The old proprietary medical school in this country taught medicine very badly as viewed by modern standards. There was no attempt even to demonstrate the foundation sciences in laboratories, which, except for the dissecting room and the study of necropsy material, scarcely existed. Chemistry and physiology were taught only in lecture rooms, while bacteriology and pharmacology had not even been discovered. That physicians and surgeons of any ability were trained at all was due entirely to the presence on the teaching faculties of great personalities who, by their precept and their example, dominated the fields of clinical medicine and clinical surgery. Those early schools taught the theory and the practice of medical and surgical art well, so far as they could be taught in the lecture room and at the bedside in hospital wards. A fixed and graded course of instruction of three years' duration was generally adopted about 1886,
LAMBERT SW. DEVELOPMENT OF A FIFTH YEAR IN MEDICAL EDUCATION IN THE UNITED STATES. JAMA. 1916;LXVI(8):545–548. doi:10.1001/jama.1916.02580340001001
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