednational scholarship venture. They goalso with Edward C. Smith and HelenS. Morford, who have become respectively information officer and treasurerin the new corporation, and with Dr.Ross A. Dykman, who left the Association at about the same time to becomeassociate professor of psychology at theUniversity of Arkansas School of Medicine.
Dr. Helen Hofer Gee has been appointed Director of Research and hasassumed the responsibilities that hadbeen discharged by Mr. Stalnaker. JoanMcJoynt has taken over Mr. Smith'sfunctions, serving half-time as administrative officer for the National InternMatching Program and half-time astechnical assistant to Dr. Gee. HelenMcBride has succeeded Mrs. Morford asDr. Gee's administrative assistant andthe Committee is currently seeking a
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successor for Dr. Dykman.
Finances: During the two years sinceits inauguration as the Committee onTeaching Institutes and Special Studies,the expenditures made to support thework of the Committee and the members of its staff have considerably exceeded $100,000 a year. The Committeehas been exceedingly fortunate in receiving substantial grants from outsideagencies, which have made it possibleto carryon the special studies programand to provide the many services to themember colleges hereinafter described.Without such "seed" money the Committee could not have moved vigorouslyforward. For its future security, a largerproportion of "hard" money must beobtained if the work of the Committeeis to be stabilized and expanded intonew research areas.
Currently, the Committee's activitiesare being financed on the basis of about20 per cent "hard" money coming fromthe Association, and 80 per cent "soft"money coming from outside sources. TheNational Heart Institute gave $45,000 tohelp meet the costs of the first TeachingInstitute and $25,000 for the second. TheNational Cancer Institute also gave$25,000 toward the expenses of thesecond Teaching Institute. The Commonwealth Fund and the National HeartInstitute have each contributed $25,000for the third Teaching Institute. Eachof these organizations has earmarkedfurther support for the Institute program. In 1954 the Markle Foundationsupported the general work of the Committee by a grant of $50,000. This granthas been renewed for the current year.The Commonwealth Fund also is continuing to support the Committee's general operations.
On behalf of the Association, theCommittee takes pleasure in expressingits gratitude again for the generoussupport thus received. Without this kindof venture capital, an organization suchas the Association could not haveachieved the rapid growth and development that have characterized its activities since the war.
Teaching Institutes: As the presentreport is being written, the third Teach-
ing Institute on Anatomy and Anthropology is proceeding constructivelyunder the capable chairmanship of Dr.William U. Gardner. The momentumbeing rapidly achieved at the Instituteis testimony also to the skill of the sevenpreparatory subcommittees, which haveworked diligently for more than a yearin drawing up plans. All of the 127participants have been involved in thepreparation and analysis of informationbeing used at the Institute, thus insuring active communication with the faculties of the medical schools of theUnited States and Canada, and of several abroad.
In a short report on the Committee'sactivities, space does not permit a discussion of the philosophy of the Teaching Institutes or a description of theirmany accomplishments. These accomplishments may be found emphasizedin the prefaces to the reports that havebeen published as supplements to theJuly 1954 and the September 1955 issuesof the Journal of Medical Education. Asthe reports clearly indicate, the Teaching Institutes have become a major activity of the Association.
The Institute immediately precedingthe 66th Annual Meeting is the sixthactivity of this type with which theAssociation has been concerned since1951. In June of that year and duringJune of the next year, the Associationjoined forces with the American Psychiatric Association In organizing thefirst and second conferences on psychiatry and medical education. In November 1952, the Association co-sponsoreda conference at Colorado Springs on theteaching of preventive medicine, underthe skillful co-chairmanship of Dr. LloydFlorio and Dr. Ward Darley.
The first of the Association's ownTeaching Institutes was that held inAtlantic City during October 1953 onphysiology, biochemistry and pharmacology. Under the brilliant chairmanshipof Dr. Julius H. Comroe Jr., thIS Institute achieved the high level of excellence that has been a stimulus eversince. The second Teaching Institute washeld at French Lick during October 1954on pathology, microbiology, immunologyand genetics under the chairmanship ofDr. Douglas H. Sprunt and the cochairmanshIp of Dr. Robert A. Moore.They provided distinguished leadership.
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The significant contributions of thegeneticists to this Institute and theclearer understanding of teaching problems that resulted from the skillful workof the preparatory committees and theactive discussions of the participants, arebeing beneficially felt in medical schoolseverywhere.
