this paper, that before I concluded it I should have listened to far stronger remarks than any I have indulged in, in an assembly of medical teachers and practitioners in London at a meeting of the Metropolitan branch of this Association, under the presidency of Dr. Andrew Clark. On this occasion, Mr. Huxley said that to expect students to pass an examination in the subjects on which they are now examined, after only four years' study, was little short of "criminal." He characterized the attempt "to cram the student with all these subjects as utterly preposterous. The amount of work expected is simply gigantic." Mr. Hutchinson said: "The best memories stagger under the present load. . . . That after four years' study a student can be expected to bear his subjects in mind is simply an absurdity."
But it is time to ask, What is the remedy for these evils?
First of all it is necessary to make them widely known. Educators and examiners must at least have no chance of sinning from ignorance, although, as I have said, some who know most of the laws of physical and mental health are the chief culprits. It must be insisted that they are oftentimes putting too heavy a weight upon the camel's back, and it is for them in the first instance to consider in what way they can best diminish the tension, and, as regards medical education, rearrange the curriculum. What I complain of is that at the present moment the tendency in certain quarters is to render this curriculum, and consequently the examinations, harder and harder, more and more unpractical; so that many can feelingly unite with the Earl of Ellesmere, who said to a friend, shortly before his death, that he was not sorry to go. The world was clearly becoming very disagreeable; everybody was going to examine everybody, and he was sure he should be plucked!
In the second place there must either be a change in the character of medical examinations, or the period of time occupied in study must be extended. I believe that the first is absolutely necessary, and that the second is in any case highly desirable. As regards the change in the character of the examinations, it should be in the direction of lessening the demands made upon the memory; and, as regards length of time, I think a year more than is now required would be a great advantage. It would also be an immense gain to the student if, while he is engaged in hospital-work, he should have no examinations hanging over him, except "medicine" or "surgery." This means the subdivision of medical examinations.
Mr. Hutchinson proposes that students should be thoroughly examined during their curriculum (by hospital teachers or traveling examiners) on the various subjects, and bring up certificates of proficiency to the Examining Boards. These would accept the certificates as proofs of competency in details, and would give a good, general, practical examination before granting a diploma. If this course be adopted, and is not overdone, it will certainly be an immense improvement
