AAMC minutes of the proceedings sixty-fifth annual meeting ... · C. Nash Herndon, associate...

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~October 18 -19 - 20, 1954

FRENCH LICK, INDIANA

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Office of the Secretary185 N. Wabash Ave.

Chicago I, Illinois

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Offic:ers and Members of the Exec:utive Counc:il

OFFICERS OF THE ASSOCIATION

1953-1954

President: STANLEY E. DORST University of CincinnatI School of Medicine

ehairman, ExecutIVe CounCil: JOSEPH C. HINSEY -- __ New York HospItal-Cornell Medical Center

President-Elect VERNON W. LIPPARD Yale University School of MedIcme

Vice President WILLIAM S. MIDDLETON _University of Wisconsin Medical School

Treasurer: JOHN B. YOUMANS VanderbIlt University School of Medicine

Immediate Past President. WARD DARLEY_University of Colorado

Secretary: DEAN F. SMILEY 185 N. Wabash Ave., Chicago 1, Ill.

Director of Studies: JOHN M. STALNAKER 185 N. Wabash Ave., Chicago 1, Ill.

ExecutIVe CounCil, 1956: GEORGE N. AAGAARD University of Washington

School of Medicine (Seattle)

ExecutIVe CounCil, 1956: WALTER R. BERRYHILL University of North CarolinaSchool of Medicine

ExecutIVe CounCil, 1955: JOHN Z. BOWERS __ University of Utah Collegeof Medicine

Executive CounCil, 1955: STOCKTON KIMBALL University of Buffalo Schoolof Medicine

ExecutIVe CounCil, 1954: ROBERT A. MOORE Umversity of Pittsburgh

STAFF

Secretary; EdItor, Medical Education

_Director of Studies

Director, Medical Audio-Visual Institute

DEAN F. SMILEY

JOHN M. STALNAKER

J. EDWIN FOSTER

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The Results of the Ithaca Conferences on the Teaching of Psychiatry-TheodoreLid:

The Results of the Colorado Springs Conference on Preventive Medicine in MedicalSchools-John P. Hubbard. Duncan W. Clark

French lick Springs Hotel, French Lick, Indiana

October 18-19-20, 1954

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TUESDAY, OCTOBER 19, 1954

Address-Rev. John Courtney Murray, S.J., "A Theologian Looks at Professional(to be published in later issue of the Journal of MEDICAL EDUCATION)

Election of Officers for 1954-55

Presentation of the Borden Award in the Medical Sciences for 1954

(President Stanley E. Dorst presiding)

Meetings of Round Table Discussion Groups

Highlights of the Institute on the Teaching of Patholagy, Microbiology,Immunology and Genetics

Presidential Address-Stanley E. Dorst (see page II)

Introduction of New Deans

Sixty-Fifth Annual Meeting

Association of American Medical Colleges


Naming of Nominating Committee

The Association Pays Tribute to Joseph C. Hinsey-Ward Darley

MONDAY, OCTOBER 18, 1954

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The Results of the 1953 Instifute on the Teaching of Physiology, Biochemistryand Pharmacology-Julius P. Comroe

Professional Education as a University Function

As Viewed by a University Chancellor-Henry T. HealdAs Viewed by a Law College Dean-Shelden D. Elliott

(Both addresses to be published in a later issue of the Journal ofMEDICAL EDUCATION)

Open Hearings on Annual Reports of CommitteesNames of Members of Committees

(For full reports as acted upon see page 48)

Medical Audio-Visual Institute Film Program

Executive Council Meeting


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WEDNESDAY, OCTOBER 18. 1954


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Journal of MEDICAL EDUCATION

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Report of the Treasurer-John B. Youmans.

Roll Call.....

Report of the Chairman of the Executive Council-Joseph C. Hinsey .

Report of the Director of Studies-John M. Stalnaker .

Report of the Director of the Medical Audio-Visual Institute-J. Er/win Foster

Report of the Secretary and Editor-Dean F. Smiley

Approval of Minutes of the 64th Annual Meeting....

Financing Medical Education-John B. Youmans.

International Relations in Medical Education-Francis Scoff Smyth .

licensure Problems-Charles A. Doan ..

Internships and Residences-Currier McEwen....

Audiovisual Education-Walfer A. Bloer/orn .

Editorial Board-John Z. Bowers .

Medical Care Plans-Dean A. Clark .

Continuation Education-James E. McCormack.

Public Information-John L. Caughey .

The National fl!nd for Medical Education-Chase Mellen Jr.

Veterans Administration-Medical School Relationships-R. Hugh Woor/.

Teaching Institutes and Special Studies-George Packer Berry ....

The American Medical Association Foundation-Hiram Jones

The National Society for Medical Research-Ralph Rohwer/er .

Planning for National Emergency (MEND)-Stan/ey Olson page 60

The National Intern Matching Program-F. J. Mullin .

Business Meeting of the Association

Reports and Recommendations of Committees

Reports from Related Organizations

Presentation of Resolutions...

Installation of President. . .

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Association Committees and Representatives to Related Organizations for 1954-55

Time and Place of the 1955 Teaching Institute on Anatomy and Anthropology . ....

Time and Place of 66th Annual Meeting

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William B. Wartman, professor of pa!hology, Northwestern University Medlcal School- Should the ExaminationServe as a Learning Exercise?

Colin M. MacLeod, professor of microbiology, New York University Collegeof Medicine-The Scope of Microbiology.

C. Nash Herndon, associate professorof medical genetics, Bowman GraySchool of Medicine-Genetics in MedicalEducation.

Dale R. Coman, professor of experimental pathology, University of Pennsylvania School of Medicine - ProjectTeaching.

I. Davidsohn, professor of pathology,Chicago Medical School-Integration ofPreclinical and Clinical Studies.

Brief remarks also were made byRobert A. Moore, Institute co-chairman,and George Packer Berry, chairman ofthe Committee on Teaching Institutesand Special Studies.

ROUND TABLE DISCUSSIONS

Eight round table Institute discussionswere held concurrently. Groups andtheir chairmen were:

A. G. Lyman Duff, McGill UniversityFaculty of Medicine.

B. William B. Wartman, NorthwesternUniversity Medical School.

C. John T. Cuttino. Medical Collegeof South Carolina.

D. Granville A. Bennett, University ofIllinois College of Medicine.

E. John F. Sheehan, Stritch School ofMedicine of Loyola University.

F. James P. Tollman, University ofNebraska College of Medicine.

G. Mark R. Everett, University ofOklahoma School of Medicine.

H. George A. Wolf Jr., University ofVermont College of Medicine.

THE BORDEN AWARD

The nominating address for the Borden Award in the Medical Sciences wasmade by Ashley Weech, Borden AwardCommittee chairman, as follows:

A signal event at the annual banquetof the Association of American MedicalColleges is the presentation of the BordenAward. It is an event which permits our

NOMINATING COMMITTEE

The Nominating Committee was namedby President Stanley E. Dorst as follows: George Packer Berry, chairman;Walter A. Bloedorn; Marion Fay; W.Clarke Wescoe; R. Hugh Wood; Richard H. Young.

INSTITUTE HIGHLIGHTS

Highlights of the recently concludedIZ:;titut.e on the Teaching of Pathology,MlCroblOlogy, Immunology and Geneticswere presented after introductory remarks by Douglas A. Sprunt, chairmanof the Institute. Speakers and theirSUbjects were:

G. Lyman Duff, dean and professor ofpathology, McGill University Faculty ofMedicine-How to Deal with the Important Needs for Service.

INTRODUCTION OF NEW DEANS

The following new deans were announced:

John B. Lagen (acting dean) University of California School of Medicine(S.F.); George T. Harrell, University ofFlorida College of Medicine; Marcus D.Kogel, Yeshiva University, Albert Einstein College of Medicine; E. HughLuckey, Cornell University Medical College; Granville A. Bennett, University ofIllinois College of Medicine; HomerMarsh, University of Miami School ofMedicine; George Morris Piersol, University of Pennsylvania Graduate Schoolof Medicine; A. J. Gill (acting dean),Southwestern Medical School; HowardW. Potter (acting dean), State University of New York College of Medicineat ~ew York City; Grant Taylor, Universlty of Texas Post-Graduate Schoolof Medicine; George N. Aagaard University of Washington School of Medicine(Seattle); Carl V. Moore, WashingtonUniversity School of Medicine (St.Louis); Chester Bryant Stewart, Dalhousie University Faculty of Medicine.

Other administrative appointees wereRobert A. Moore, vice chancellor University of Pittsburgh Schools ~f theHealth Professions; Jean A. Curran, associate executive dean of medical education, State University of New York.

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Minutes of the Proceedings

Association to express in a concrete wayits appreciation and its recognition ofoutstanding scientific achievement. Sincewe are happy in being able so to expressthese sentiments, it is altogether properand just that we should thank theofficers of the Borden Company Foundation and of its parent company for thephilanthropy which has made the eventpossible. We also want to assure theseofficers through their representative, Mr.McCain, that we have not forgotten thatthe Borden Awards serve a two-foldpUrPose. Not only are we enabled tohonor the living great, but also the actserves to illuminate the work and theideals of a great scientist of a hundredyears. ago. Gail Borden, whose featuresappear in bas-relief on the awardmedals, would himself have approved ofthe method chosen to commemorate hisachievements.

It is also proper and just to thank themembers of the Association for theirvery great labors in connection withnominations. Those many of you whohave nominated are aware of the laborinvolved. You have assembled andmailed reprints and bibliographies. Youhave furnished the curricula vitae. Youhave done more. You have sent yourpersonal comments in assessing theachievements of your nominees. Withoutyour help, your committee could nothave proceeded. The committee, in turn,can assure you that the informationturned in was studied thoughtfully indetail. Each committee member actedwithout consultation and made his ownassessments. The assignment was noteasy. I know I speak for the others whenI say that all of the nominees deservedconsideration. All of them are scientistsof distinction and all have contributedimportantly to recent advances in medicine. In attempting evaluation, I wasreminded of an old high school debatein which the opposing sides argued thevirtues of the orange versus those ofthe apple. How does one compare therelative value of important scientificdiscovery in widely different fields ofinquiry-a life-saving advance in cardiac surgery; a new understanding ofthe clinical usefulness of newly isolatedhormones; the discovery of an antibiotic effective against viruses x, y or z?Evaluation depends upon assessment ofthe imagination, ingenuity, intellect andpersistence of the investigator as well

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as on the importance of the discovery.With so many factors to be considered,the selection would seem to depend inpart on the constitution of the committee as well as on the achievements ofthe investigator.

Mr. McCain, we are grateful to youfor what your foundation has done. Weare grateful to the foundation for clearelucidation of purposes and ideals. Ihave described some of the problemsof a committee. With solemn wonder,in view of the difficulties, I can reportto you that our nominee for 1954 waselected on a single ballot. Karl F. Meyerof San Francisco is the choice of theyear. The choice for the year is right.

Stipulations imposed upon your committee in selecting a nominee state thatthe award is to be given for greatscientific achievement during a preceding five years. Karl Meyer meetsthese stipulations with an imposing listof more than 50 publications during thisspan of time. But, the committee wouldfail in frankness if it did not honestlyadmit respect and esteem for a constantly productive career over more than40 years. Early in his investigativeperiod of life, Karl Meyer recognizedthe advantages and the unavoidablenature of symbiotic relationships between men and animals. In a rather recent paper, he verbalized his reflectionsby saying, "Animals have always shapedthe destinies of man." Contacts betweenman and animals have been attendedby many hazards detrimental to humanhealth and threatening human life. Thecareer of Karl Meyer has been dedicatedto removing the hazards and threats.His many contributions to currentknowledge of plague, brucellosis and thepsittacosis group of viruses have furnished answers of great importance tothose concerned with preventive medicine and public health on a worldwidescale. The contributions are more thandeserving of the honor of a BordenAward.

Mr. McCain, the committee of the Association greatly regrets that KarlMeyer is unable to be here this eveningto accept the award in person. Nevertheless, the regrets represent a polite verbalization of mingled emotions. Weglory in the fact that counsel with Meyerremains in high demand. Numerous priorcommitments prohibit his presence here.May I, therefore, present to you, Francis

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Scott Smyth, professor of 'pediatrics ofthe college of medicine of the Universityof California, and a colleague of Dr.Meyer, who will accept the award andbring to you a personal message fromMeyer.

FRANCIS SCOTT SMYTH, professor ofpediatrics and former dean, Universityof California School of Medicine, accepted the Borden Award for Dr. Karl F.Meyer as follows:

Commitments made several monthsago have conspired to prevent me fromattending the meeting of the Associationof American Medical Colleges and fromexpressing to you in person my appreciation of the recognition you have afforded me in choosing me the recipientof the Borden Award. It is a personaldisappointment to be absent on thisoccasion. To be selected from the manydeserving is indeed a singular privilege.It is an acknowledgment of the accomplishments of all who, through the past50 years, have devotedly and loyallyassisted my humble efforts. Since youhonor the University of California, whichafforded me the opportunity for unrestricted investigative work during theworld period of great scientific and social change, it is indeed appropriate thatmy good friend, Dr. Francis Scott Smythof the school of medicine, has kindlyconsented to accept the Borden Awardin my behalf.

Your committee entrusted with theselection of the recipient of this awarddoubtless inquiries into diverse activities, mainly those documented in scientific writings, but in such writings themotivating ideas are not always discernible. Every human being adheres toa philosophy of some kind that gives ameaning to his life as an individual andgrants him a certain satisfaction. In thetwilight of life I would like to reminiscethrough the guiding philosophy of myown life.

In the upper classes of a classicalEuropean high school curriculum anassignment was made to translate fromLatin certain chapters of the classicaltreatise by Ramazzini on the diseases ofworkers, written in 1700. Instead of onlytranslating the chapter, which describesdisorders due to lead poisoning thatattack painters, I perused this work withpleasure and profit. The scholarly observations of a cultivate51 writer left a deep

DECEMBER 1954, VOL. 29. NO. 12

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imprint, because they were the thoughtsand interpretations of an observer offirst rank. To Ramazzini it was the dutyof the physician to "exhaust himself ininfinite examinations, in continual experiments, to try to resolve the greatestas well as the most insignificant medicalproblems."

Scarcely had the impact of this exercise passed when another assignmentwas made: to discuss a formal academicoration made in Latin by Johann PeterFrank in 1790 to the faculty and students at the University of Gottingen.It had been translated into Germanunder the title "The People's Misery.Mother of Disease." In this address,rarely read now, the interrelationshipof poverty, crime and disease are vividlydescribed. Johann Peter Frank approached the problem as a physicianand described in eloquent terms thehigh incidence of illness, the high mortality and the decrease in populationobserved in rural districts. He was alsoa statesman and saw clearly that healthis merely one aspect of much broadersocial and economic problems. Over ahundred years had passed since Frankdelivered his address. The high schoolstudent ready to enter the universitywas profoundly moved by the words andfound them as true in a later century.Poverty is still among the chief causesof disease and the chief sources of crime.Any traveler in underprivileged countries sees clearly that Frank's conceptis as true today as it was in the 18thcentury. Anyone who takes an unbiasedview of his own country sees that it istrue. There is bound to be unrest unlessthe social and economic conditions ofthe underblest are improved.