Medical College Admission Test: Anincreasingly large proportion of applicants to medical schools are takingthe Medical College Admission Test, andthere is evidence that more and moreschools are finding the data an important ancillary source of information.In May of this year, a total of 6,974students were tested, an increase ofabout 400 over May 1954. Whetherthis increase represents an increase inpercentage of applicants taking the test,or an increase in the number of applicants for entrance to medical schoolcannot be determined until applicantdata becomes available for the 1956freshman classes. Several studies utilizing test score data have been madeagain during the year since the FrenchLick meeting, and others are beingplanned for the future.
Last year at French Lick, Mr. Stalnaker in his report as Director of Studies (J. Med. Educ., December 1954, pp.42-46), discussed the interpretation anduse of MCAT test scores. This followedthe practice of earlier years. Nevertheless, there is still considerable misunderstanding both in medical schoolsand in undergraduate colleges of themeaning and significance of these tests.Recently, for example, it was found thatthe admissions committee of one medical school has interpreted the quantitative score on the test as a measure ofthe applicant's ability to work rapidly. Acommittee's consideration of such askill will, it is hoped, vary from its consideration of the kind of ability thissection of the test is actually designedto measure, that is, the capacity forlearning to manipulate numerical orquantitative concepts.
Another kind of problem to whichthe attention of the Committee has beendrawn concerns the stage reached inthe undergraduate student's educationat the time the test is taken. Evidently,there remains a mistaken belief thatthe more science training a student has,the higher will be his science score.l'his section of the test is constructed
DECEMBER 1955, VOL. 30, NO. 12
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to measure understanding of fundamental principles of science.
The problem is not a new one; itarose some years ago and was the subject of an extensive study which waspublished in the Spring 1951 issue ofEducational and Psychological Measurement. The relationship between MCATScience scores and above and belowaverage amounts of science training wasanalyzed. The author concluded: "Theresults would appear to offer no supportfor the hypothesis that taking additionalcourses in biology, chemistry and physICS beyond a certain minimal numberleads to better scores on the MCATTest."
In the reports of MCAT scores anddistributions prepared by the Educational Testing Service to be issuedduring the coming year, recipients willfind that introductory statements havebeen considerably expanded to aid inthe interpretation and to contribute tothe utility of this material.Reports to Medical Schools:
A. "Drawing Power": In November1954, a report was issued to each medical school showing average scores onthe MCAT of applicants to that medicalschool from each undergraduate college. Also given was the average scoreon the MCAT of all students from theseundergraduate colleges applying to anymedical school. Medical schools werethus enabled to compare their relative"drawing power" in the various undergraduate colleges with respect to theability and achIevement levels of students seeking medical education. Inasmuch as this kind of report requiresseveral months for preparation, the nextreport will appear in 1956. It will beon students applying for entrance toboth the 1954-55 and 1955-56 classes.
B. Freshman Classes of 1949-50 and1950-51: Three photo-offset reports inthe Special Studies series, based on the1949-50 freshman class, were sent tomedical schools this past year.
The first of these reports (unnumbered) showed the number of studentsin the 1949-50 freshman class who camefrom each undergraduate college in theUnited States, the number who wereregular students, the number who wereirregular and the number who withdrew.
The second report (No.2) gave information to each medical school con-
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cerning the number and percentage ofthe total enrollment coming from thosetwo undergraduate schools supplying thelargest number of students. The performance of these students in terms ofregularity of attendance and proportionof withdrawals could be compared withthe performance of students from otherundergraduate colleges in the same class.
The third report (No.3) provided astatistical analysis of materials developed for the first and second reports.It was found, for example, that aboutone half of the 1949-50 freshmen inthe median tax-supported medical schoolcame from undergraduate colleges affiliated with the medical school, while onlyabout 30 per cent of those in privateschools were derived from the affiliatedsource. Private schools tended to havelower proportions of permanent withdrawals, but at the same time the proportion of drop-outs among studentswho went into the medical school affiliated with their undergraduate collegewas lower than it was among studentswho went to a medical school not affiliated with the undergraduate collegethey attended. In general, the percentage of withdrawals varied inversely withthe number of students supplied by anundergraduate college.
A report to appear in an early issueof the Journal of Medical Educationentitled, "The History of the 1949-50Freshman Class," analyzes further information about this class, giving comparative MCAT average scores for various groups of students, analyses of reaSOilS for withdrawals and scholasticachievement of students in various agegroups.
The first two reports cited above havebeen repeated for the 1950-51 freshmanclass and an analytical study and comparison with the 1949-50 class is inpreparation.
