Education of Physicians

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Review and Herald Publishing Association · Takoma Park Station, Washington, D. C. · Sep 9, 1915

FromReview and Herald, Vol. 92, No. 44.

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Education of Physicians

JESUS CHRIST is justly called “the Great Physician.” We are also taught to look upon him as the greatest teacher the world has ever seen. I take it, then, to be reasonable that we should look to the life and teachings of Jesus for a revelation of the fundamental truths to be followed in the teaching of men to become physicians.
There are three great truths in Christ’s life and teachings which particularly stand out in my mind in connection with this subject: First, love must be the motive of service, and not the desire for gain. And this truth is taught so universally by him that it is difficult to select those parts of his life and teaching which best exemplify it. Perhaps the story of the good Samaritan is the best illustration. In the Testimonies of the spirit of prophecy this truth is emphasized over and over again in the warnings to physicians against what is called commercialism. For example, we are warned not to “seek to grasp the very highest wages or else do nothing,” and again, against “exacting the large fees that worldly physicians demand for their services.”
We sometimes use the word “professionalism” to mean about the same as “commercialism.” I think this is not a justifiable use of the word. The practice of medicine should never be on a commercial basis, but should always be a high type of professional work, which to my mind should mean an enthusiastic service from the motive of love for those who suffer and demand relief, and a love for the doing of the work.
There is one element that often comes into the work of the physician which tends to commercialism, and which is inimical to disinterested service, or the highest type of professional work. I refer to the evil of competition. It is a well-known fact that the great majority of medical practitioners in their work are in very strong competition with one another. I believe that the Christian physician should not put his services on such a basis, nor consent to work in a place where it is necessary for him to be in such a position. It is not conceivable that the work of Christ should be of such a nature that those who are taking part in it should have to be competing with others for work which they feel is necessary to bring in an adequate financial return.
The second great outstanding truth of Christ’s message, which it seems to me is especially applicable in a consideration of medical education in this relation, is that which he enunciated with reference to the true method of study. When the Jews marveled at his wisdom and authority, in view of the fact that he had never taken a course of study in the schools of the day, he explained his intellectual power and moral authority by saying, “If any man will do his will, he shall know of the doctrine,” or teaching. In order rightly to know the truth, we must do the things which we are studying. This truth is expressed in the following words: “We must have a living experience in the things of God before we are able to understand his Word. This experimental knowledge is what strengthensthe intellect and builds us up into Christ, our living Head.”—“Counsels to Teachers,” page 97.
In our medical teaching, this principle of the superiority of practical study is recognized in the teaching of the fundamental subjects of anatomy, physiology, chemistry, pathology, etc., as well as in the teaching of the clinical subjects; and the tendency of the better medical schools in late years is to put the large part of the teaching on this experimental basis. In my opinion we should plan our work to make all our teaching even more strongly practical than is the general rule. It should be our effort in planning the teaching and the clinical and laboratory facilities, to make it possible for, and in fact incumbent upon, the medical student to make use of the essential laboratory procedures himself in the examination of all the patients with whom he deals, as well as to apply the therapeutic procedures in the individual cases himself.
The third important teaching of Christ which should be constantly held up before the medical student during the period when his mind and body are becoming trained for the work of the physician, along with these two other thoughts, is the idea that sickness, disease, and death are the direct result of sin, and that sin includes the breaking of any of the laws of nature, which are the laws of God, and that the only real cure of disease comes through removal of the cause, which means the ordering of the life in accordance with law. In other words, our great work as Christian physicians should be the study of causes of diseases and of the laws of right living, and the teaching of these truths to those who need them. Or we might say it is the practice of preventive medicine in the broadest and highest sense.
We should become specialists in the art and science of the use of pure air and pure water, cleanliness, proper diet, exercise, purity of life, and a firm trust in God’s love and providence as preventive and curative agents. In Christ’s words to the man who was sick of the palsy, “Thy sins be forgiven thee,” he indicated that the sickness from which the man suffered was the result of sin, and that the same creative power was as effective to forgive the sin as to remove the results of sin.