These early imprints on a receptivemind were well nurtured during its student years by a professor in legal medicine, who emphasized daily the importance of health consciousness and ofa sense of responsibility in a cooperativesociety. General welfare comes beforeindividual welfare. The more specializedsociety becomes, the more man is obligedto give up certain individual libertiesand to assume responsibilities toward thesocial group of which he is a part. Notonly the deadly dramatic epidemic andendemic diseases affect human welfare.Numerous lesser ailments cause endlessSUffering and inflict tremendous economic burdens to the population.

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Early contact with the populations ofthe high plateau and the jungle beltsof Africa created an interest in theproblems of rural health, which cannotbe seen alone as a study in medicine.The health of the 1,300 million ruraldwellers in a world population of 2,400million depends on their success ingrowing food of the right kind andamount, in breeding animals and inbuilding houses and water supplies andall the other adjuncts to communal life.Even a casual acquaintance impressedthe traveler that the diseases predominantly rural are widespread and affectso high a proportion of the populationas to be dominant impediments to socialand economic development. Medicallythey may mask other diseases to thepoint of making them, at least temporarily, clinically irrelevant. The impact of the zoonoses directly and indirectly on the health of the dweller inrural areas of the world has offeredmany fascinating challenges. It has beena delight to exercise the wits in tryingto find the mysterious pathways of thespread of these infections. But nothinghas been as gratifying as applying thelittle knowledge gained to the benefit ofhumanity.

The pursuit of epidemiological problems has been deeply satisfying and hasfulfilled the ideals that give purpose tolife. Now you have graciously decidedto recognize the contributions I havebeen able to make by granting me the1954 Borden Award. With a sense ofhumility and deep appreciation I acceptthis honor. I am profoundly grateful.

TRIBUTE TO DR. HINSEY

The Association paid tribute to thecontributions of Joseph C. Hinsey in hisnine years of service on the ExecutiveCouncil. Ward Darley, president, University of Colorado, spoke as follows:

I count it an honor to appear beforethe Association on this occasion. I saythis particularly because tonight's assignment has made me pause in mybusy life and think back over 10 verypleasant years-years that have beenvery important to my wife and myselfbecause of the many friends we havemade from among you who have beenlaboring together in the interests of thisAssociation and good medical education.It pleases me very much indeed thattonight we are to single out one of these

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friends for special mention, and it is ofgreat personal significance to me that Ihave been selected for the task.

Joseph Clarence Hinsey is a native ofIowa, a product of the middle west. Hespent four years each on the facultiesof Washington University of St. Louisand of Stanford University before hesettled at Cornell University MedicalCollege in 1936 as professor and headof the department of physiology. Threeyears later he was named professor andhead of the department of anatomy, andin another three years the deanship ofthe college was added to his responsibilities. He served in these positions for14 years. In 1953 he was made presidentof the joint administrative board of theNew York-Cornell Medical Center.

Joe is an excellent teacher and hisformer students are now among theworld's leading scientists and physicians.He is also a scientist and in spite of hisheavy administrative responsibilities hehas published some fourscore scientificarticles. He is a member of numerousscientific and medical societies and associations, most of which base theirinvitations to membership upon performance of a high order. Joe has heldhigh office in many of these organizations.

As would be expected of an individualwith demonstrated teaching, scientificand administrative ability, Joe has along record of public service. I can listonly a few of his most notable assignments: The President's Commission onthe Health Needs of the Nation, theboard of managers of the Memorial Hospital of New York City, trustee of theSloan-Kettering Institute, trustee of theChina Medical Board, trustee of CornellUniversity, member of the Committee onthe Survey of Medical Education.

All of his scientific, administrative andpUblic service duties have not kept Joefrom his home. Many of us in this audience have been in his home and havecome to know his charming wife, Sally,and his two children, Elaine and Joseph.Few of us, however, know that he isnow a grandfather-Elaine's twins, aboy and a girl, arrived just in time toallow "Grandpa" to show his usualprompt arrival for the Executive Council meetings last week.

Joe Hinsey is a warm and friendlyman, as you all know. He rarely forgetsa name, and those who know him marvelat the ease and the. pleasure with which


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he can strike up a conversation withanyone with whom he may come in contact-the lonesome student, the man whomay sit beside him on the train or inthe restaurant, a waiter or a porter, andnine times out of 10 he will have beenin their home town, will find a mutualacquaintance or find some other item ofcommon interest. This capacity to establish rapport has no doubt added greatlyto Joe's success as a teacher, an administrator and a public servant.

This academic, scientific, administrative, altruistic and personal picture thatI have tried to draw does but poorjustice to the background from whichJoe has come to give so much and sogenerously of his talents, time and energy to work of this Association andthe cause of medical education.

Joe first came to the Executive Council in 1945 as vice president of the Association. He served as president in 1949.He has been chairman of the ExecutiveCouncil for the past eight years. Inservice to this Association, Joe has beenmilitant and yet considerate; he hasbeen tenacious and yet patient; he hasbeen critical and yet judicious. For adecade he has played a leading role inthe progress of this Association. Underhis leadership it has grown from a rathersmall and not too significant organizationof deans to an Association of medicaleducators and faculties-an Associationthat has played an important part inprotecting the interests of good medicaleducation during World War II and inkeeping medical education abreast, evenahead, of the progress in medicine thatwas to follow. In order that this Association could play this kind of role, itwas essential that it be ably representedin high places. As chairman of the Executive Council Joe has, frequently,either alone or in cooperation withothers, played an important part inseeing to it that the cause of good medical education has been properly andably presented. Even in the course ofhis activities not necessarily related tothose of this Association, he has constantly let it be known that this Association is an important part of this nation'smedical health armamentaria.

In pointing up Joe's significance tothis Association, I could detail suchthings as an improved Journal of MEDICAL EDUCATION, the work of the Committee on Student Personnel Practices, the


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development of the Medical AudioVisual Institute, the broadening of theAssociation's committee activities, andthe development of the Teaching Institutes. Joe has played some role invirtually every facet of the Association'sactivities and it has particularly been because of his efforts that these achievements have been adequately financed. IfI seem to pass these things by withoutelaboration, I do not mean to minimizetheir importance. Of course they areimportant. But what I think is of thegreatest importance to Joe, and thisshould also be of the greatest importanceto us, is that all of his activities, perhapseven his work in this Association, havenot been ends in themselves. To those ofus who know him well, it seems that theall-important thing to Joe has been goodmedical education. His work with Washington University, Stanford and Cornell;his extracurricular activities with foundations, boards, governmental agenciesand countless committees and councils,as well as his service to this Associationhave all been to this end-the improvement of medical education.

We who have worked with Joe haveno fear that his leaving the Council willdiminish his efforts on behalf of medicaleducation. We all know that he has givenan undue amount of his time and energyto our common cause and we are grateful that his work has been so obviouslysuccessful. The present stature of theAssociation is in large measure due tothe spirited leadership he has provided,and we all recognize this fact. If wefeel sad that his leaving the Council willresult in the absence from that body ofa person, a voice and a mind that wehave grown to count on and respect, wecan be happy in knowing that Joe's workfor the Association will never be completed so long as he is active. As youall know, much of the Association's workand responsibility must be and shouldbe carried by non-Council members.While Joe is, by legal requirement, leaving the Council, we are happy that hewill still be one of us and we take comfort in the fact that his skill, his energy,his knowledge and his wisdom will stillbe available for special assignment.

We do not want Joe to retire from theCouncil without an expression of appreciation of him as a person, of our gratitude for his effective hard work andleadership and of our sincere hope that,

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for him, there lie ahead many moreyears of health, happiness and the satisfactions of accomplishment.

DINNER ADDRESSThe address at the Annual Dinner of

ELECTION OF OFHCERS

The report of the Nominating Committee was read by Chairman GeorgePacker Berry. Upon recommendation ofthe committee and in the absence offurther nominations from the floor, thesecretary was instructed to cast a unanimous ballot for the following officers for1954-55:

For president-elect-Robert A. Moore,vice chancellor, Schools of the HealthProfessions, University of Pittsburgh.

For vice president-John McK. Mitchell, dean, University of PennsylvaniaSchool of Medicine.

For treasurer-John B. Youmans, dean,Vanderbilt University School of Medicine.

For elective members of the Councilto serve until 1957-Lowell T. Coggeshall, dean, Division of BiologicalSciences, University of Chicago; ThomasH. Hunter, dean, University of VirginiaSchool of Medicine.

Other Council members are: 1955John Z. Bowers, Stockton Kimball; 1956-George N. Aagaard, Walter R. Berryhill.

CONFERENCE REPORTS

Reports of three teaching conferenceswere presented as follows:

1. "The Results of the Ithaca Conferences on the Teaching of Psychiatry,"Theodore Lidz.

2. "The Results of the Colorado SpringsConference on Preventive Medicine inMedical Schools," John P. Hubbard,Duncan W. Clark.

3. "The Results of the 1953 Instituteon the Teaching of Physiology, Biochemistry and Pharmacology," Julius H.Comroe.

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the Association, "A Theologian Looks atProfessional Education," was presentedby the Rev. John Courtney Murray,S.J., professor of theology, Woodstock(Md.) College.

PROFESSIONAL EDUCATION AS AUNIVERSITY FUNCTION

Henry T. Heald, chancellor, New YorkUniversity, discussed professional education as a university function from theviewpoint of a university chancellor.Shelden D. Elliott, dean of the lawschool, New York University, discussedthe subject as viewed by a law collegedean.

OPEN HEARINGS ON ANNUALREPORTS OF COMMITTEES

Open hearings on annual reports ofcommittees were held as follows:

1. Audiovisual Educatio~Chairman,

Walter A. Bloedorn; Thomas P. Almy;Clarence E. de la Chapelle; William W.Frye; Theodore R. Van Dellen; W. ClarkeWescoe.

2. Continuation Education-Chairman,James E. McCormack; George N.Aagaard; Robert Boggs; Robert Howard;Samuel Proger; Frank Roberts; John B.Truslow.

3. Editorial Board-Chairman, John Z.Bowers; William B. Bean; Stanley E.Bradley; Alan Chesney; James W. Faulkner; Russell L. Holman; Chauncey D.Leake; Dean F. Smiley.

4. Financing Medical EducationChairman, John B. Youmans; Walter A.Bloedorn; Ward Darley; Joseph C. Hinsey; Vernon W. Lippard; Norman Topping.

5. Graduate Medical EducationChairman, Kendall Corbin; Clarence E.de la Chapelle; John Deitrick; Aims C.McGuinness; R. L. Pullen; C. J. Smyth.

6. International Relations in MedicalEducation-Chairman, Francis ScottSmyth; E. Grey Dimond; Frode Jensen;Maxwell E. Lapham; John McK. Mit-


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chell; Elizabeth T. Lam; Harold H.Loucks; Myron Wegman.

7. Internships and Residencies-Chairman, Currier McEwen; D. W. E. Baird;Robert Berson; Harold Jeghers; Warren T. Brown; Charles A. Doan; GordonE. Goodhart; James E. McCormack; JohnMcK. Mitchell; Otto Mortensen; F. J.Mullin; Hayden C. Nicholson; James P.Tollman; Richard W. Vilter; Emil G.Holstrom; George A. Wolf Jr.; Eugene B.Ferris Jr.

8. Licensure Problems-Chairman,Charles A. Doan; John P. Hubbard;J. Murray Kinsman; Frank E. Whitacre;William R. Willard; Albert W. Wright.

9. Medical Care Plans-Chairman,Dean A. Clark; Frank R. Bradley;George Hayman; Henry D. Mulholland;John F. Sheehan; Albert Snoke; Maxwell M. Wintrobe.

10. Planning for National Emergency-Chairman, Stanley Olson; Mark Everett; Thomas Forbes; Stockton Kimball.

11. Public Information-Chairman,John L. Caughey; Walter R. Berryhill;Joseph B. Kelly; Milton Murray; RalphRohweder; Raymond O. Torr; John D.Van Nuys; Harold C. Wiggers.

ROLL CALL

All institutional members were represented except the Medical College ofGeorgia, University of Minnesota Medical School, University of Oregon Medical School and Wayne University College of Medicine.

All affiliate institutional memberswere represented except Queen's University Faculty of Medicine, Universityof Manitoba Faculty of Medicine, University of Toronto Faculty of Medicine,University of Western Ontario Facultyof Medicine.


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12. Teaching Institutes and SpecialStudies-Chairman, George Packer Berry; Philip Bard; D. Bailey Calvin; Stanley E. Dorst; Joseph C. Hinsey; ThomasHunter; Carlyle Jacobsen; Vernon W.Lippard; Rolf Syvertsen; W. ClarkeWescoe; John M. Stalnaker.

13. Veterans Administration-MedicalSchool Relationshtps - Chairman, R.Hugh Wood; Harold S. Diehl; A. C. Furstenberg; Currier McEwen; Gordon H.Scott; Richard W. Vilter.

FILM PROGRAM

Two film programs, arranged by J.Edwin Foster, director, Medical AudIOVisual Institute, were presented simultaneously, beginning at 9 P.M. One ofthese was of general interest; the otherwas on medical teaching.

EXECUTIVE COUNCIL

The first meeting of the 1954-55 Executive Council was held, beginning at9 P.M. Association President Vernon W.Lippard was elected Council chairman.Dean F. Smiley, secretary, and John M.Stalnaker, director of studies, were reappointed.

APPROVAL OF MINUTES OF64th ANNUAL MEETING

The minutes of the 64th AnnualMeeting, October 26, 27 and 28, 1953, atAtlantic City, N. J., were approved aspublished.

REPORT OF THE CHAIRMAN OFTHE EXECUTIVE COUNCIL

JOSEPH C. HINSEY, chairman:I. I summarized the actions of the fall

meeting, October 21-24, 1953, in my annual report to you at Atlantic City, October 28, 1953.

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The actions of the organization meeting of the Council, October 27, 1953,were as follows:

1. George Packer Berry reported onplans for the 1954 Teaching Institute.Douglas H. Sprunt was selected as chairman and Robert A. Moore as co-chairman of that Institute in the fields ofpathology, microbiology, immunologyand genetics.

2. The following resolutions submitted by the Committee on Planning forNational Emergency were approved forsubmission to the Association on October 28, 1953:

"Resolved that the director of the Selective Service System, the chairman ofthe National Advisory Committee to theSelective Service System and the secretary of the Department of Defense beurged to develop a program wherebythe deferment or postponement of, andthe calling of faculty members and residents into military service be arrangedto correspond, whenever possible, to theacademic and residency years.

"Whereas the operation of P.L. 779has caused unnecessary disturbance infaculties in medical schools, and

"Whereas the local and state advisorycommittees are not necessarily composed of individuals competent throughexperience to advise on faculty members, be it hereby

"Resolved that the chairman of theState Advisory Committee in each statein which a medical school is located beurged to set up an advisory committeeto him composed of deans or representatives of each of the medical schoolsin the state."