C. Multiple Applications: In June ofthis year, an individual report wasissued to each medical school to provide confidential as well as generalinformation concerning multiple application and the acceptance of applicantsby more than one school. Each schoolreceived information concer,ning thenumber of accepted 1954-55 applicantswho enrolled in other medical schools.The response to this report was favorable and indicated that the informationwas useful, yet the report created some
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misunderstanding. It is evident that insubmitting this type of report, an errorwas made in not indicating more clearlythe exact nature of some of the entriesin the tables. Inasmuch as a great dealof interest in the report was expressed,the study will be repeated.
Applicant Information: The annualreport on applicants for the group entering medical school in 1954-55 willappear in the November issue of theJournal of Medical Education.
This annual study was initiated several years ago and has steadily developed in breadth and detail. Itsaccuracy is dependent on the staff members at the medical schools who prepareand check the data as they are developed. A vote of thanks is due theseindividuals without whose cooperationthe studies would not be possible.
The downward trend in the number ofapplicants observed during the past fiveyears has continued this year. In all,14,538 applicants sought entry to medical school last year. In the peak year,1949-50, the number was 24,434. Thedecline in the number of applicants maybe expected to continue, or to remain atapproximately the same level for another year or two before an upwardswing will be felt. An increase is nowjust perceptible in undergraduate college enrollments; it is expected to accelerate substantially within the next fewyears.
New York, Pennsylvania, California,Ohio, Illinois, Texas and New Jerseycontinue to supply about half the applicants to medical schools. To the1954-55 statistics, New York alone contributed about 15 per cent of the applicants and 13 per cent of the acceptedgroup.
In general, the students who apply tostate schools file fewer applications thanthose who apply to private schools. Thestate medical schools of New York arean exception. At one extreme, the students applying to one southern statemedical school apply on the average to1.5 schools each. At the other extreme,students applying to one private medicalschool apply on the average to eightother schools as well.
Another aspect of the report on applicant studies relates applicant information to state population. This part ofthe report discusses the availability ofmedical education within and betweenstates, the relationships between the
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availability of medical education andthe proportion of applicants acceptedinto medical schools, between the number of students applying and the numberof acceptances, and between the numberof doctors in a state and the number ofstudents who apply to medical schools.
The work of processing the data forthe 1955-56 applicant study has alreadybegun. An effort was made this pastyear to increase the understanding ofthe nature of applicant forms amongmedical school personnel. In the interest of increasing the accuracy anduniformity of certain kinds of information provided, a change was made in themethod of classification of applicantswhose applications are withdrawn.
Admission Procedures: For manyyears the Association through the Executive Council has been striving tofacilitate for the student his transitionfrom college to medical school. To thisend, the former Committee on StudentPersonnel Practices and then the Committee on Teaching Institutes and Special Studies were asked to devise whathave come to be called "traffic rules" toprotect both student and school withoutunnecessarily restricting the freedomof either.
The record shows that the ExecutiveCouncil, reflecting the views of the members of the Association, has been concerned about the undesirable pressuresexerted by some medical schools upontheir applicants. Thus, at the meetingof the Council in November 1949, it wasthe consensus that medical collegesshould not select students more thanone year in advance of their actual matricUlation, that is, more than one yearbefore the start of professional study.Similarly, in Chicago two years later,the Council again went on record asrecommending strongly against issuingacceptances, even provisional acceptances, more than one year prior to actualmatriculation. In 1952, the Council againrecorded its disapproval of the practice of issuing definite acceptances andrequiring substantial reservation feesprior to the January 1 preceding entrance to medical school. In October1953 at Atlantic City, the membershipof the Association supported withoutdissent the Council's recommendationthat no acceptances be offered more thanone year in advance of actual matriculation.
DECEMBER 1955. VOL 30. NO. 12
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To give more substance to these repeated recommendations of the Executive Council and of the Association, thefollowing principles for "traffic rules"to guide the admission of students tomedical school were drawn up by theCommittee on Teaching Institutes andSpecial Studies.
The obvious improvement over previous proposals was the result of the suggestions offered by the deans in response to a letter dated February 2,1954, from Mr. Stalnaker, then Directorof Studies. Their responses indicatedwidespread and enthusiastic support forthe objectives of the Committee in giving the applicant a maximal opportunityto make optimal arrangements for hismedical education.
As a result, the following resolutionwas presented to the official representatives of the member institutions at theBusiness Session of the 65th AnnualMeeting at French Lick on October 20,1954. This resolution was passed with adissenting vote of one. For convenience,this resolution is reproduced from theMinutes of the Proceedings as pUblishedin the Journal of Medical Education forDecember 1954 (Vol. 29, No. 12, pp. 7374):
"Whereas, The date of final acceptance of the applications of new studentswith the filing of a nonrefundable deposit varies widely among member institutions of the Association.
