Grounded In The Present, Aware Of The Past, And Looking To The Future

1. Grounded In The Present, Aware Of The Past, And Looking To The Future Virabhadrasana II Warrior II This pose helps develop a sense of determination and perseverance.  Being a true warrior rarely if ever means displaying aggression openly or proclaiming your strength by proving others weaker.  This is the trust of a warrior, the ability to release the need to control in order to create openness and authenticity.

2. University of Edinburgh College of Medicine & Veterinary Medicine • Faculty of Medicine was founded in 1726 on models established at the University of Padua in the 16th century • boost the economy of the city by attracting foreign students rather than send Scots to the continent • in 1720, Alexander Monro appointed Chair in Anatomy. 3 generations of Monro’s continued for 128 years • In 1726, 4 additional chairs added to new Faculty of Medicine 200 Bed Royal Infirmary in 1738 http://www.mvm.ed.ac.uk/history/note4.htm

3. Early Medical Education in US 1st medical school in the colonies was founded in 1765 at the University of Pennsylvania, then known as College of Philadelphia, by Dr. John Morgan, a graduate of Edinburgh. Department of Medicine Surgeons' Hall 1765 - 1801 http://www.archives.upenn.edu/histy/features/1700s/people/morgan_john.html http://hdl.library.upenn.edu/1017.6/20040114013

4. Roots in Edinburgh and London • With Edinburgh as their model, they built the school within institution of higher learning • With their experience in London, they emphasized the need to have bedside teaching at Pennsylvania Hospital founded by Ben Franklin and chartered in 1751 Request To Admit Bearer Signed By Ben Franklin in 1753 Cast of Pregnant Woman During Autopsy http://www.uphs.upenn.edu/paharc/collections/gallery/artifacts/Cast_2.html http://www.uphs.upenn.edu/paharc/collections/gallery/artifacts/Admission.html

5. Early Curriculum • Medical education included formal lectures for a semester or two and several years of apprenticeship. • The first lectures were in anatomy and the theory and practice of “physik” • There was no formal tuition, no prerequisite academic preparation, and written exams were not mandatory

6. Harvard Started Lectures in 1782 • The 1st professors included John Warren of anatomy and surgery, Benjamin Waterhouse of the theory and practice of physic, and Aaron Dexter of chemistry and materia medica • In 1809 John Warren's son, John Collins, Warren John Gorham and James Jackson joined the faculty Annual Circular 1810 http://countway.med.harvard.edu/rarebooks/exhibits/broad_foundation/broad_foundation2.html

7. Education at Harvard Admission Ticket for Ichabod Tucker to the Lectures of Aaron Dexter onOctober 14, 1790 Engraving of Holden Chapel Used for classes 1800 – 1810 after basement of Harvard Hall considered, "unhealthy, inconvenient, and disgraceful," http://countway.med.harvard.edu/rarebooks/exhibits/broad_foundation/index.html.htm

8. Medical Jurisprudence 1821 Medical Skill Applied In Aid of Judiciary • Deaths by violence, poisons, suicide • Rape • Infanticide • Legitimacy of children • Abortion • Venereal disease • Insanity Notes by Thomas A. Brayton from lectures by Amos Eaton  Berkshire Medical Institution, Pittsfield, MA, 1821-1822 Courtesy of Jill Newmark, National Library of Medicine

9. The Cause of Female Medical Education – Female Medical College of Pennsylvania • Established by Quaker businessmen, clergy and physicians in 1850 • “Practice of midwifery by males is itself an innovation upon ancient and legitimate practice” • Females should have physicians of their own sex to attend to “their many peculiar maladies” • A woman is the best physician for all diseases of women and children • Means of gaining an honorable and independent subsistence

10. 3rd Annual Announcement of the Female Medical College of Pennsylvania • Completed ordinary education • 3 years of study including 2 under supervision of a physician • Attended 2 full courses of lectures • Write a thesis • 6 scholarship students • 52 students in 1852 http://archives.drexelmed.edu/womanmd/item.php?object_id=001143

11. Council on Medical Education • In 1904, AMA created the Council on Medical Education (CME) to promote restructuring of US medical education. • CME outlined its 2 major reform initiatives: • standardization of preliminary education requirements • “ideal” medical curriculum consisting of 2 years of training in laboratory sciences followed by 2 years of clinical rotations • Abraham Flexner, a pioneer of active, learner-centered education, hired by Carnegie Foundation for the Advancement of Teaching Beck AH, The Flexner Report and the Standardization of American Medical Education. JAMA, 291:2139-2140, 2004

12. Flexner’s Approach to Evaluating Medical Education • Reform had been promoted as means to  status • The business ethic that governed profit-seeking medical schools was incompatible with values necessary for a socially useful medical education. • Flexner’s unique contribution was to promote educational reform as a public health measure. “The overwhelming importance of preventive medicine, sanitation, and public health indicates that in modern life the medical profession is an organ differentiated by society for its highest purposes, not a business to be exploited.” Beck AH, The Flexner Report and the Standardization of American Medical Education. JAMA, 291:2139-2140, 2004

13. Flexner Report • Examined 5 principle areas: entrance requirements, size and training of faculty, endowment and tuition, quality of laboratories, and availability of a teaching hospital • Flexner’s unique contribution was to promote educational reform as a public health measure • State government is proper instrument for regulating medical education, because social welfare is inextricably linked to the quality of the nation’s physicians • State licensing boards began to force schools to implement heightened admission standards and stricter curriculum requirements according to CME guidelines Beck AH, The Flexner Report and the Standardization of American Medical Education. JAMA, 291:2139-2140, 2004