3. The following resolution submittedby the Subcommittee on Medical Education for National Defense was approved for submission to the Associationon October 28, 1953:

The MEND Committee concludesafter its review of the first year ofoperation of the program in the fivepilot schools that:

"Whereas there is a well-defined andrecognized need for modifications ofmedical curricula to make medicalgraduates better able to cope with medical problems encountered in disasterand war,

"Whereas the underlying philosophyof the MEND pilot program is consistentwith sound concepts of medical education,

32

"Whereas the acceptance by the faculties and the student bodies in the pilotschools after one year of operation ofthe MEND program has been remarkably good,

"Whereas representatives of the armedforces, the United States Public HealthService and the civil defense organization have likewise been favorably impressed with the progress made by theMEND program,

"Whereas it is apparent that this program would not have been possible without the financial support which enabledthe schools to engage a program coordinator and to defray necessary traveling expenses,

"Whereas the value of close cooperation among the representatives of thearmed forces and the opportunity forthe coordinators from the several schoolsto exchange ideas with each other andwIth the representatives of the governmental agencies has been amply demonstrated, and

"Whereas the following have beenmajor elements in the success of theMEND program thus far: (a) close coordination among the various branchesof the armed forces, (b) the cooperationof the federal agencies with the individual schools, (c) the opportunity afforded faculty members for travel, (d)availability of teaching aids such asfilms, special military reports and technical manuals,

"Be it resolved therefore that the Association of American Medical Collegesstrongly recommends that the MENDprogram be continued in the five schoolsin which it has already been initiated,and

"Be it further resolved that the program be made available to all medicalschools on a voluntary basis as rapidlyas possible."

4. Members of the Association's committees and representatives to relatedorganizations were appointed. (Thenames appear on the printed program.)

2. The mid-winter meeting of theExecutive Council was held February 5and 6, 1954, at the Palmer House, Chicago, with action as follows:

Those present were: George N. Aagaard, W. R. Berryhill, John Z. Bowers,Ward Darley, Stanley E. Dorst, JosephC. Hinsey, William N. Hubbard, Stockton Kimball, Vernon W. Lippard, Robert


A. Moore, Dean F. Smiley, John M.Stalnaker, John B. Youmans.

William S. Middleton was unavoidably absent due to illness.

1. Dr. Smiley reported on changes inthe staff as follows: (a) William N.Hubbard Jr., presently associate dean atNew York University College of Medicine, has accepted the position as associate secretary of the Association. Hewill give part time to the work of theAssociation beginning in March 1954,and will begin devoting full time to thework of the Association with the nextacademic year, July 1954; (b) RoyParry assumed the position of advertising manager of the Journal of MEDICALEDUCATION as of January 11, 1954.

2. The decision was made to hold the1955 Annual Meeting at the New OceanHouse, Swampscott, Mass. The TeachingInstitute to be held October 17 through21, 1955, and the Annual Meeting October 24, 25 and 26, 1955.

3. The decision was made to hold the1956 Annual Meetipg at the BroadmoorHotel in Colorado Springs; the TeachingInstitute being held November 5 through9, 1956, and the Association's AnnualMeeting to be held November 12, 13and 14, 1956.

4. The report of the ad hoc committee,consisting of Vernon W. Lippard, JosephC. Hinsey, Stanley E. Dorst, John M.Stalnaker and Dean F. Smiley, appointedto bring in a recommendation concerning means of screening foreign medicalgraduates for licensing in the UnitedStates, was read. After considerable discussion a number of changes were incorporated and Robert A. Moore prepared a final copy which was approvedas follows:

In the opinion of the Executive Council of the Association of American Medical Colleges ways should be kept openby which well qualified physicians mayobtain licensure to practice in theUnited States. It is equally important,however, that the public be adequatelyprotected against the dangers attendanton permitting unqualified physicians toobtain a license to practice.

Inspection and accreditation of American medical colleges has proved to bean important adjunct to the examination of graduates of these colleges bythe various state licensing boards in theeffective screening of American trainedphysicians.

DECEMBER 1954, VOL 29. NO. 12

65th Annual Meeting

However, because of differences inculture, in traditions, and in objectivesit is not desirable or feasible for Americans to undertake a comparable program of accreditation of schools in othercountries. Therefore, some other type ofscreening procedure for those whograduate from a foreign medical schoollisted by WHO and wish to practice inthe United States, is desirable. TheCouncil suggests this procedure:

(1) The applicant should apply to aspecific state licensing board presentingsuch documentary evidence as may berequired by that board.

(2) If the licensing board to whichthe application is made is satisfied thatthe applicant is otherwise qualified, itmay issue the applicant a permit to takePart I of the examination of the NationalBoard of Medical Examiners.

(3) If the applicant successfullypasses Part I of the examination of theNational Board of Medical Examinersthis fact should be certified to the stateboard which may then proceed under itsregulations and requirements.

5. The increasing number of stateswithdrawing support of the nationalboard examinations was noted with regret. The secretary was instructed toprepare a letter which would go out tothe deans of all the medical schoolscalling attention to the problem andsuggesting that possibly it might be wiseto set up a liaison committee betweenthe medical schools of the state and thelicensing board of the state. The deanswould also be asked to keep CharlesDoan, .:hairman of the Committee onLicensure Problems, informed of any action that they take in this field.

6. Final approval was given to theplan of the National Fund for MedicalEducation to issue certificates for leadership in the support of medical education.It is agreed that such certificate shouldbe a joint certificate of the Council onMedical Education and Hospitals of theAmerican Medical Association and ofthe Association of American MedicalColleges. The nominations for such acertificate will be made by the nationalfund, but both councils will have anopportunity to pass on the nominations.

7. A statement, prepared by a committee consisting of Dean Smiley, VictorJohnson, Edward Turner and John Stalnaker, was revised and approved asfollows:

33

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In answer to inquiries regarding policies relative to the transfer of studentsfrom a graduate school to a medicalschool the following principles are suggested:

(1) When students registered in thegraduate school of a university takecourses in the medical school which arethe regularly required courses for medical students, such graduate studentsshould be expected in every instanceand in every respect to meet the samestandards of accomplishment as are expected of medical students.

(2) Students who obtain credit, whileregistered in the graduate school of auniversity, in courses in the medicalschool which are regularly required ofmedical students, may be permitted toapply that credit without questiontoward their M.D. degree if they transferfrom the graduate school and are permitted to officially register in the medical school.

(3) The accumulation of credit by agraduate student in courses usually required of medical students will in noway obligate a medical school to acceptsuch a person as a medical student. Onthe contrary, the committee shouldmake its decision as to the admissabilityof a student purely on its judgment asto his eventual fitness for the medicalprofession.

(4) Whether a university or medicalschool wishes to award credit towardan advanced academic degree such asthe M.S. or Ph.D. for work completedin regular medical school courses, is amatter for the university itself to decide in accordance with that institution'srules relating to graduate degrees.

8. The following were named to continue as members of the Medical Advisory Committee of the Institute ofInternational Education: Duncan W.Clark, Dayton J. Edwards, Aura Severinghaus, Cornelius T. Stepita; Frode Jensen and James McCormack-alternates.

9. The secretary was instructed towrite J. M. Godard, executive secretaryof the Southern Association of Collegesand Secondary Schools, declining the invitation to take part in joint universityvisitations and inspections with that association, at least for the immediatepresent. Since joint evaluation procedures are in the process of being developed with the Middle States Association and have been by no means

34

completed, it was the feeling of theCouncil that further study of this pilotexperiment would have to be completedbefore further cooperative relationshipscould be established.

10. In answer to the Middle StatesAssociation invitation to take part in theevaluation of the University of PuertoRico, Howard University and GeorgeWashington University, it was the decision of the Council that (a) in view ofcurrent reports already on file therewould be no need to take part in theevaluation of the University of PuertoRico and Howard University, (b) in viewof the fact that the only current reportson George Washington UniversitySchool of Medicine are those made inthe Survey of Medical Education underDr. Deitrick, it was voted that the Association would participate along with theCouncil on Medical Education and Hospitals in the evaluation of GeorgeWashington University.

11. After careful consideration anddiscussion of the matter of federal military scholarships the Council approvedthe following statement:

The Council sees no objection to federal military scholarships provided theyare offered under proper conditions.

12. After thorough discussion of summer clinical clerkships in Army hospitals, it was the consensus of the Council that the matter would be left entirelyto the decision of the individual schools.Such clerkships should, however, beoffered on a purely voluntary basis.

13. Stockton Kimball gave a resumeof the findings of his recent questionnaire on draft and selective service difficulties, the returns on which are stillnot complete.

14. The Committee on Planning forNational Emergency was instructed torestudy the report on Medical Education in Time of National Emergency andrevise it, making reference, if possible,to all current problems. After revisionthe report should be submitted to theJoint Committee on Medical Educationin Time of National Emergency.

15. Upon the recommendation of theinspection committee, the University ofBritish Columbia Faculty of Medicinewas voted into full Affiliate Institutional Membership in the Associationof American Medical Colleges. Sinceauthority was voted to the Council tomake this decision at the October meet-


120000

65th Annual Meeting

35

lows: William N. Hubbard Jr. will devote one-third of his time to the Association as associate secretary beginningJuly I, 1954. He will continue, however,to act as associate dean at New YorkUniversity College of Medicine. RossDykman will become full-time assistantdirector and research associate in theCommittee on Teaching Institutes andSpecial Studies. Edward Smith will become half-time IBM technical advisorto the Committee on Teaching Institutesand Special Studies. (He is also halftime managing director of the NationalIntern Matching Program, Inc.). Mrs.Helen H. Gee will take the place ofSarah Counts, resigning September I,as research associate. Mrs. Helen Morford becomes John Stalnaker's administrative assistant in special studies aswell as in the teachmg institutes.

3. An ad hoc committee consistingof John M. Stalnaker, chairman; JosephC. Hinsey, and Dean F. Smiley was appointed to draw up a report and makerecommendations to the whole Executive Council by July 15, 1954, as to theprovision of permanent housing arrangements for the Association's centraloffice.

4. A report by John Z. Bowers, chairman, on the work of the new EditorialBoard was read and plans set forthfor building up and improving theJournal were given general approval.

5. The work of the MAVI was discussed as it was set forth by Dr. Fosterin graphic form. It included school vIsitations, developing information, answermg inquiries, film publications, previewcircuits and miscellaneous activities. Itwas suggested that Dr. Bloedorn consult with Dr. Aagaard, who is on theCommittee on Motion Pictures of theAMA, to see if there are any ways inwhich the work of the two committeescan be better coordinated.

6. Dr. Smiley reported that there areto date 1,071 paid applications for Individual Membership. It was agreed thatanother copy of the brochure and application blank should go out to all nonmembers next year.

7. Plans for the 65th Annual Meeting,to be held at French Lick Springs October 18-20, 1954, were discussed, andapproved.

8. A statement entitled, "Objectivesand Aims of the Association of American Medical Colleges," prepared by

Secretary's Office __ _ _ $ 75,130Journal and Publications_ 74,875Medical Audio-Yisual Institute__ 18,000Committee on Teaching Institutes

and Special Studies_

2. Staff changes were reported as fol-

DECEMBER 1954, YOLo 29, NO. 12

'There are also two additional grants of $25,000 each,one from the Heart Institute and one from the Commonwealth Fund. They are both for the TeachingInstitute.

Total _ __ _ __ _ $288,005The budgeted income for the fiscal

year beginning July I, 1954, was estimated as follows:

Unrestricted Income to the Asso-ciation . $112,500

Earned Income to Sections __ 37,000Giant Income to Sections _ ___ ___ 140,000·

ing of 1953, this is the final action onthis school.

16. Approval was given to a letterwhich will go out on Association ofAmerican Medical Colleges letterheadsand over Stanley E. Dorst's signatureto American industries in connectionwith the National Fund for Medical Education.

17. Lowell Coggeshall made a reportto the Council on the proposed NationalFund for Psychiatric Research andTraining. Suggestions were made as tohow the new organization might be correlated with the National Fund forMedical Education, yet confusion between the two organizations avoided.

18. For the information of the CouncilDr. Berry outlined the plans for the1954 Teaching Institute and briefly reviewed the special studies that the Committee on Teaching Institutes and Special Studies is engaged in.

3. The summer meeting was held June18 and 19, 1954, at the Palmer House,Chicago, with the following actions:

Those present were: George N.Aagaard, Walter R. Berryhill, Joseph C.Hinsey, William N. Hubbard Jr., Stockton Kimball, Vernon W. Lippard, DeanF. Smiley, John M. Stalnaker, John B.Youmans. Unavoidably absent, becauseof illness or conflicts with school commitments, were Stanley E. Dorst, William S. Middleton, Ward Darley, JohnZ. Bowers and Robert A. Moore.

1. The budgeted expenses for the nextfiscal year beginning July I, 1954, wereapproved as follows:

Total ___ _ _ _ $289,500

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John Z. Bowers, was discussed. The secretary was instructed to prepare copiesof this statement and to send them toevery member of the Council with thesuggestion that they send Dr. Bowerstheir suggested revisions or additions.After final revision by Dr. Bowers itwas suggested the statement be published in the Journal of MEDICAL EDUCATION.

9. Reports of recent visitations of eightschools were discussed.

The University of Puerto Rico Schoolof Medicine was voted into full Institutional Membership in the Associationby the Executive Council under theauthority given it by the Association atits October 1953 meeting.

10. Reports were made on the possible development of new medical schoolsin Ohio, Connecticut and New Jersey.

11. A school visitation and consultation schedule for 1954-55 in cooperationwith the Council on Medical Educationand Hospitals of the American MedicalAssociation was discussed and approved.This will leave only three medicalschools in the U. S. that have not beenvisited within the past five years.

12. Plans for cooperation with certainof the regional accrediting associationsin university visitations were discussedand approved.

13. The appointment of representativesto a joint committee (with the AMAand the AHA) to consider changing ofthe traditional dates for the beginningof internships and the beginning of residencies was confirmed. They are F.Joseph Mullin, John M. Stalnaker andHoward Armstrong.

Confirmation was made of the appointment of John Deitrick, of JeffersonMedical College, as the AAMC representative to the Council on MedicalEducation and Hospital's Internship Review Committee.

Dr. Mullin reported that the StudentAmerican Medical Association had requested membership in the corporationof the National Intern Matching Program, Inc. The Council voted its approval of membership of the SAMA inthe corporation.

The following recommendation of aJoint Committee which was appointedas a Subcommittee of the Association'sCommittee on Internships and Residencies was presented by F. Joseph Mullinand, after some revision, approved:

36

The need for filing duplicate application forms as a national procedure forinternship appointment, one to be sentto the hospital and one to be given tothe dean of the medical school by eachstudent, no longer exists. In those medical schools which require that applications be forwarded through the office ofthe dean a duplicate application form,so marked, should be sent by the student directly to the hospital at the timehe leaves his official form with the deanfor transmission to the hospital fromthe school. In those medical schoolswhich do not require that the application be forwarded through the office ofthe dean, the medical student shouldsend his application for internship directly to the hospital.