"Whereas, This variation in acceptance date makes it very difficult for theaverage student applying to four ormore medical schools to make sure thathe is making the best choice of schoolsavailable to him.
"Whereas, This matter has been carefully studied by the Committee onTeaching Institutes and Special Studiesand its recommendations have had furtiler study by the Executive Council, beit therefore,
"Resolved, That the membership ofthe Association of American MedicalColleges approves the following admission procedures:
"1. No place in the freshman classshall be offered to an applicant morethan one year before the actual startof instruction for that class.
"2. Following the receipt of an offerof a place in the freshman class, a student shall be allowed at least two weeks
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in which to make a written reply tothe medical school.
"3. Prior to January 15, this writtenreply may be either a declaration ofintent or a formal acceptance of theplace offered. When the applicant hasdeclared his continued mterest withinthe two-week period, the medical schoolagrees to hold a place for him untilJanuary 15, unless he indicates that hehas been accepted elsewhere and withdraws his application. He may, of course,and often will, enter into formal arrangements with the one medical schoolof his choice before January 15. Becauseof the wide variation in the acceptancedates of different medical schools, somestudents will wish to change their mindsafter filing a declaration of intent andit is understood that nothing unethicalis implied when a student does so changehis mind. In such an event, the studentis obltgated to send prompt written notification to every school holding a placefor him.
"4. The payment of a nonrefundabledeposit shall not be required of anyapplicant prior to January 15.
"5. When a student files a declarationof intent, a refundable deposit-not toexceed $100-may be required at thediscretion of the school granting theacceptance. Such deposits will be refunded without question upon requestmade prior to January 15.
"6. The deposit, when required tohold a place in the frcshman class afterJanuary 15, shall not exceed $100.
"7. By January 15 each applicant forwhom a place in the entering class isbeing held must either accept the offerformally and pay any required nonrefundable deposit or withdraw his application.
"8. Following January 15, all applicantoffered a place in a frcshman class musteither formally accept or refuse theplace, but he shall have at least twoweeks in which to decide. Deposits madeafter January 15 shall be nonrefundable.
"9. To assist the medical schools, theflAMC office will compile a list of thestudents who have formally accepteda place in the freshman class This listwill be distributed about February 1and will be kept current by frequentrcpisions."
Because the Executive CouncIl wishedeach medical school to report its considered opinion of the resolution, a copy
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was sent to each dean by Mr. Stalnakeron November 2, 1954. His letter wasaccompanied by a brief questionnaire.The questions and the tabulated repliesare reported herewith.
The questionnaire went to 85 schools,including five schools just coming intoactivity; 75 questionnaires were returned.
Cjluestions Concerning the"Traffic Rules"
1. Do you, speaking for your medicalschool, approve of the "traffic rules"resolution as an expression of Association policy? (While the resolution isnot binding upon any member who doesnot agree to follow it, it will be helpfulonly if almost all schools agree to accept it.)
Yes-63 (84%) No-7 Did Not Vote-5
2. Does your medical school agree tofollow, starting at once, the code asset forth in the resolution passed bythe Association?
Yes-62 (83%) No-6 Did Not Vote-7
3. Have you already put these "traffic rules" into operation?
Yes-56 (75%) No-15 Did NotVote-4
4. If you do not approve of this resolution, do you believe that "traffic rules"concerning admission dates or procedures 'deserve further consideration bythe Association?
Yes-9 No-6 Did Not Vote-605. Do you think it might be detri
mental to medical education and itsrelations with undergraduate collegesto accept students into medical schooltwo, three or even four years beforethe opening date of their freshman medical school class?
Yes-58 (77%) No-6 Did Not Vote-11
It is clear that the member collegeshave overwhelmmgly supported the objectives incorporated in the "trafficrules" in order to promote the bestmterests of both applicants and medicalschools.
Information to Undergraduate Colleges, Educational and ProfessionalOrganizations:
A. Admission Requirements Handbook. The 1956 edition of the handbookwas published on September 16, 1955.
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The format and content are essentiallythe same as for the 1955 edition. Information on two new schools, Seton Halland Florida, has been added this year.The introduction has been rewrittenand expanded, and more uniformity inpresenting the information about eachmedical school has been achieved.