This view of disease, if kept before our minds, must naturally exclude the empirical treatment of symptoms by poisonous drugs, or even other therapeutic agencies, as the large part of our duties as physicians.
In this special instruction which has come with reference to the work at Loma Linda, the one thought repeated more often perhaps than any other, is the importance of getting away from the idea of the necessity of following after the pattern of the world in our educational work. This is seen in such expressions as, “Shall we represent before the world that our physicians must follow the pattern of the world before they can be qualified to act as successful physicians?” “The less dependent you are upon worldly methods of education the better it will be for the student. I would that all might see the inconsistency of our being God’s commandment-keeping people and yet feeling that we must copy after the world in order to make our work successful.”
I have given considerable thought to these expressions in trying to comprehend what is meant by worldly methods. Of course they cannot be interpreted as condemning all methods of teaching and study used in the larger scientific schools. I think we must look to the written instructions themselves in order to learn what some of these worldly methods are which are to be avoided. Some of the specific points which are set before us as goals in our work are as follows:—
  1. Simplicity in all of our teaching, which is not seen in the worldly schools.
  2. Great emphasis laid on the practical education.
  3. Avoidance of the use of poisonous drugs.
  4. Avoidance of the spirit of competition.
  5. Superficial work on the part of the students in covering a subject, simply with the motive of passing the required examinations and receiving their credits.
In our effort to hew to the line in the matter of avoiding worldly methods, as we are so frequently warned, we must not confuse these worldly methods with high scientific attainments: for we are repeatedly urged to strive for the highest scientific and literary attainments, and to turn away from being satisfied with any superficial knowledge. “The light that God has given in medical missionary lines will not cause his people to be regarded as inferior in scientific medical knowledge, but will fit them to stand upon the highest eminence.”
“In striving in a legitimate way and in the fear of God for this scientific knowledge which will fit us, and those whom we are training as students, to stand upon the highest eminence, we should think carefully of the principle of specialization. In the present state of medical knowledge it is impossible for people of ordinary ability to do efficient work without more or less of specializing. This principle is recognized in these words in the Testimonies: ‘No man can hope to be a complete whole.’ God has given to every man certain gifts, and has ordained that men be associated in his service in order that the varied talents of many minds be blended.”
However, this principle of special training must not be allowed to interfere with the complete training of every physician in all the fundamentals of medicine, with an adequate knowledge of each of the special groups of diseases; and this is particularly applicable in the case of those men and women who are to do their work in fields where they must work alone without other physicians, as in the foreign mission fields.
In our plans for our medical school curriculum we must give first place to a systematic and daily study of the Bible. “If medical students will study the Word of God diligently, they will be far better prepared to understand their other studies; for enlightenment always comes from an earnest study of the Word of God. Nothing else will so help to give them a retentive memory as a study of the Scriptures. Let our medical missionary workers understand that the more they become acquainted with God and with Christ, and the more they become acquainted with Bible history, the better they will be prepared to do their work.”
The work in Bible teaching should be so arranged, and the teachers of Bible so selected, as to make it possible to correlate the Bible teaching with the teaching of the medical sciences in such a way as to make each shed light on the other; for, rightly understood, science and the written Word agree. But we should always emphasize the fact that the Bible is not to be tested by men’s ideas of science, but science is to be brought to the test of the unerring standard. Teachers should be selected who are able to teach after the method of Christ, bringing spiritual lessons from a study of natural phenomena.
The preparatory work for the medical course should receive very careful consideration. The consensus of opinion of the medical educational authorities seems to be that two years of regular college work is sufficient, but that that standard is about the minimum ideal standard; and many of the States are now requiring that amount of preparation for those who are to be allowed to begin practice in those States. I see no reason why this standard should not be accepted.
The principle of requiring, or at least strongly recommending, the year of practical work (interne year) after graduation, I am sure is a good one, and I believe we should lay definite plans so to arrange the work in our institutions as to make it possible to supply this practical work in a systematic manner.