A report was made on the meetingof the ad hoc committee of the Houseof Delegates of the AMA appointed "tostudy the entire intern problem." Themeeting was held April 24, 1954, at theAMA headquarters in Chicago, and Dr.Smiley and Mr. Stalnaker attended thismeeting. The committee consists ofGeorge S. Klump, Williamsport, Pa.,chairman; Abraham H. Aaron, Buffalo,N. Y.; H. Russell Brown, Watertown,S. D.; George A. Earl, St. Paul, andWilliam A. Hyland, Grand Rapids, Mich.

14. Stockton Kimball discussed therevision he recently made of the originalStatement of the Joint Committee onMedical Education in Time of NationalEmergency. This he prepared and presented to the Subcommittee on Over-AllPlanning for Medical Services in Timeof All-Out War of the Task Force onFederal Medical Service of the Commission on Organization of the ExecutiveBranch of the Government on March12, 1954.

The secretary was instructed to duplicate this report and distribute it to thedeans of all medical schools under acovering letter written by Dr. Kimball.Suggestions and comments are to be sentto the secretary's office since Dr. Kimballwill be in Brazil part of the summer.

15. Dr. Kimball reported on the unfavorable attitude of the Department ofDefense toward continuation of the support of the MEND program in ourmedical schools.

The secretary was instructed to telegraph Frank Berry that the Council isdeeply concerned over the attitude ofthe Department of Defense toward the


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MEND program and has gone on recordas favoring extension of this programto all medical schools that desire it.

The secretary was also instructed toduplicate the correspondence betweenFrank Berry and Dr. Olson and distribute it to the deans of the membermedical colleges.

16. Dr. Sebrell and Dr. Price of theNational Institutes of Health appearedbefore the Council and reported on theprojects to provide long-term supportof investigators in the preclinicalsciences. Many questions were asked andsuggestions given. Dr. Sebrell reportedthat six out of seven of their institutecouncils had approved the project andit would likely be started with about 2030 career investigatorships, building upto as many as 120-130 (for medicine,dentistry and public health) at the endof five years.

17. The secretary was instructed to seethat the availability of the AMA's "Public Relations Manual" for physicians iscalled to the attention of the deans ofour medical schools.

18. Dean James W. Colbert was namedas Association representative to the National Conference on "ApproachingEquality of Opportunity in Higher Education" schedUled for November 15-16,1954, at the Jefferson Hotel, St. Louis.This conference is being sponsored bythe American Council on Education.

19. The results of the American Council on Education's poll on amendment ofPublic Law 550 (the Korean G.!. Bill)was discussed. No action was taken.

20. For information only a report ofthe Committee on Resources of theMedical Library Association was summarized pointing up their planning fornational emergency. No action wastaken.

21. Medical military scholarships involving three-year terms of serviceand no escape clause were discussed.Reservation was expressed but no action taken.

22. VA residencies with stipends equalto regular hospital staff salaries werediscussed. Reservations were expressedbut no action taken.

23. Dr. Berry reported on the plansfor the 1954 Teaching Institute statingthat 12 committee meetings have already been held, the questionnaire hasbeen sent, and that much of the preliminary planning has been completed.

DECEMBER 1954, VOL 29, NO. 12

65th Annual Meeting

24. Dr. Berry and Mr. Stalnakerbriefly discussed the results of a recentstudy of the undergraduate origin ofmedical students.

4. Actions taken at Executive CouncilMeetings-October 13-16, 1954:

1. The Council recommended the locating of the Association's central officein Evanston, Ill., provided funds for thepurchase of land and the erection of asuitable building can be procured fromoutside sources. It recommended thatthe Executive Council be authorized toproceed with bUilding plans and construction if and when such funds becomeavailable.

2. The Council approved extension ofthe present lease on space at 185 N.Wabash Ave., Chicago, to March 1, 1956.

3. The following recommendationsmade last year were reaffirmed; Le., (a)that no member medical college shouldaccept applicants more than one yearbefore the actual start of classes, (b)that no member medical college shouldrequire a deposit before January 2 ofthe year of intended registration.

4. Approved the school visitation program for 1954-55 including 18 schools.

5. The Council recommended to thedeans of member institutions that theylose no opportunity to express theirgratitude to the National Fund for Medical Education for the support beingprovided medical education by that fund.

6. Instructed Dr. Lippard to write aletter to President DWight Eisenhowerpointing out the harmful effects on medical education of the present practice ofrefusing deferment for medical teacherswho transfer from one essential positionto another.

7. Expressed the opinion that themedical profession has a real responsibility to participate in the accreditingof nonmedical but professional personnel working in the medical field. (RobertMoore abstained from voting on thisissue.)

8. The Council expressed its full confidence in and support of the efforts ofthe MEND Committee to give permanence to and provide expansion of theMEND program. A special vote of appreciation was given Stanley Olson forhis vigorous and persistent leadership inthe development of this program.

9. The Council expressed serious concern over the fact that in many areas of

37

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national planning involving medical education, the Association found no readychannel through which to make knownthe impact of this planning on medicaleducation. Since many of these plansrepresent long-term government policyas well as plans for possible nationalemergency it is most important thatthese channels of communication becarefully kept open.

ACTION: The annual report of theExecutive Council was accepted withoutrevision.

REPORT OF THE SECRETARYAND EDITOR

DEAN F. SMILEY: Last year at thistime you voted to create a new type ofmembership, individual membership.Some, I'm sure, were skeptical as to thesuccess of this innovation. It is, therefore, a pleasure to report that this newtype of membership is a real success.In the first six months that it wasoffered, more than 1,000 persons applied, and as of today, with only onepromotion letter having been sent byour deans, the total stands at over 1,300.Special mention should be made ofGeorge Washington with its 93 individual members, Medical Evangelists andNorthwestern with their 56 memberseach, Pittsburgh with its 50 members,SUNY-Brooklyn with its 48 members,and Loyola with its 43 members. This isa very auspicious beginning and we hopethat as time goes on we may see thisfigure increase to 10,000 memberships.There are over 30,000 medical teachers,surely one-third of them should beeventually participating through individual membership in the work of theAssociation.

Another important step forward wastaken when the Executive Council votedat its June meeting to construct a homeoffice for the Association in or aboutEvanston, Ill. Northwestern Universityhas deeded us a very attractive site onthe corner of Ridge Ave. and CentralSt., just a few blocks north and west ofthe university campus, and plans aredefinitely under way for construction.It is hoped that we may occupy the newbuilding by March 1956.

Important additions to our staff havealso been made. William N. HubbardJr., associate dean of New York University College of Medicine, has assumed the post of associate secretary,

38

and will devote one-third of his timethis year to the work of the Associationwith the expectation of assuming fulltime with the Association on July 1,1955. Ross Dykman has been procuredas full-time assistant director of studies,Edward Smith has assumed the positionof managing director of the NationalIntern Matching Program, Inc., and RoyParry the position of advertising manager of the Journal.

The school visitation program hasmoved forward at a greatly acceleratedpace. Visited last year by your representatives were 15 medical colleges including Trinity College, Dublin; University College, Dublin; North Carolina;Maryland; West Virginia; British Columbia; College of Medical Evangelists;Miami; Puerto Rico; Nebraska; Creighton; Missouri; Southwestern; Marquette,and Tufts. Planned for this coming college year are 18 medical college visits.It is a great satisfaction to record thatif this schedule is successfully met therewill remain on June 30, 1955, only threemedical schools in this country whichhave not been visited by representativesof the Association within the last fiveyears. Such an accelerated program ofvisits would have been impossible without the addition of an associate secretary to share the travel and reportwriting. This has been made possiblethrough the generosity of the ChinaMedical Board.

I hope you share with me the beliefthat the Journal of MEDICAL EDUCATION,thanks to the assistance of the MarkleFund, is really beginning to provide thekind of service it should provide as theonly journal devoted exclusively tomedical education. The Editorial Boardhas assumed active responsibility forthe program, policy and content, and isactively soliciting and evaluating articles, and planning for a steady flow ofarticles from our American schools andfrom schools abroad. Dr. Bowers, thechairman, will report on some of theplans being made by the board. Advertising is up 20 per cent above last yearand cirCUlation has made a similar increase. Our weakest department is stillthat of our Editorials and Comments.We learned from our readership surveythat our editorials are well read but notvery highly regarded. You are urged tomake your contribution to this department. We hope you will agree with the



352 990In addition to these 352 foreign stu

dents registered in our undergraduatemedical colleges there were, however,according to Diehl, Crosby and Kaetzel5,589 foreign physicians participating ininternship, residency or fellowship training in over 800 United States hospitals

39

REPORT OF THE TREASURER

DEAN F. SMILEY reporting for JOHN

approved for such training. Of 500 advanced FUlbright Scholars, 124 as ofSeptember 1954, were studying in themedical sciences.

In answering the many inquiries received from foreign students at ourAssociation office, it has been our policyto make very plain the difficulties thatlie in the path of the foreign studentwho comes to the United States to takehis undergraduate medical work, eitherwith or without premedical work in theUnited States colleges. A question weare attempting to answer is how manyforeign premedical students succeed inestablishing residence by virtue of theirstay in American liberal arts collegesand then gain admission to undergraduate medical schools as bona fide residents?

Assistance in the form of bookletsand letters of advice was given 115foreign medical graduates interested inadvanced medical training in this country last year. Special assistance in placement was provided through our Committee on International Relations inMedical Education for a few foreignmedical graduates who were planningon returning to teaching posts in theirown country after the advanced traininghere.

In reviewing the record of the lastsix years of the Association it is apparent that the list of responsibilities thrustupon it has grown at almost an alarming rate. In order that we may not findourselves eventually over extended it isobviously essential that we continue tokeep our basic budget and commitmentswithin the limits of what those who receive the services are in the long rungoing to be able and willing to pay for.As outside funds are made availablefor special projects they should, ofcourse, be accepted and put to the greatest possible use, but the basic budgetshould be expanded only with the greatest caution and after full study by ourExecutive Council. We want to be progressive and perhaps even a little aggressive but we certainly want to avoidthe hazards that go along with beingoverly expansive.

ACTION: The annual report of the secretary and editor was accepted withoutrevision.

65th Annual Meeting

Premedical404

7328114767144

MedicalAsia and the Near East 119Canada 79Latin America _ _ _ 76Europe 65Africa 9Australia and Oceania__ 4Stateless __ _ 0

Editorial Board that the front cover ofthe Journal should indicate what is inside. We have redesigned the cover andit will carry henceforth at least a partof the table of contents. Thanks to theChina Medical Board, 312 foreign medical schools receive gift subscriptions.Every medical school listed in the WHOdirectory has been offered a free subscription to the Journal. Only a few ofthe schools beyond the "Iron Curtain,"however, have had the temerity to accept our offer.

A great deal of effort has gone intoimproving the Association's publicationsthis year. The Directory has been expanded and we hope made more useful;the booklet, "Fellowships, Funds andPrizes Available for Graduate MedicalWork in the United States and Canada,"has been revised and brought up to date;the booklet, "Admission Requirementsof American Medical Colleges," has beenrevised and expanded to include answersto a wide variety of student questions.Dr. Foster has prepared an exhibit ofour publications and I hope you will alltake the time to view it and order whatever you find is missing from your deskor files at your office.

According to statistics furnished bythe Institute of International Education,there were 38,833 foreign students in theUnited States in 1953-54. Students inthe field of medicine made up only 9per cent of all foreign students comparedwith 20 per cent for the humanities, 20per cent for engineering, 14 per cent forthe social sciences and 12 per cent forthe physical and natural sciences. Therewere 352 students in the field of medicine, 990 listed as premedical studentsfrom sources distributed as follows:

ao<.l:1

Association of American Medical Colleges185 North WabashChicago, Illinois

Gentlemen:We have examined the financial statement of the Association of American

Medical Colleges as at June 30, 1954, and the related statements of current receipts,disbursements and balances for the period from July 1, 1953 to June 30, 1954. Ourexamination was made in accordance with generally accepted auditing standardsand accordingly included such tests of the accounting records and such other auditing procedures as we considered necessary in the circumstances.

The following changes in accounting policies, approved by the Executive Councilof the Association of American Medical Colleges, were effected during the fiscalyear ended June 30, 1954.

1. Unexpended and/or overdrawn balances of the secretary's office, Journal ofMEDICAL EDUCATION, Committee on Teaching Institutes and Special Studies and the

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B. YOUMANS, treasurer: The fiscal affairs of the Association during the pastyear have continued in the generallysatisfactory state of recent years withone notable and favorable exception;namely, the income from the recentlyestablished individual membership. Although the actual amount received fromthis source so far is not large, the encouraging results emphasize the largepotential of this source of incomewhich, if fully developed, offers a solution for the most pressing fiscal problems of the Association; namely, anadequate amount of annually recurring,unrestricted general income.

On the recommendation of the auditors, the staff of the Association andyour treasurer, the method of accounting has been changed from a "cash receipts and disbursements" basis to"budgetary fund accounting," a systembelieved to give more easily understoodfinancial reports and one common to thatof most colleges and universities. Thischange has been approved by your Executive Council.

General income for the fiscal yearending June 30, 1954, including unrestricted gifts and grants but not specialrestricted grants, totaled $220,713.22.Income from investments amounted to$3,691.40, an increase of $1,250.40 overlast year. Income from individual memberships totaled $10,970.25, and fromoverhead on special grants, $2,380. Thebalance is accounted for by dues ofthe member schools, earnings of variousactivities and miscellaneous income.

Disbursements of nonrestricted funds

40

totaled $221,765.82, resulting in a netdecrease of $6,052.60 in nonrestrictedfunds. The balance with the GeneralFund account as of June 30, 1954, was$153,053, compared with a comparablefigure of $137,418.18 last year.

The balance sheet as of June 30, 1954,reveals total assets of the Associationof $320,173.48 including restricted funds,compared with $207,070.82 the previousyear. The increase is represented largelyby special restricted funds and investments, including short-term securitieswhich totaled $157,770.75.

Budgets for the current fiscal year, notincluding budgets for restricted projectsand studies but including the Journalof MEDICAL EDUCATION, the Committeeon Teaching Institutes and SpecialStudies and the Medical Audio-VisualInstitute, total $186,951.85, of whichsome $65,000 is drawn from specialfunds. Special studies and projects, including the Teaching Institutes, operating budgets are financed by restrictedgifts and grants.

Details of the finances of the Association are contained in the report of theauditors, Horwath and Horwath (seebelow). I recommend that those who areinterested in the fiscal details consultthe auditor's report, which is availablefor inspection.

I wish to thank again all who haveassisted me, and in particular the staffof the Association whose help has beeninvaluable.

ACTION: The annual report of thetreasurer was accepted without revision.