The 1955 edition of the handbookwas extensively revised and more thandoubled in size. With the publicationof that edition, a change in the methodof distribution was also instituted. Freedistribution to undergraduate collegesand counseling offices was discontinued,and a charge of $2 a copy was set todefray the cost of preparation and publication. Response to promotion of thisrevised edition was far greater than hadbeen expected; a total of 8,000 copieswas finally issued. This supply wasexhausted early in the summer of 1955.An initial printing of 10,000 copies wasaccordingly ordered for the 1956 edition,which is currently being distributed.Sales promotion begun last year is beingcontinued this year. Already, duringthe first two weeks following publication, 150 complimentary and reviewcopies have been sent out, and ordershave been received and filled for nearly1600 copies. More and more medicalschool deans are finding the handbookuseful in their dealings with the undergraduate colleges. College bookstoresare stocking the handbook in greaterquantity than heretofore.
B. Reports to Undergraduate Colleges:1. Academic Achievement. In February1955, a report was sent to all undergraduate colleges that had students enrolled in medical schools between thefall of 1950 and the spring of 1954. Thisreport included the names of all students, the medical school each had attended, and the class standing and levelof achievement for those years between1950 and 1954 during which the studentwas in attendance. In 1954 a similarreport was sent to undergraduate colleges describing the accomplishment oftheir students who had entered medicalschool in the 1949-50 academic year.Nearly all of the undergraduate colleges,in acknowledging receipt of these reports, have expressed appreciation ofthem and have requested that the Association continue to send them.
Data for the report on 1950-51 entrants to medical schools is being assem-
DECEMBER 1955, YOLo 30, NO. 12
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bled. On an annual basis, four-yearsummaries for all students entering ina given year are probably more valuable to the undergraduate schools. Reporting data on single classes providesinformation that can be more readil;>utilized for studies of trends.
The issuance of a report on academicachievement of students at the completion of the freshman year is being seriously contemplated. This kind of upto-date information, coupled with thefour-year reports on the groups graduated the previous year, would provideuseful data for purposes of comparison.
2. MCAT Scores. An MCAT scorereport was sent in March of this yearto 507 undergraduate colleges. Themeans and distributions of scores of allformer undergraduate students testedbetween May 1952 and November 1954were reported. Also included in thisreport were summaries showing themean score distribution of all of thecolleges on each of the four tests. Themean scores of students from five colleges (one per cent) were over 600;those for 35 colleges (seven per cent)were below 400.
It is planned to repeat this studyduring the present year. In the future,It would be desirable to establish aconvenient dividing point in order tocompare mean scores of students testedbefore and after a given date, thus allowing colleges to determine whetherthere has been a change in the level ofability and academic achievement oftheir undergraduate students applyingto medical schools.
C. Special Services. The staff frequently receives requests from collegesand other educational and professionalorganizations for mformation about special groups of students in the medicalschool population. Subject to limitations of staff time and facilities, everyeffort is made to provide these serviceswhen the information sought is notelsewhere available, not of a confidential nature to anyone other than theinquirer, and when it appears that thepurpose in seeking the information isJustifiable. Several such studies haverecently been completed. They have included reports on the accomplishmentsof students at a given school, summariesof numbers of students and graduatesin designated categories, summaries ofMCAT scores, and the like. When an ap-
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preciable amount of staff or IBM machine time is required, the costs incurred in providing these services havebeen borne by the organization seekingthe information.
Cooperation with Government Agencies: A. Faculty Register. Throughout1954-55, biographical data forms havebeen received for inclusion in the Faculty Register. Copies of the forms havebeen sent to the Health Resources Advisory Committee of the Office of Defense Mobilization, and that organization is developing an IBM punch cardfile that will be available for researchpurposes. For a majority of medicalschools information is now completeand is being kept up to date. A fewschools, however, have not yet returnedthe registry forms. They are urgentlyrequested to do so-completeness isessential to the value of the register.
B. Deferment of Residents. Again thisyear a questionnaire for fourth-yearmedical students was distributed andcollected in cooperation with the Department of Defense. The results of thissurvey serve as a basis in Washingtonfor determining further action in carrying out the Armed Forces Reserve Medical Commissioning and Residency Program, as well as serving the purpose ofproviding for students the opportunityto register their preference with respect to the fulfillment of their militaryobligations.
C. Selective Service. The SelectiveService System requested and receivedthe help of the Association in obtainingan inventory of the students actuallyenrolled in undergraduate classes ofmedical schools in the first semesterof 1954-55, together with a statementof their draft status. All of the medicalschools cooperated fully, thus permittingthe Association to send complete returnsto the Selective Service System.
D. Student Survey. The Office of Defense Mobilization also was assisted incarrying out a survey of students inmedical schools during the past year.This survey sought to determine howmany students eligible for military service were currently in attendance atmedical school, and to what extent students in medical schools were ineligiblefor compulsory service.
Women in Medicine: A study of women in medicine has been completedit will be submitted soon for publication
734
in the Journal of Medical Education.The study is based on information supplied by about 1,200 women who graduated from medical school between 1925and 1940. A random sample of almost800 men who graduated during the sameperiod was used for comparison.
A smaller proportion of women entering the profession of medicine thanof women in general, marry. Almost onethird of them are single. Another 10per cent are widows, separated or divorced. While 59 per cent of the womenare married, the corresponding figurefor men in medicine is 95 per cent.
With respect to the full-time practiceof medicine since graduation, 91 percent of the men have been so occupiedin comparison to 49 per cent of thewomen. Of the unmarried women, aboutthree-fourths have engaged continuouslyin full-time practice, but the more common pattern is full-time practice fora period, followed by part-time workor no practice at all. Women obtainingthe M.D. degree who marry and thencease to practice still make use of theirtraining and experience in many ways.Approximately one-fourth of the womenin medicine are diplomates in somespecialty, while about one-third of themen attain the diplomate status. Aswould be expected, fields of specialization vary considerably. In the order oftheir frequency, the specialties womenmost often enter are: pediatrics, psychiatry, obstetrics and gynecology andinternal medicine. Among men, the mostpopular specialties are, in order; surgery, internal medicine and obstetricsand gynecology. In general, women physicians earn less than men and workfewer hours per week.
Bibliography on Admission to MedicalSchool: The compilation of a bibliography on the broad subject of admissionto medical school was begun in 1954,with the objective in mind of facilitatingresearch in this area by making available for ready reference the extensivebut scattered literature on the subject.Such a bibliography will provide aneasily consulted source of informationfor those interested in performing research, or simply in informing themselves of research that has been attempted in these areas.
Two files-an author and a subjectmatter file-are being developed. Entriesin the author file include citation of
Journal of MEDICAL EDUCATION
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the source of an article or book and anabstract of the subject matter. The subject matter catalogue is now dividedinto thirteen areas-it will be revisedin case the quality of material suggeststhe desirability of eliminating or furtherdifferentiating an area. The thirteenareas are:
1. Admission requirements2. Characteristics of students3. Factors related to success in medi
cal school4. Geographical distribution of medi
cal facilities, student facilities and applicants; applicant studies; enrollmentfigures
5. Mechanics of filing applications tomedical school
6. Objectives of admission policies7. Premedical education8. Selection procedures-general dis
cussion9. Selection procedures - academic
record10. Selection procedures-intelligence
and achievement tests11. Selection procedures-interviews12. Selection procedures-interest and
Many books and a large number ofjournals in the fields of education, medicine, psychology, psychiatry and sociology have been gleaned. Many potential sources of information remain tobe consulted. The study, however, willbe completed and references made available during the coming year, if possible.
Plans. The program of studies described above, in both its conceptionand technical aspects, has developedeffectively during the past six years asa result of Mr. Stalnaker's leadership.The several annual reports to medicalschools and undergraduate colleges haveprovided an invaluable means for gaining new insights into the characteristicsof applicants, of medical students andof medical schools.
Significant advances in the techniquesof measuring intellectual capacity andachievement have been capitalized uponto excellent advantage in the development of the MCAT. Thus, through theCommittee's programs, medical education has assembled a unique fund ofinformation about its student population. The completeness of this informa-
DECEMBER 1955, VOL. 3D, NO. 12
Minutes of the 66th Annual Meeting
tion makes it valuable to education farbeyond the medical scene.
Notably lacking, however, is information concerning motivational variables related to problems of selectionachievement and differentiation at th~professional level. Recent research activities in this area, taken in combination with the rich fund of data alreadyavailable to the Association, offer challenging prospects for the developmentof a research program in this littleunderstood field.
REPORT OF THECOMMITTEE ON VETERANSADMINISTRATION-MEDICALSCHOOP. RELATIONSHIPS
JOSEPH M. HAYMAN JR., chairman:1. Your committee has held no meet
ings during the year. In August membersof the committee, the deans of schoolsaffiliated with V.A. hospitals offeringinternships, and the V.A. central officewere asked if they knew of any problems which should be considered byyour committee. On the basis of repliesreceived an open meeting was scheduled for Sunday afternoon, October 23,1955 at the New Ocean House.
2. An open meeting of the Committeeon Veterans Administration-MedicalSchool Relationships was held at 3 p.m.,October 23, 1955 at the New OceanHouse, Swampscott, Mass. As a resultof the discussions and deliberations atthis meeting, the following report issubmitted to the Association for consideration.