September 10, 1954


.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

Association of American Medical CollegesChicago, Illinois

Summary Statement of Current Receipts, Disbursements and BalancesJuly 1, 1953 to June 30, 1954

P40A

$113,167.14

$ 60,682.00

Exhibit B

$ 3,952.97

$ 5,429.59

$50,000.00

$ 150.92(150.92)

$ 9,393.09(9,393.09)

$ 250.67(250.67)

$ 1,424.01(1,424.01)

NON· RESTRICTED FUNDS RESTRICTED FUNDS

Commi"eeJournol on Teaching Medical China

of Institutes Audio Medical RevolvingSecretary's Medical and Special Visual Board Film Speciflc

Office Education Studies Institute Grant Fund ProJects

$44,928.73 ($12,677.32) $90,596.85 ($ 8,909.06) $50,000.00 ($ 1,476.62) $ 52,485.14(44,928.73) (90,596.85)

12,677.32 8,909.06

$50,000.00 ($ 1,476.62) $ 52,485.14.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .......... .. .. .. .. .. .. ..

$ 2,859.55 $ 1,526.432,781.55

27,083.48$ 6,420.54

333.50

$50,000.0020,000.00 $ 50,000.00

5,000.00

68,581.95

21,500.00 74,400.00 $28,000.00$50,000.00 5,000.00

$50,000.00 $74,224.58 $81,259.93 $28,000.00 $50,000.00 $11,420.54 $118,581.95------ .. .. .. .. .. .. .. .. ---._. ------- ------- ------- ._----.$15,960.62 $20,471.63 $50,441.82 $19,946.80

925.00 100.00 1,385.57 834.39230.53 303.32 880.50 317.92

1,577.15 1,330.39 2,459.09 18.864,017.15 1,652.49 4,263.53 2,202.574,187.08 2,434.87 5,888.12 2,576.49

439.91 176.73 1,476.20 (170.23)10,572.88 382.67 2,471.34 1,048.602,928.90

$ 5,990.9577.39 77.38 66.60 84.55

4,414.61 37,957.01 1,502.96 489.137,610.091,477.33

1,214.58657.02

1,031.11914.30458.87

$ 57,360.20539.75

500.00 $50,000.00

$48,575.99 $73,973.91 $71,866.84 $27,849.0a $50,000.00 $ 5,990.95 $ 57,899.95

2,380.04

GeneralFund

52,801.11

$ 41,250.0010,970.25

3,691.4035.91

$159,105.97

$ 45,166.77135,525.58(21,586.38)

$111,128.71

$153,053.37

$123,900.004,500.00

$128.400.00

123,900.0055,000.00

TotalFunds

$ 41,250.0010,970,253,691.404,421.892,781.55

27,083.486,420.54

333.5052,801.1150,000.0070,000.00

5,000.002,380.04

68,581.95

$320,173.48

$106,820.873,244.961,732.275,385.49

12,135.7415,086.56

1,922.6114,475.492,928.905,990.95

305.9244,363.71

7,610.091,477.331,214.58

657.021,031.11

914.30458.87

57,360.20539.75

123,900.0055,000.00

$524,615.71

$260,114.49

$260,114.49

$ 60,058.99 ($ 17,271.2911,218.69

$464,556.72

) Denotes red flgures.

Disbursements Salaries •••Annuities ••Payroll taxes.Contracted services and equipmentOffice supplies, telephone and postageRent and house expensesFurniture and equipment.Traveling •••••••Annual meeting • • • •Film costs and expenses.Insurance •••••••Publications • • • • • •Advertising and circulation promotion.Mailing and engraving • • • • • • •Comm,"ee on Internships and Residencies.Comml"ee on Foreign Students.Special studies. • • • • • • •Architects' fees reI housing • •Moving expenses. • • • • • •Restricted funds - Schedule B-2ProJect balances absorbed by general fund - Schedule B-2Budget allotment transfers •Transfers to other funds. •

Total receipts.

Total disbursements.

Balances-June 30, 1953-after transfers ••Receipts-

Membership dues -Institutlonal- 5chedule B-1Membership dues-Individual.Interest on InvestmentsPublications • • • • •5ubscriptlons. • • • •Advertising • • • • •Film sales and rentalsInterest tests - net • •Educational Testing Service, Inc.China Medical Board • • • • •John and Mary R. Markle Foundation - Schedule B-2 •National Intern Matching Program, Inc.Overhead on proJects - Schedule B-3 •Restricted funds - Schedule B-2Other additlons-

Budget allotment transfersTransfers from other funds

Balances-June 30, 1953-befare transfers •••.Transfer af unexpended balances to general fund.Transfer of general funds to absorb deflcits


Balances-June 30,1954

Excess or (deflciency) of receipts over disbursements for flscal year endedJune 3D, 1954 ••••••••••••••

Transfer of unexpended balances to general fund

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65th Annual Meeting

Very truly yours,

(Signature) HORWATH AND HORWATH

Accountants and Auditors

Medical Audio-Visual Institute were transferred to the General Fund at June 30,1953, and June 30, 1954.

2. Income from the following sources is credited directly to the General Fund:

Formerly credited to:

Secretary's officeSecretary's office

iCommittee on TeachingInstitutes andSpecial StudiesSecretary's office

Membership dues incomeIncome from investmentsEducational Testing Service

Overhead on projects

3. The grant from the China Medical Board is cre~ited to a separate restrictedfund until the year for which it is allotted.

In our opinion, after giving effect to the changes mentioned in the proceedingparagraph, the accompanying financial statement and the statements of receipts,disbursements, and balances present fairly the financial position of the Associationof American Medical Colleges as at June 30, 1954, and the results of its operationsfor the period from June 1, 1953 to June 30, 1954, in conformity with generallyaccepted accounting principles.

$319,696.49 $152,576.38 $50,000.00 $3,952.97 $113,167.14

Association of American Medical CollegesChicago, Illinois

Statement of Financial ConditionAs at June 30, 1954

DECEMBER 1954, VOL 29, NO. 12 41

SpecificProlects

Exhibit A

RevolvingFilmFund

Restricted FundsChina

MedicalBoardGrant

NonRestrictedGeneral

Fund

(Continued on Page 42)

Total Assetsliabilities andFund Balances

100.00

33,000.00

152,288.939,536.81

124,770.75

AssetsCash and Investments

Petty cash fund ••••••• $First National Bank••••

General account ••••Operating account•••

InvestmentsUnited States Savings

Bonds-Series G ••United States Treasury

Bills •••••••••••••Total cash and

Investments•••••

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97.80425.00

1,420.00349.58

507.15 507.15

739.42

1,000.00

739.42

1,000.00

1,769.58 1,769.58

$321,943.06 $154,822.95 $50,000.00 $3,952.97 $113,167.14

$320,173.48 $153,053.37 $50,000.00 $3,952.97 $113,167.14

Accounls ReceivableEmployees' Blue Cross

premiums ••••..••.• $Airline Iravel deposil .•National Inlern Malch.

ing Program, Inc.....__2_1_6._6_2Tolal accounls

receivable ...•..Loan Receivable

National inlern Malching Program, Inc.....

OlherPrepaid insurance ..•.. $ 227.73Poslage meIer ....•..•__2_7~9._4-,2

Tolal olher ..•..

Tolal assels .•..Deduct liabilities 10 be

paidFederal income lax with

held from employees.$Federal retiremenl lax.•

Tolalliabililies ••----

Fund balances-Exhibit B.


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REPORT OF THE DIRECTOR OF STUDIES

JOHN M. STALNAKER: An outline ofthe principal activities occupying thetime and efforts of the director of studiesmay be found in the report of the Committee on Teaching Institutes and Special Studies. For those who read betweenthe lines of that report, especially thosewho appreciate that the director ofstudies has been on half-time leave during the past year, it will be apparentthat a competent staff must have beenat work. Such was indeed the case. Somecomment on this staff and on the problems of obtaining and retaining competent personnel is in order.

Both time and money are necessary,of course, to build a competent staff,but meeting these requirements alonedoes not provide the whole answer. Association work, however significant, isstill not university work. It does nothave the same appeal although the typeof person fully qualified for academicwork is needed. In the Association tenure is not permanent. While the workof the director of studies has been generously supported, it has not been possible to estimate the size of the budgetwith which to work for as long as two

42

years in advance. Located as the Association now is in the heart of the business district of a large city, the flavorof the competition tends to be commercial rather than academic.

After five years and in spite of theseobstacles, the staff is now a highly ableone. If it can be kept intact, it will soonincrease the quality and quantity of useful reports stemming from the Association office. Let me describe briefly afew key members of my staff.

On the professional side, Ross Dykman (Ph.D., Chicago) has returned afterseveral years spent at Johns HopkinsUniversity. In 1950 he worked part timein the Association office, leaving to accept a USPHS post-doctoral fellowship.This led to an appointment for him asa research member of the departmentof psychiatry at Hopkins. His training,experience, enthusiasm and intelligencemake him a valuable person for the research team of the Association. Although he devotes more time than theusual full-time worker to the Association's work, he also holds an appointment as research associate at the University of Chicago.

Assisting Mr. Dykman was Miss Sarah


Counts (Ph.D., Chicago), who left inSeptember for a post more clinicallyoriented. She will be replaced by Mrs.Helen Gee who, after handling theanalysis of the questionnaire for thesecond Teaching Institute, has returnedto the University of Minnesota to complete her thesis for her Ph.D. She plansto be back with us in January.

E. C. Smith returned to the Association last May after an absence of oneyear. He came to us from the IBM Corporation. At 29, he has a remarkableknowledge of what business machinescan and cannot do, and how to organizemachine operations efficiently. Hisknowledge of effective methods for presenting statistical information invitinglyand meaningfully is a tremendouslyvaluable attribute. His time is now divided between managing the operationof the matching program for the NIMPand the work in the Association's office.

Another key figure who helps to makethe office of the director of studies clIckis Mrs. Helen Morford, an experienced,skilled and devoted person without

65th Annual Meeting

whose long hours of mtelligent laborthe Teaching Institutes would run muchless successfully. As my chief admimstrative assistant, she IS fully responsiblefor the skillful and tactful handling ofthe many delicate problems which ariseboth within and without the office.

There are others too, but time doesnot permit even a brief description oftheir qualifications. To one and all mustgo in full measure the credit for thestudies being produced and the reportsbeing prepared.

The second section of my report willbe used to discuss briefly the sIgnificanceof the MCAT scores in medical schooladmiSSIOn work. ThIs test has now beenused long enough and widely enough tostimulate a rash of simple correlationalstudies relating each section of the testto average freshman grades in medicalschool. The Journal of MEDICAL EDU

CATION is already receIving many suchstudies. If the correlations are found tobe low, as they generally are--almostby necessIty-the author will usuallyconclude or imply that the test has little

FIGURE 1

THE PER CENT dropping out related to scores on the Science Section of the MCAT is shown inFigure 1 above.

43DECEMBER 1954, YOLo 29, NO. 12

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FIGURE 2


value. Such a conclusion is not necessarily sound.

The best single predictor of successin medical school is success in collegeimmediately preceding the professionalstudy. A student who has been successful in three or four years of work at anundergraduate college of known highquality is more than likely to succeedalso in medical school. Test scores canadd something important, however, ifthey are considered in connection withall the other information available aboutan applicant: his transcript, letters ofrecommendation, results of personal interview, etc. Alone, the test scores areless significant in the context underdiscussion.

You have been sent extensive reportsshowing that the applicants to medicalschool from what are known as the "better colleges" receive, on the average,high scores on the MCAT. This fact isno accident. The so-called "better col-

leges" select bright students to beginwith and then give them a favorableenvironment for a sound education. Individuals who are bright obtain hightest scores in general, including thescores on the MCAT. They are scholastically apt, they learn classroom material quickly. But note this. The MCATdoes not reflect interest in the study ofmedicine (presumably an important factor in attaining success in medicalschool), adjustment to the medicalschool's methods of education, financialresources, the family situation, ambition, drive or the ability and desire toapply oneself to the task at hand. Brightstudents, like dull students, can be lazy,disinterested and neurotic, althoughprobably less frequently. Parents canforce disinterested bright students intothe study of medicine just as often asparents of less apt students.

In diagnosing the illnesses of the sick,logic would dictate, physicians of high

lOW GROUP... 24

. ..... /. . . . . 1

. 1

DROP-OUT 31 %

4(5%)

REASON FOR DROP-OUTHIGH GROUP

/ . . . . . . . . . . . FAILURE. . ..2 . . NO INTEREST.1 /JEATH .

...... OTHER .

HIGH GROUP (99 STUDENTS)


IRREGULAR

LOW GROUP (87 STUDENTS) DROP-oUT

A COMPARISON of the record of all admitted students scoring over 700 on both the science andthe verbal sections of the MCAT with all admitted students scoring under 400 on both the scienceand the verbal sections of the MCAT is shown above in Figure 2.

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intellectual competence will be rightmore frequently than less talented physicians. Most of us in selecting our ownphysician will prefer a bright one to adull one. Thus. it is understandable thatadmission committees, when there is achoice, select a hright applicant over aless bright one. The MCAT scores helptremendously in supplying the basicdata on which a wise decision canbe made. The scores are being used morewidely and more properly for this purpose all the time.

Because the test scores are so extensively used in admission work and because many of the medical schools makecareful selections from an able groupof applicants, the significance of thescores tends to be obscured. This mayseem to be paradoxical, but it is true.A low-scoring student, for example, isadmitted only when there is positiveevidence to indicate that the test scoresin that particular case do not appear tobe an appropriate guide or a valid index. Thus, any check of low-scoringstudents who are admitted to medicalschool will usually show that many ofthem do succeed. Where the low testscores confirm the other evidence available about the student, he is usuallyrejected. Of the applicants who aretested, about 16 per cent score under400 on the MCAT; but of the admittedgroup in 1949, only 5 per cent scoredunder 400.

Although the MCAT is now widelyused in relation to admissions, the studyof pertinent data shows that differentmedical schools use the test in differentways. This is as it should be, for thewisest use of the test will differ fromschool to school. It also should be notedthat the students admitted by one medical school differ significantly from thoseadmitted by another. Take an extremeexample. The mean scores for the admitted group at a medical school, A,was 175 score points higher than themean scores of the admitted group atanother medical school, Z. Academicfailure at School A may be, and undoubtedly is, quite a different matterfrom failure at School Z. Both medicalschools, it should be recognized, arecontributing to medical progress in thiscountry. They are probably doing so indifferent ways.

To graduate is the most vital achievement for a student admitted to any


65th Annual Meeting

medical school. Predicting his gradesin medical school may be an interesting,indeed a tricky game, and one not without value, but the important matter isfor him to graduate. The bottom man inthe graduating class of any medicalschool may be expected to contributeprofessionally. Also, no matter howbright, able, well motivated and nobleof character every student at a medicalschool may be, there must always be abottom man in the class as long as students are ranked. If a student drops outof medical school, on the other hand, nomatter where he stands in his class, heis a loss to the medical profession.

A study is now being completed of the7,032 students admitted to medical schoolin 1949-50. Of this group, 87 per centgraduated on schedule, and only 8 percent dropped out during the four-yearprogram. (Of course the various medical schools differ. One medical schoolhad 1 per cent drop out while anotherhad over 20 per cent drop out.) Theother 5 per cent were irregular, butmost of them will graduate in time. Actually, 91 per cent of this total 1949-50group have graduated now-an astonishingly good record, probably unequalledby any other professional group. Whenso few students drop out, prediction ofjust who will fail is difficult. But let ussee what the test scores show.