3. a) The deans committees for V.A.facilities were established at therequest of General Hawley andthe V.A. to help improve themedical care furnished veteransthrough the V.A. Since this Association is of the opinion thatthe best medical care is provided in teaching hospitals, itwas natural that resident training programs should be set upas a means to this end, and thatother teaching in V.A. hospitalsshould be encouraged. Researchprograms were instituted as anessential part of good teachingprograms and hence of the bestmedical care. From the beginning it was believed that thedeans should not justify residency programs unless theywere good. It is perfectly true
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that the clinical material inV.A. hospitals and the highcalibre of the staff attracted toV.A. hospitals by the teachingprograms have been of advantage to medical schools, thusestablishing a mutually beneficial relation. However, aid tomedical schools was never theprimary objective of the program. All affiliations must beconsidered on the basis ofwhether they are good for theveteran.
b) Intern programs in V.A. hospitals must be viewed in thislight. These were never requested by the V.A. The internprogram has always been asmall one. After reviewing theopinions of those most closelyassociated with them in the pastand at present, your Committeeis of the opinion that internships in V.A. hospitals are notnecessary for the best care ofthe veteran, and are not required for the resident trainingprogram. Your committee recommends that if this is theopinion of the Association it sostate to the chief medical director of the V.A.
c) It was brought to the attentionof your Committee that approval of certain residencies atsome V.A. hospitals had recently been reduced or curtailedby the Council on Medical Education and Hospitals of the AMAand the organizations associatedwith it. All V.A. hospitals having residency programs werewarned on December 22, 1953that their programs were subject to review. In consonancewith the principles statedabove, your Committee believesthat to fulfill their purpose,residency programs in V.A. hospitals must have appropriateapproval by established reviewcommittees. It should be pointedout that where a V.A. residencyprogram is deficient in somearea, it can frequently bebrought up to standard by affiliation with a university or othercivilian teaching hospital.
d) There have been many queriesconcerning supplemental com-
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pensation for full time physicians in the Department ofMedicine and Surgery of theV.A. Your Committee is verymuch concerned with this problem, and recommends that fulltime V.A. physicians not be putin any position which mightjeopardize their status underPL 293 which has operated sosuccessfully both for the benefit of the veteran and for medical education. Your Committeestrongly urges that such salaryadjustments may be made aswill prevent further loss of superior men from the top gradesamong full-time V.A. physicians.
e) Your committee recommends tothe Association that it endorseand reaffirm its enthusiasticsupport of the relations betweenthe V.A. and the medical schoolswhich have been in effect forthe past 10 years.
ELECTION OF OFFICERS
The report of the Nominating Committee was read by Chairman Granville A. Bennett. Upon recommendationof the committee and in the absence offurther nominations from the floor, thesecretary was instructed to cast a unanimous ballot for the following officersfor 1955-56:
For president-elect: John B. Youmans,dean, Vanderbilt University School ofMedicine.
For vice president: Harold S. Diehl,dean, University of Minnesota MedicalSchool.
For treasurer: Stockton Kimball,dean, University of Buffalo School ofMedicine.
For elective members of the Councilto serve until 1958: John Z. Bowers,dean, University of Wisconsin MedicalSchool; John F. Sheehan, dean, StritchSchool of Medicine of Loyola University.
Other Council members are: 1956,George N. Aagaard and Walter R. Berryhill; 1957, Lowell T. Coggeshall andThomas H. Hunter.
67th ANNUAL MEETING
The 67th Annual Meeting of the Association will be held November 12-14,1956, at the Broadmoor Hotel, ColoradoSprings, Colo.
Journal of MEDICAL EDUCATION
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TEACHING INSTITUTE
The next Teaching Institute will bcheld in 1957, on Clinical Teaching Including the Internship.
FILM PROGRAM
Two film programs, arranged by J.Edwin Foster, director of the MedicalAudio-Visual Institute, were presentedat 9 o'clock. One was of general interest,the other of medical interest.