The chances of a student graduatingon schedule increase as his test scoresgo up. Of this class for 1949-50, only74 per cent took the MCAT. Merely submitting to the test was a positive sign.Of the tested group, 7 per cent droppedout, but of those who were admittedwithout test scores, 12 per cent are nowlost to the study of medicine.

Consider only one section of the test,the science section-ignore all other evidence, no matter how pertinent. Therewere among the admitted group 21 whoscored under 300, and 234 who scoredover 700 on this science section. Onethird (33 per cent) of the low-scoringstudents dropped out of medical school,compared with 3 per cent of the highscoring group. And this is but one section of the test, and the reasons fordropping out are ignored. Bright students are not immune to injury, loveor debt. They are more prone to develop an interest in graduate work. Contrast this with the students who graduate on schedule (see Figure 1, page 43).

45

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Now consider two of the scores onthis test together, the scores on the verbal section and on the science section.Take only the top group scoring 700 orover on both sections: there were 79such individuals in the 1949-50 class.How many of them graduated on schedule? Some 91 per cent (see Figure 2)!Only four students (5 per cent) in thistop group dropped out: one died, twoleft for lack of interest but would bewelcomed back, and one failed. Theseindividuals, furthermore, in general attended the medical schools having thehighest competitive standards. Comparethis record with the one for the studentsscoring under 400 on both the verbaland science sections. There were 87 suchstudents admitted in the class underscrutiny. Only 59 per cent graduated onschedule (compared with 91 per cent ofthe high-scoring group); 31 per centdropped out (none can return), and 10per cent were irregular.

The complete study of the class entering in 1949-50, soon to be published,will give in detail the figures summarized here. It will give a great many morefindings of significance. These resultshave been presented here to point outthat the MCAT appears to have important predictive significance. Like anysensitive measuring device, it must becarefully and properly used. Medicalschools differ, as has been shown, anddifferent schools should use the test indifferent ways. For those medical schoolsinterested in the bright student, thescholastically apt applicant, the studentmore hkely to succeed in medical school,the test scores can be of great help. Ifthe scores do not correlate highly withthe freshman grades at a given medicalschool, there may be several reasonsand these do not necessarily reflect detrimentally on the significance of theMCAT.

ACTION: The annual report of the director of studies was accepted wIthoutrevision.

REPORT OF THE DIRECTOR OF THEMEDICAL AUDIO·VISUAL INSTITUTE

J. EDWIN FOSTER: The activities of theMedical Audio-Visual Institute were inconformity with the recommendations ofthe Committee on Audiovisual Educationto concentrate on direct services in

46

utilization and distribution to the medical colleges.

The following activities are describedin the order listed on the chart on page47 rather than in order of importance.

1. School VisitationFourteen medical colleges outside of

Chicago were visited by the directorduring the July-to-July year. Since Julyfive additional schools have been visited.All visits were of an informal nature,having been prompted by some specificpurpose which provided an opportunityto assist the AV coordinators and asmany other faculty members as desiredsuch help.2. Library of Congress CatalogCards for Films

The Institute has continued to cooperate with the Library of Congress byproviding information required for thepublication of catalog cards on medicalfilms. As yet less than a dozen medicalschools are direct subscribers for thesecards on medical motion pictures butthe Institute is hesitant to withdrawencouragement to the Library of Congress because of the resources that library has for the development of aunion card catalog which has potentialreal value for all medical school teachers.The Institute is, however, endeavoringto spread the responsibility for this task.During the year two other nationalgroups, the American Dental Associationand the American Hospital Association,and five or six major film producershave accepted direct responsibility forthe submission of film data or information to the Library of Congress.

3. Answering InquiriesAs an information center, the Institute

receives a moderate flow of inquiries relating to audiovisual materials, equipment and literature. To the limits ofstaff time all inquiries were answereddirectly. Other inquiries required referral to other specialty groups.

4. Film Publications"Film Publications" refer to the buy

ing, selling and renting of prints ofMAVI-produced films. The chief activitywas with the first 10 of the cancer shortteaching films which became availableduring the laiter half of the year. Inthat period 115 films were sold to 46medical schools or medical school departments. The rentals were chiefly of

Journdl of MEDICAL EDUCATION

MAYI Staff Activities 1953·54

65th Annual Meeting

Miscellaneous

activities

Previewcircuits

Filmpublica

tions

concerned with the specific materials.Although a circuit schedule permittedonly a limited use of the materials foractual teaching purposes, the studentviewers were reported as 6,752 in number.

6. Miscellaneous Activities(a) Conference Planning(1) Midwest Conference of Medical

School Audiovisual Coordinators: Thiswas the first attempt to bring medicalschool audiovisual coordinators togetherto study their common problems of providing audiovisual services in the medical schools. The conference was held inChicago at the time of the NationalAudio-Visual Trade Show and Conven-

47

Answeringinquiries

Developinginformation

I

565 filmprograms

tocolleges

-Reported

Conferencefacultyviewers: planning

I 2240 -- News

115 Reported Pouchfilms student -sold viewers: Consul-

- 6752 tations

Data 159 -for 500 films Cardio-

200 letters rented vascular

films - filmValue of study

suppliedsales & -to the rentals: JME

14 Library$5.247 -

schools of FilmCongress exchange

Visitation& travel

6

Total time: 3400 hrs.Budget: $18.000

previously-produced longer films of theMedical Audio-Visual Institute.

5. Preview CircuitsThe preview circuits were a means of

circulating audiovisual materials to themedical colleges for the simple purposeof letting the teaching faculty see them.The organization and printed information relative to the materials were designed to encourage a critical environment for determining their teachingvalues and methods of use.

The 76 schools of the circuits receiveda total of 565 programs and the printedinformation that preceded the receipt ofeach program. The programs were seenby a reported 2,240 faculty who were

12

24


18

Percentageof

time

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Reports and Recommendations of Committees

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tion with an attendance of eleven. Theconference evaluated it as a success.

(2) Audio-Visual Conference of Medical and Allied Agencies: This was awork meeting of the audiovisual peoplein national organizations. The purposewas to consider the common problems ofsuch national associations. The type ofproblem considered is exemplified bythe Library of Congress film catalog.

(b) NewspouchThese packages of reprints and other

printed material on instructional materials were collected and sent to theaudiovisual coordinators.

(c) Films in the Cardiovascular Diseases Part II

The concluding report on "Films inthe Cardiovascular Diseases," by Drs.Ruhe and Nichtenhauser, was completed, printed in mimeographed formand distributed to the medical schoolsand interested organizations or individuals. The study was made withfunds from the National Heart Institute,Public Health Service.

REPORT OF THE COMMITTEE ONAUDIOVISUAL EDUCATION

WALTER A. BLOEDORN, chairman: Thecommittee continues to concern itselfprimarily with the program of the Medical Audio-Visual Institute, as reportedon by the director.

The major film reviewing and production projects have been completedand the emphasis directed to the problems of utilization and distribution. Specific activities have included the provision of film card data to the Libraryof Congress, two audiovisual conferencesfor medical audiovisual coordinators,contributions to the Journal of MEDICALEDUCATION, preview circuits, the distribution and sale of the cancer short

48

(d) "Audiovisual News" department,published monthly in the Journal ofMEDICAL EDUCATION.

The "Audiovisual News" section inthe Journal has been maintained and anattempt made to include practical professional information as contributed bythe medical colleges.

(e) Medical College Film ExchangeThe need for and the problems of an

audiovisual library serving the medicalschools directly has been stUdied. Thisli1xchange or library would distribute theeasily transported materials such asfilms, film-strips and certain models.Consideration has been given to thosefilms which have been produced by themedical colleges. Information on 250films produced by the colleges or individual faculty members has been received. The film exchange would makeselected materials readily available toall medical colleges.

ACTION: The annual report of the director of the Medical Audio-Visual Institute was accepted without revision.

teaching films, school visitations anddirect correspondence with teachingfaculty. Under the limitations of abudget further reduced to $18,000 for1954-55, the committee affirms the continuation of such activities.

The Committee on Audiovisual Education recommends a basic medicalteaching film library operated by theAssociation for the medical colleges. Themultiplicity of sources of such films andthe inevitable difficulties of procurement emphasize the need for such acentral library. The library should beoperated on a self-supporting basis bymeans of a realistic service charge onall materials distributed.

ACTION: The annual report of the


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Committee on Audiovisual Educationwas accepted without revision.

REPORT OF THE COMMITTEE ONCONTINUATION EDUCATION

JAMES E. MCCORMACK chairman:There is within the medical professiontoday a healthy tendency to self-examination with respect to the needs andthe opportunities in continuation education. The special study of the Councilon Medical Education and Hospitals inthis field has not yet been published,but meanwhile more and more individuals and groups are becoming vocal,especially in the category referred toas the consumers as compared to thepurveyors of education. Each year bringsto the Annual Meeting of the Association of American Medical Colleges anincreased number of guests representing organizations and agencies whoseprimary interest is in postgraduate medical education. This suggests that theyare looking to the medical schools forleadership. The unabated speed of medical progress magnifies the need for physicians to obtain appropriate refreshertraining. Where better can they searchfor this refreshment than at the wellsprings of medical knowledge, the medical schools and medical teaching centers!

The fact is that only a fourth or lessof the physicians who take refresher orcontinuation courses do so under theauspices of medical schools (Table I).Many organizations which are not primarily educational institutions have fora long time conducted postgraduatemedical courses. The excellence of someof these courses is well known. In mostinstances these organizations utilize theservices of medical school teachers,usually clinical teachers. SometImes,however, when practitioners control thecontent of courses, there is a tendencyto emphasize pragmatic therapeutic desiderata at the expense of scientific rationale. This road leads back to empiricalmedicine.

The demand for postgraduate coursesis considerable, although the postwarpeak demand has SUbsided. From thestatistics assembled annually by theAmerican Medical Association, the number of postgraduate courses offered andthe attendance each year are known.In order to eliminate temporary variations, one might select three-year periodsand derive average annual figures in


65th Annual Meeting

each period. Thus one obtains meaningful figures for a typical prewar year.(1938-41), a typical war year (194245), a typical peak postwar year (194750), and the current status (1950-53).

Table I

POSTGRADUATE STATISTICS

Annual National Average in Three-Year Periods

Course AttendanceOfferings Per

Year Per Year Year(Prewar) 1938-41 'o' 171 ", 44,504(Wartime) 1942·45", 565""""",25.585(Postwar) 1947-50",,1 ,538 " ",,80.502 (15,605

under medical schools)(Current) 1950-53... 1,606 ,'" 61,763 (15,961

under medical schools)

It is obvious that there is a continuing demand which is considerably higherthan the prewar demand. It is alsoapparent that when the peak attendancewas passed the number of course offerings did not decrease. This suggests thatthere may possibly be a lack of balancebetween supply and demand. The relationship between supply and demandmay be further out of balance in respectto local areas and subject matter. Forexample, in certain parts of the countrythere may be an excess of course offerings in particular clinical fields, whereasa dearth of such opportunities may exist in other sections of the country inthese same fields. In all probabilitythere is a relative excess of course offerings in the limited aspects of certainspecialties such as ophthalmology. Theday when a person can acquire specialization by a series of short courses hasgone. There is now a generation ofphysicians who have had the opportunityof formal hospital residency training inthe various specialties, and the demandfor certain limited specialty courses israpidly diminishing.

It is important that those who areresponsible for administering postgraduate programs frequently review theirofferings in order to delete courses forwhich there is no real demand and,where the appropriate teaching talentexists, to establish new courses forwhich there may be demand. When thereis flagrant duplication of course offerings in fields for which there is limiteddemand, one encounters too frequentlythe unpleasant situation where a physician who has applied and been accepted

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for a course receives subsequently anotice that the course has been cancelledfor lack of a sufficient number of applicants. Since the physician may havealready cancelled consultations and goneforward with plans to attend the course,the unfairness of this situation is alltoo obvious.

The tendency to experimentation inthe field of continuation medical education is still evident including the useof radio and television, both black andwhite and colored, the seductive appealof a course on a cruise ship, and theconvenience of bringing lecturers orpanels of consultants into rural areasfar removed from the teaching centers.

ACTION: The annual report of theCommittee on Continuation Educationwas accepted without revision.

REPORT OF THE EDITORIAL BOARD

JOHN Z. BOWERS, chairman: At the1953 meeting of the Association of American Medical Colleges, the ExecutiveCouncil indicated that the EditorialBoard should actively assume responsibility for the program, policy and content of the Journal of MEDICAL EDUCATION. Accordingly, on Sunday, February7, 1954, the Editorial Board convened inthe Palmer House, Chicago, and madethe following decisions which should beof interest to all readers of the Journal:

1. The philosophy, techniques andachievements in premedical, undergraduate, graduate and postgraduate medicaleducation, including students, teachersand curriculum, are the primary fieldsof interest for manuscripts. Manuscriptsrelating to such fields as nursing education, dental education, technician training and hospital administration mightbe included when they relate directlyto problems of medical education.

2. A correspondent to the Journalshould be designated by the dean ofeach college of medicine affiliated withthe Association of American MedicalColleges. (Correspondents have nowbeen designated in about one-half ofour schools.)

3. Correspondents from other countriesshould be appointed in order to obtaina more global approach to medical education. The Journal is distributed toevery medical school in the world thatmakes a request to receive it.

4. The book reviews should considerthe value of a book as a teaching device

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rather than include exhaustive reviewson general content.

5. The section entitled "Personnel Exchange" should be deleted from theJournal.

6. Discussions should be held withDean George Berry, chairman of theCommittee on Teaching Institutes andSpecial Studies, in regard to the reporting of the Teaching Institutes.

7. Several changes in format andpagination of the Journal would improveappearance and readability.

8. Reduction of the extensive film reviews in the section on audiovisual education and a greater orientation towardother aspects of audiovisual programswould be valuable.

9. All manuscripts should be reviewedby at least two members of the EditorialBoard.

10. Editorials should, as far as possible, represent the policy of the Association of American Medical Collegesand should be signed or initialed.

11. A program should be developedto reprint papers which are "milestones" in medical education.

The Editorial Board's immediate concern relates to the manuscripts whichare available for publication in theJournal of MEDICAL EDUCATION. The Editorial Board is endeavoring to improvethe quality of the manuscripts by soliciting individual contributions and by thedevelopment of symposia on pertinentproblems, Symposia are being developedon "Graduate Education" with KendallCorbin as guest editor, and on the "Medical Library" with Chauncey Leake asguest editor. "Medical Students andStudent Advisory Programs" and "Evaluation of Education Experiments" maybe covered in other symposia.

A number of medical schools areconducting experiments in medical education and the Editorial Board is anxiousthat these should receive full reportingin the Journal. In view of the long-rangecharacter of experiments in education;some type of descriptive reportingwould seem to be desirable. The Editorial Board hopes that educators whoare experimenting in educational processes will cooperate in bringing theirprogram to the early attention of theircolleagues.

The Editorial Board needs to be keptfully acquainted with meetings, seminars and conferences which deal with


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problems of medical education. Throughthe designation of correspondents in ourmedical schools, it is hoped that a fullerreporting of activities in the field ofmedical education can be developed.

There is considerable enthusiasm forarticles which report methodology-howto run a department, how to teach acourse, etc.

The Editorial Board solicits the adviceof the members of the Association, andwelcomes the opportunity to reviewcontributions to the various sections ofthe Journal.

ACTION: The annual report of theEditorial Board was accepted withoutrevision.

REPORT OF THE COMMITTEE ONFINANCING MEDICAL EDUCATION

JOSEPH C. HINSEY, reporting for JOHNB. YOUMANS, chairman: In contrast torecent years, no proposals for federalaid to medical education were pressedin Congress during the past year, andthe work of the committee centeredaround a consideration of other aspectsof the problem, inclUding the activitiesof the National Fund for Medical Education and the American Medical Education Foundation.

Consideration was given to threesources of funds to provide for medicalschool needs: (1) the establishment ofthe position of a consultant in the raising of funds to be available to medicalschools during his association, (2) thecontribution of funds for general medical education from organizations raisinglarge sums from the general public formedical purposes and (3) the care ofveterans by contract.

Investigation of these sources has notbeen concluded. It has been again found,however, that one of the main blocksto increased financial support to medicaleducation is the confused and evenreasonably inaccurate approximation ofthe cost of medical education. This situation not only is a direct hindrance todiscussions designed to discover meansof additional support, but is used as anexcuse for failure to assist by sourceswhich may be considered as natural andjustifiable contributors. Attention, therefore, is being directed to means of removing this obstacle.

The committee has aided the work


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of the National Fund for Medical Education and the American Medical Education Foundation whenever possible. Thechairman has been appointed to theMedical Educational and Scientific Advisory Council of the national fund, andhas spoken at two meetings sponsored by the fund's Committee on American Industry. Other members of thecommittee, as well as members of theAssociation not on the committee, havemade similar contributions.

It is interesting to note that some attention has been paid to the medical student as a source of additional incomethrough the mechanism of deferredcharges for full cost of tuition; a planpresented in a recent number of theJournal of MEDICAL EDUCATION.

The report of the committee's activities up to this meeting has been mimeographed and distributed (see above).A meeting of the committee was held atFrench Lick on Tuesday morning, October 19, at which time the following matters were discussed, with the actionstaken as indicated:

1. The cost accounting study of theUniversity of Colorado Medical Schoolwas reported by Dr. Darley and thepossibility of an extension of suchstudies was discussed.

2. The committee recommended thatthe Association, through this committee,take appropriate steps to present to theDepartment of Health, Education andWelfare the problem of allowances foroverhead on research contracts of thePublic Health Service.

3. The committee approved the taking of appropriate steps to developinga program under which allotment offunds for undergraduate education fromnational medical fund raising organizations would be sought, to be distributedthrough the National Fund for MedicalEducation.

4. The committee suggested that anapproach be made to the Conference ofGovernors as a means of education andwith the possibility of securing statefunds from some schools.

5. The committee asked that the possibility be explored of a one-time grantprogram by the federal government forrehabilitation and modernization ofplants.

ACTION: The annual report of theCommittee on Financing Medical Education was accepted without revision.

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REPORT OF THE COMMITTEE ONINTERNATIONAL RELATIONS INMEDICAL EDUCATION

FRANCIS SCOTT SMYTH, chairman. Withthe interest of the Council on MedicalEducation and Hospitals currently verymuch concerned with the foreign medical school graduate interning in theUnited States, it is pertinent to reviewthe developments since our last reportand meeting of this Association.

In February 1954, the council calledan unofficial meeting of a group representing the Council on Medical Education, the Federation of State MedicalExamining Boards and the Associationof American Medical Colleges in Chicago in connection with the AnnualCongress on Medical Education andLicensure.

Discussion highlighted the shortage ofinterns in the United States, especiallyin those states which had a preponderance of entrants into foreign schools.Attention was called to "states rights"in the matter of licensure and the varying attitudes to be found in states; e.g.,New York which has made it easierfor foreign graduates by not requiringlicensure for internship. Dr. Rappleyeaddressed the combined meeting onmedical education and gave a preciseand clear picture of the threat to American standards if easy licensure followsthe intern experience of foreign medicalschool graduates. This excellent exposition of the problem has been publishedin the Journal of the American MedicalAssociation of April 3, 1954. A somewhatsimilar treatise by James McCormackappeared in the June 26 issue of theJ.A.M.A. titled "The Problem of theForeign Physician."

In June, at the San Francisco meetingof the AMA, your chairman was askedto represent this Association at anotherad hoc committee meeting called by Dr.Murdock of the AMA Board of Trustees.While the majority of the committeeseemed to favor some type of examination of individual graduates of foreignschools as a method of screening foreligibility for state boards, it was evident that others preferred to continuethe current system of accrediting foreignmedical schools. You are familiar withthe attitude of your committee on thissubject, but it should be reiterated thatmany state boards are legally unable to

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accept an individual examination as asubstitute for current procedure. Doubtwas expressed as to the acceptability ofa preliminary screening examination inlieu of accrediting schools, unless locallaws are changed. A communicationdated September 22 to members of theExecutive Council and to the chairmenof the Committee on Licensure Problemsand the Committee on International Relations in Medical Education announcesthe appointment of a cooperating committee to study and submit plans for asatisfactory screening program for foreign trained physicians.

In California, your chairman appearedbefore the Council of the California Medical Association and the State Board ofLicensure, which discussions resulted inpublication of an article which appearedin the April issue of California Medicine.

The subject of the alien physicianinterning in our U. S. hospitals is furtherreviewed in a report by Diehl, Crosbyand Kaetzel, representing the HealthResources Advisory Committee of theAmerican Hospital Association and theOffice of Defense Mobilization, publishedin the J.A.M.A. September 4, 1954. Ananalysis of the present situation by themshows that a total of 5,589 foreign medical school graduates who held appointments as interns, residents or fellowsat civilian hospitals approved for training in 1953-54, over 60 per cent were innonteaching general hospitals, and twothirds of the aliens were in five states.

With representation of the Health Resources Advisory Committee (Dr. Diehl),we are reminded of the projected shortage of physicians which Dr. Rusk anticipated in his discussion before this Association some time ago. But while there isno quick solution to that shortage, thisAssociation and its members continue todiscourage any acceleration of trainingor lowering of standards.

What we did not know or anticipate,however, was the ease with whichAmericans, often rejected applicants tothe U. S. schools, would gain admissionto foreign schools. Nor did we realizethat the ease of admission in severalforeign countries would lead to an excess of graduates beyond the need ofthe respective foreign country. In otherwords, we have the pattern by whichoverproduction in certain countriesabroad seeks to meet the shortage herein the intern hospital services in the


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U. S. For example, in Munich, out of atotal of 8,000 university students, 4,000are in medical school, there is an obvious excess production of physicians,with standards of training and fitnessinferior to OUrs. This is further borneout by the fact that despite West Germany's favorable and rising economicstatus, there are 6,000 unemployed physicians in Germany. It is unreasonableto suppose that this flow of applicantsto U. S. hospitals can be stopped. However, it can and should be controlledadequately in order to protect our ownstandards, both as to professional personnel and professional education.

Both the survey by Diehl, Crosby andKaetzel as well as the report of Rappleye mention the Educational ExchangeAct of 1948, and the role of governmental agencies in fostering educationalexchange between friendlY countries. Itis to be recalled that your committeewas initially organized to orient members of this Association to the responsibilities and opportunities of the programas it involved the field of medical education in international relations.

For the past year, your chairman hasserved on the President's Board of Foreign Scholarships and has been able tobring to representatives of the Fulbrightprogram, the Institute of InternationalEducation and the Conference Board ofAssociated Research Councils some ofthe problems relating to the foreignstudent in the field of medicine in theUnited States. For example, as reportedin this committee's report of 1951, boththe Institute of International Educationand the Conference Board of AssociatedResearch Councils have adhered to therecommended policy of placing foreignstudents in medical teaching hospitals,and have consistently discouraged candidates from interpreting entrance intothe premedical field as tantamount toadmission into medical school. However,since the law does permit "travel funds"for certain foreign students recommended by the committee in their owncountry, and they can maintain themselves on private funds, they are verynaturally welcomed by many nonteaching hospitals, and they may request theU. S. Immigration Offices for sponsoringpermits to permit visa applications forthe foreigner. The legal basis is thusformed for the accommodation of manyforeign graduates in the internships of


65th Annual Meeting

nonteaching but accredited hospitals. Itis difficult to evaluate the number whomay find positions in nonaccredited institutions.

To clarify the position of this Association in regard to our policies, E. GreyDimond surveyed the component medicalschools. A circularized questionnairebrought replies from 67 of the 72 fouryear curricular schools, and all sevenof the two-year schools. A total of 1,468foreigners were accommodated in allcategories (students, interns, residentsand fellows). Of these, 317 were undergraduates, 603 were interns, residentsor fellows, and 478 were in other staffcategories in the institutions covered.This survey also included the totalnumber of foreign scholars in the respective states, contrasted with the number enrolled with the teaching medicalcenters, and will lend itself to manyinterpretations. It will be transmitted tothe central office of our Association forwhatever value it may have, and thecommittee expresses its appreciation forthis valuable contribution from Dr.Dimond.

A survey submitted by Elizabeth P.Lam of the Conference Board of Associated Research Councils summarizedthe participation of this organization inthe placement of foreign grantees whowere placed exclusively in teaching hospital centers. This report further clarifies the program of the conference boardand shows the countries from whichstudents are drawn and the institutionsin the United States which accommodatethem.

From a study of these reports, aswell as the documentary evidence ofthe Rappleye and Diehl reports, it becomes apparent that the vast majorityof foreign graduates are placed in internships or house positions of nonteachinghospitals. It is unfortunate that theseinstitutions, often with U. S. immigration numbers for visa permits, are aptto be less reliable in the provision ofthe education experience for the foreigngraduate and are in some instancescareless about urging students to returnto their native countries.

The Board of Foreign Scholarships isacutely aware of the existing problemsand though there is no way to preventmiscarriage of intent, they will renewefforts to present the problem to embassies and foreign commissions who

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are responsible for the screening andprocessing of foreign applicants. Thereremains, however, the integrity and responsibility of hospital directors and theprofessional staff in regard to theircharges.

For those foreign school graduateswhose intention it is to remain in theUnited States, whether in violation oftheir visa or not, it is hoped that adequate screening of the individual willenable licensure of only the well qualified.

While the surveys of Dr. Dimond andthe conference board show a very goodrecord regarding the cooperation of ourmedical schools, there has not beenmuch progress in the development ofaffiliations with specific areas, regions,or selected foreign schools. Some unofficial exchanges between faculty offoreign schools and those in the U. S.are known to exist. Eminent scientistsparticipate in international conferencesand often tour our institutions. However, in the technically underdevelopedareas there is little appeal to the American faculty on sabbatical leave, exceptfor certain types of field experience(e.g., tropical medicine).

Mention should be made of the Institute of Inter-American Affairs andthe Kellogg Foundation in regard toCentral and South American medicaleducation, as well as the Medical Education Information Center through whichMyron Wegman is indexing the variousagencies in this field. A olan whichanticipated an affiliation bet~een Tulane

'and the schools in Colombia has notyet materialized, but is being pursuedby Dean M. E. Lapham of Tulane. Representatives of the University of Minnesota have visited Korea, where it ishoped to work out an affiliation betweentheir National University in Seoul andthe University of Minnesota. This willbe financed by the Foreign OperationsAdministration and will cover the fieldsof agriculture, engineering and medicine.

Since July 1954, an affiliation hasbeen in effect between the Universityof Indonesia Faculty of Medicine inDjakarta and the University of California School of Medicine in San Francisco. A staff of 10 faculty will be sentto Indonesia over a period ranging fromone to three years, while graduatesfrom Indonesia will receive advancedtraining in this country preparatory to

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assuming faculty positions in their owncountry. The red tape involved in sucha program is familiar to all of youthe ramifications through the governmental agencies of two countries, theirbureaus and embassies, not to mentionthe regulations of a large university.However, there is much that is satisfying and encouraging, especially in thedeep growing understanding and friendship between the two faculties of therespective schools of medicine. For thosewho might be interested, I should liketo solicit your help in obtaining facultyfor specific areas.

Yet to be formalized is a plan whichmay bring a number of prominent physicians from our European allies to U. S.teaching centers, in order to effectsome common progress in regard tomedical care (of military personnel).The College of Surgeons is expected tosponsor and spearhead the mechanics inthis country since surgery will play aprominent role in the plan. It is hopedthat each and every medical school ofour organization will give full cooperation to the program.

Some of you will be interested in theproposed establishment of internationalscience centers. Such centers are toserve as "clearing houses" for visitingscientists in the locale of the center.San Francisco and New York City havealready been designated, and a total of11 such centers are to be establishedin appropriate American cities. Probablymany of the scientists will be interestedin the field of medicine, and we can expect to continue our cooneration in welcoming this added facility to the causeof good international relations.

ACTION: The annual report of theCommittee on International Relationsin Medical Education was acceptedwithout revision.

REPORT OF COMMITTEE ONINTERNSHIPS AND RESIDENCIES

CURRIER McEWEN, chairman: Twomeetings of the committee were heldone at the time of the Congress on Medical Education and Licensure and theother immediately prior to this meeting-as well as three meetings of asubcommittee consisting of the chairman and Drs. Howard Armstrong, JeanCurran, William N. Hubbard Jr., JamesMcCormack and John Mitchell. Dr.


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Edward Leveroos of the Council onMedical Education and Hospitals of theAmerican Medical Association also satwith this subcommittee by invitation onseveral occasions.

A number of questions relating to thematching plan were dealt with in behalf of the Association as well as various matters of routine nature. The maJortopic of consideration, however, was theAssociation's "Confidential Ranking ofInternships as to Educational Standing."This list was started a number of yearsago in an effort to provide the deans andstudent advisors in the various medicalschools with a listing of hospitals whichwould provide better information as tothe educational value of the variousinternships than could be obtained fromthe American Medical Association's approved list. The effort was an important one but, at least in recent years,the list has not been sufficiently accurate to be useful.

The following factors make the maintenance of an adequate list very difficult:

(1) The quality of the educationalexperience (particularly where varyingnumbers of foreign graduates are appointed) in an internship is not constantfrom year to year.

(2) Reliable evaluations of a hospitalare at best difficult to obtain now thatthe number of internships is so great.

(3) The cost of a really effective inspection program, and the difficulty ofobtaining appropriate inspectors forevaluating the educational standing ofinternships mitigate against this program.

(4) The individualized needs of thestudents and the particularized advantages of any given internship make auniform system of evaluation somewhatunrealistic.

Furthermore, the need for the list isnow less urgent than previously because relatively few students are todaychoosing unsatisfactory internships asa result of the matching plan and because pertinent information is morereadily available in the offices of thevarious schools.