EXECUTIVE COUNCIL
The first meeting of the 1955-56 Executive Council was held on Tuesdayevening, October 25, at 8: 30 p.m. Association President Robert A. Moore waselected Council chairman. Dean F.Smiley, secretary, was reappointed. TheExecutive Council passed the followingresolutions:
RESOLUTION 1. Whereas this Association in 1944 asked Dr. Anton J. Carlson to head a committee to cope withthe then-growing problem of antivivisection agitation, and
Whereas, Dr. Carlson's committee ofthis Association established the NationalSociety for Medical Research to focusthe influence of all organizations andinstitutions concerned in any way withmedical progress, and
Whereas, the National Society for Medical Research under Dr. Carlson soonreversed the defensive, apologetic andsecretive policies that had nourished theantivivisection movement, and
Whereas, the program of factual public education and affirmative action ledby Dr. Carlson has contributed inestimably to the freedom and efficiency ofexperimental biology and medicine, and
Whereas, this year Dr. Carlson hasretired from the active leadership ofthis work as the president of the National Society for Medical Research,
Now therefore be it resolved that theAssociation of American Medical Colleges does hereby express the gratitudeof its members to Dr. Carlson for hisinvaluable contribution to public understanding and support of medical education and medical research.
RESOLUTION 2. Whereas, John M.Stalnaker has resigned as Director ofStudies for the AAMC on September 1,
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1955, to become president of the National Ment Scholarship Corp., and
Whereas, for the past SIX years he hasserved the AssocIation with distinction,Initiating and directing many and import~mt research studies and serviceactivities, and
Whereas, at the open hearing on theannual report of the Committee onTeaching Institutes and Special Studiesit was unanimously agreed, be it therefore,
Resolved that the membership of theAAMC, indivldualy and collectively, expresses to John Stalnaker ItS deep andsincere gratitude for his loyal, devotedand invaluable serVice, unshntinglygiven to the AssociatIOn and that theASSOCiatIOn wishes him every successin his new endeavor.
RESOLUTION 3. Whereas, a significant step has been taken by the Department of Defense to increase the complement of career military medical officersthrough the Implementation of theSenior Student Program,
Therefore, be it resolved that the AsSOCiation of American Medical Collegesgo on record as endorsing the Department of Defense Student Program.
RESOLUTION 4. Whereas, the Association of American Medical CollegesWill soon begin the construction of itsown buildIng in Evanston, Illinois, and
Whereas, this building Will significantly increase the potentialities of servIce by the Association to the memberschools, to the American people and tomedicine throughout the world, and
Whereas, this new venture With theresultant broadening of scope was madepossible by a gift of land from Northwestern University and gifts for construction by The China Medical Boardof New York, Inc., and the Alfred P.Sloan Foundation,
Be it therefore resolved that the Association express appreciation to Northwestern University, to the China Medical Board of New York, Inc, and to theAlfred P. Sloan Foundation for thegenerous support they have given theAssociatIOn.
REPORTS ON EXPERIMENTS INMEDICA'- EDUCATION
CommencIng on Monday, October 24,and concluding on Tuesday, October 25,nine reports were given on experimentsrecently conducted, or at present goingon, in the medical schools.
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Speakers and their topics were:Robert K. Merton, Columbia Univer
sity; and Samuel Bloom, University ofPennsylvania School of Medicine--Studies in the Sociology of Medical Education.
George G. Reader, Cornell UniversityMedical College--Some Problems inTeaching Comprehensive Medicine.
Francis R. Manlove, University ofColorado School of Medicine--The General Medical Clinic: An Experiment inClerkship Teaching.
Milton J. E. Senn, Yale UniversitySchool of Medicine--A New Orientationfor Instruction in Pediatrics.
Joseph T. Wearn and T. Hale Ham,
SYMPOSIUM ON COMPENSATIONOF FACULTIES OF CLINICALDEPARTMENTS
On Wednesday morning, October 26,1955, a symposium was held on Compensation of Faculties of Clinical Departments. Speakers and their subjectswere:
Lowell T. Coggeshall, University ofChicago-The Full-Time Plan at theUniversity of Chicago.
Wilburt C. Davison, Duke University-The Private Diagnostic Clinic at DukeUniversity.
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Western Reserve University School ofMedicine--The Development of an Experiment in Medical Education.
John W. Patterson, Western ReserveUniversity School of Medicine--Interdepartmental and Departmental Teaching of Medicine and the Biological Sciences in Four Years.
John L. Caughey, Western ReserveUniversity School of Medicine--ClinicalTeaching During Four Years.
W. Clarke Wescoe, University of Kansas School of Medicine--Preceptors asGeneral Educators in Medicine.
John B. Truslow, Medical College ofVirginia-Medical Education and theDistribution of Physicians.
Thomas H. Hunter, University of Virginia-The University of Virginia Plan.
Norman B. Nelson, University of Iowa-The University of Iowa Plan.
George Packer Berry, Harvard Medical School-The Harvard UniversityPlan.
INSTALLATION OF PRESIDENT
Robert A Moore, president-elect in1954-55, was installed as president ofthe Association for 1955-56 on Wednesday, October 26.