After careful consideration it wasagreed to recommend to the Associationthat the current list be discontinued. Asa SUbstitute it was suggested that adequate data on specific hospitals can beobtained by using other published material (such as the reports of the JointCommission on the Accreditation of


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Hospitals, the lists of approved internships and residencies published by theAmerican Medical Association, etc.),supplemented by information gainedthrough personal communications withdeans in the area about which a student has expressed interest, and throughthe information published on the resultsof the matching plan.

The committee also considered theadvisability of making another stUdy ofthe role of the internship and residencyin medical education and agreed that,in view of the recent report of the Advisory Committee on Internships to theCouncil on Medical Education and Hospitals, of the coming Teaching Institutedealing with the internship, and of thecurrent problem created by the largenumber of foreign physicians filling internships in this country, it would beinadvisable to attempt a survey of theeducatIOnal role of internship and residency by the Association at this time.Of very timely importance in the committee's judgment, however, are nationalstudies of the impact of the foreign interns on medical standards in this country. The committee will be happy tocooperate with other appropriate bodiesin furthering these efforts.

In addition, the committee recommendsthat each member school of the Association undertake a careful study of theinternships in its major teaching hospitals with a view to appraising their organization and their educational valueto the intern. Furthermore, it is urgedthat the schools review their proceduresfor advising their students in the selection of internships to assure that theyare as effective as possible.

Finally, the committee agreed that abrochure for medical students outliningthe principles and steps involved in theselection of a satisfactory internshipwould be desirable and gave provisionalendorsement to a draft of such a brochure prepared by Howard Armstrong.It is anticipated that if the Associationapproves the printing of this brochureit can be available for distribution during the academic year 1954-1955.

In conclusion, the committee wishesto point out a number of serious problemswhich require continued study. Severalof these are perennial questions whichhave long preoccupied our Associationand others are newer problems peculiarto recent years. Among the time-hon-

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ored problems the committee feels needfurther study are:

(1) How to develop the internshipsand residencies to provide the best educational opportunity.

(2) How to acquire adequate information about the quality of internshipsand residencies of the country for theguidance of our students.

(3) How to reduce the number of approved internships and residencies sothat only those truly adequate are solisted and so that the total number isrealistically related to the number ofavailable graduates of approved American medical schools.

(4) How to meet the service needs ofthose hospitals which cannot and shouldnot have interns.

Among the newer problems are:(5) How to control the number of

graduates of "unapproved" foreign medical schools who are now filling so manyinternships in American hospitals to thedetriment of medical standards in thiscountry, and often to their own disadvantage.

(6) How to offset efforts to regimentand to uniformly standardize the internships and residencies.

(7) How to solve the problem presented to the internship and residencyprograms by the needs of the armedforces.

ACTION: The annual report of theCommittee on Internships and Residencies was accepted without revision.

REPORT OF THE JOINT COMMITTEEON LICENSURE PROBLEMS

CHARLES A. DOAN, chairman: The Executive Council of the Association ofAmerican Medical Colleges, at its meeting in February 1952, created a committee to review and to advise regarding the current problems involving medical licensure in the United States. Atthe first public hearings in ColoradoSprings in November 1952, representatives of the Federation of State MedicalBoards indicated an interest and concern in the same questions and theirsuggestion of joint representation onthis Association's committee was cordially received and approved. In April1953, Donald G. Anderson, then secretary of the Council on Medical Education and Hospitals, forwarded a writtenrequest that this important council ofthe American Medical Association be

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advised of the Association's deliberationson licensure procedures and in thefuture be officially represented on thejoint committee. On May 2. 1954, theExecutive Committee of the NationalBoard of Medical Examiners, in regularsession, requested that officially designated representatives (the president andexecutive secretary) be granted theprivilege of joining in future deliberations of the Committee on LicensureProblems.

The joint committee meets two or threetimes a year; viz., during the annualmeetings of the AAMC in October, ofthe federation in February and of theAMA in June. Most assuredly the combined judgments of the representativesof these four cooperating agencies maybe expected to be correspondingly morecomprehensive and pertinent than otherwise, and since each group has vestedinterests in medical licensure laws andprocedures, it is to be hoped that unitedaction may be recommended by thisjoint committee and approved by therespective cooperating bodies from timeto time as the evidence may justify.

In our second annual report last year,eight specific recommendations weremade to this Association, with theunanimous approval of the committee.Following the two committee sessionsduring the Atlantic City meetings, asupplemental report was prepared, presented at the final business meeting andreferred to the Executive Council foractivation, with six specific resolutionsagain unanimously supported by allmembers of the committee. On February 9, 1954, the same supplementaryreport was presented by your chairmanfor consideration by the federation inChicago, and supported formally byCharles L. Shafer of that association.It was also submitted to the Councilon Medical Education and Hospitals.

Pertinent to the continuing deliberations of this committee are the following problems:

(1) The committee reaffirms its recommendation that the further extensionof basic science laws be discouragedand that those now in force and existence be repealed (see Appendix A tosupplemental report of this committee,October 28, 1953).

(2) In the best interests of geographically widespread postgraduate education and hospital training, it is believed

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that every licensing board should makeprovision for temporary time, place andcondition-limited, or "postgraduate" certification, or its equivalent, to permitqualified medical graduates desiringfurther intern, residency and researchexperience, to accomplish these objectives freely and expeditiously, and withinsurance protection.

(3) We strongly support the objectives of the Committee to Draft a Uniform Medical Practice Act, currentlyworking under the Federation of StateMedical Boards, with Bruce Underwoodas chairman. The questionnaire recentlycirculated to the deans of all medicalschools should be thoughtfully and carefully answered and promptly returned.

(4) Only a few responses were received from individual deans to the request for information regarding therelationship which exists between theirfaculties and the respective state licensing boards in their areas. It would seemapparent, however, that in those regionswhere medical school faculties are represented by one or more members on thestate licensing boards, fewer instanceshave been reported of mutual misunderstanding and recrimination (for theinformation of Dr. Underwood's committee).

(5) This committee has noted withregret and concern the growing misunderstanding between the Federationof State Medical Boards and the NationalBoard of Medical Examiners. In themany discussions which have been initiated by both parties, an attempt hasbeen made to redefine the respectiveroles and responsibilities of each agency,and to emphasize their complementaryand supplementary, rather than competitive, functions. It is sincerely to behoped that continuing discussions inan atmosphere of friendly objectivitymay resolve promptly the existing conscientious objections and differences.

Quoting from a memorandum datedFebruary 12, 1954, addressed to thedeans of all medical schools from DeanSmiley, our executive secretary:

"It is the unanimous opinion of ourExecutive Council that this trend awayfrom the national board examinations isan unwise and unfortunate one.

"Your secretary was, therefore, instructed to (a) call your attention tothis unfortunate trend, (b) remind youthat in some states action by the medi-


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cal schools has halted this trend, (c)suggest that in each state the medicalschools form a liaison committee withthe State Board of Medical Examinersto explore this important matter andfind out, if possible, the causes lyingback of this trend, (d) suggest that anychanges in your state in regard to thismatter be called to the attention ofCharles A. Doan, chairman of our Committee on Licensure Problems."

(6) The problem of licensing graduates from foreign medical SChools continues to focus the attention of all segments of the medical profession, as wellas of the general American public,today. This committee has devoted muchtime to the consideration of every angle,partiCUlarly as it affects the responsibility of our own medical colleges. Theresolution referred to the ExecutiveCouncil of this Association one year agowas as follows:

"Be It Resolved: (2) That in furtheractivation of paragraph 3, this Association definitely approves in principle andencourages as one means of helpingsolve the current problem of licensureof medical graduates from foreignschools, the acceptance into the medicalschools of the United States and Canada,of carefully selected candidates for atleast one additional year of undergraduate medical education, where and whenotherwise unfilled vacancies occur intheir upper classes. Concurrence by theappropriate state licensing boards wouldneed to be obtained. Successful passingof Part I of the national board examinations as now required by certain medicalschools, or some equivalent screeningdevice, should be used as a basis forselection and acceptance. Each medicalfaculty would decide if and when theirown M.D. degree would be given following the successful demonstration ofadequate medical knowledge for suchan honor.

"Following such an undergraduateyear, a further intern year of appraisaland training would be automatically required before the examinations couldbe taken for a permanent license. Actionof this kind by this Association wouldsupplement other efforts such as thatof the postgraduate school at New YorkUniversity, where for the past two yearsa full academic year has been providedfor specially screened physicians fromforeign medical schools. It is probable

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that no one answer will be found forthis increasingly pressing problem, sothat a number of different approacheswill need to be carefully considered bythe medical profession of this country,to meet the ever-pressing urge for moreadequate approved medical care in thiscountry."

The following paragraph 4 is takenfrom the official minutes of the Executive Council meeting of the AAMC heldin Chicago, February 5 and 6, 1954:

"The report of the ad hoc committee,consisting of Vernon W. Lippard, Joseph C. Hinsey, Stanley E. Dorst, John M.Stalnaker and Dean F. Smiley, appointedto bring in a recommendation concerning means of screening foreign medicalgraduates for licensing in the UnitedStates was read. After considerable discussion a number of changes were incorporated, and Robert A. Moore prepared a final copy which was approvedas follows:

'In the opinion of the Executive Council of the Association of American Medical Colleges, ways should be kept openby which well qualified physicians mayobtain licensure to practice in the UnitedStates. It is equally important, however,that the public be adequately protectedagainst the dangers attendant on permitting unqualified physicians to obtaina license to practice.

'Inspection and accreditation of American medical colleges has proved to bean important adjunct to the examinationof graduates of these colleges by thevarious state licensing boards in theeffective screening of American trainedphysicians.

'However, because of differences inculture, in traditions, and in objectivesit is not desirable, or feasible for Americans to undertake a comparable program of accreditation of schools in othercountries. Therefore, some other type ofscreening procedure for those who graduate from a foreign medical schoollisted by WHO and wish to practice inthe United States, is desirable. The Executive Council suggests the followingprocedure:

'1. The applicant should apply to aspecific state licensing board presentingsuch documentary evidence as may berequired by that board.

'2. If the licensing board to which theapplication is made is satisfied that theapplicant is otherwise qualified, it may

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issue the applicant a permit to takePart I of the examination of the National Board of Medical Examiners.

'3. If the applicant successfully passesPart I of the examination of the National Board of Medical Examiners, thisfact should be certified to the stateboard which may then proceed underits regulations and requirements.' "

Toward the end of the Conference onForeign Medical Graduates, called byEdward Turner for the AMA counciland held in Washington, D. C., on April30, 1954, it was suggested that this problem be referred to the federation forfurther consideration and advice. E. W.Schnoor, president, and Walter L. Bierring, secretary, then drew up a preliminary draft for a Joint Commissionfor the Evaluation of Foreign MedicalGraduates, to be sponsored by the threecooperating agencies represented on thiscommittee and to be financed by selectedfoundations or other interested agencies.This approach was very thoroughly considered by the House of Delegates at theSan Francisco session of the AMA inJune 1954, with referral back to theCouncil on Medical Education and Hospitals for review and subsequent reconsideration at the Miami session of theAMA in December 1954. Edward Turner,secretary of the Council on Medical Education and Hospitals, then called a meeting of representatives of the AMA Council on Medical Education and Hospitals,the Association of American MedicalColleges, the federation and the American Hospital Association in Chicago forSeptember 11, 1954, with the hope offinding further means of resolving thisurgent problem. Representing the AAMCwere Joseph Hinsey, Dean Smiley andJohn Stalnaker.

At that meeting the following actionswere taken:

(1) A Cooperating Committee onGraduates of Foreign Medical Schoolswas formed (membership, it is hoped,will consist of three members each fromthe Council on Medical Education andHospitals, the Federation of State Medical Examining Boards of the UnitedStates and the Association of AmericanMedical Colleges, and one member fromthe American Hospital Association).

(2) It was suggested that the cooperating committee might well develop intoa national body charged with the responsibility for examining, evaluating


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and certifying foreign trained physiciansas eligible for consideration by the various state medical examining boards. (Itprobably should not be a duty of thisbody to counsel foreign medical graduates as to what steps they might taketo make themselves eligible.)

(3) The following officers wereelected: chairman, Donald Anderson;vice chairman, Dr. Ezell; secretary,Walter Wiggins; members of the executive committee: the chairman, vicechairman, secretary, Edward Turner andDean Smiley.

(4) The executive committee was instructed to organize itself as a planningcommittee, to bring to the next meetingof the cooperating committee in Octobera suggested plan as to how a satisfactoryscreening program for foreign trainedphysicians might be set up and operated.

The matter of the AAMC's participation in the work of this cooperating committee will be discussed and voted uponat the October meeting of the ExecutiveCouncil.

ACTION: The annual report of theJoint Committee on Licensure Problemswas accepted without revision.

REPORT OF THE COMMITTEE ONMEDICAL CARE PLANS

DEAN A. CLARK, chairman: The Committee on Medical Care Plans continuesto be chiefly interested in the possibleeffects of insurance against the cost ofprofessional services upon the teachingof undergraduate medical students, interns and residents. The survey of medical school deans' opinions about thismatter, done last year, did not seem tosubstantiate widely expressed fears thatmedical care insurance was adverselyaffecting medical education, in any ofits aspects.

During the year, however, informalindividual observations by committeemembers lead to the strong impressionthat the effects of insurance, principallythat of apparently increasing the number of hospitalized private and semiprivate patients and decreasing thenumber of hospitalized ward patients,have been more serious than the deans'opinion survey suggested. The problemseems to be least difficult in regard tothe education of medical students andinterns. In many teaching institutionsthese two groups are apparently being


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taught successfully with the cooperationof private and semi-private as well asward patients.

The situation appears to be quite different, however, with respect to residency training, perhaps especially residency training in general surgery andthe surgical specialties and in obstetrics.In connection with such training a greatmany problems have been observed andvarious somewhat hit-or-miss solutionsattempted. In one hospital which is intimately associated with a medical group,for instance, the senior residents are nolonger called "residents" but "juniorassistants" to the group. They do notwear white suits and individual patientsare referred to them for care in thesame way as they are to the senior members of the group. The junior assistantsthen provide all the care needed, including major surgery, under the supervision of the senior staff members.

Where no medical group is at hand,however, solutions are harder to find.We know of one large municipal hospital with traditionally excellent teaching services which has had so few surgical ward admissions that it has foundit necessary to send its surgical residentsto another hospital to complete theirtraining.

In another teaching hospital, a planis under serious consideration by whichpatients able to pay professional fees,either through insurance or out ofpocket, would be admitted to the teaching services, if they so desire, to becomethe patients of the resident and visitingstaff and be treated exactly as the"indigent" and "medically indigent"have been treated there in the past.These patients would not be patients ofany individual private physician, butwould be patients of the teaching services as such. The professional fees paidby such patients would not go to thehospital for general purposes but wouldbe pooled in a special professional feefund to be expended for professionalpurposes only, at the discretion of thestaff.

These and other devices would seemto indicate a need for further study ofthe problem. The committee, therefore,is beginning a new survey, the resultsof which should be ready next year. Inthis survey, data will be sought not frommedical school deans, many of whomare not closely associated with resi-

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dency training programs, but ratherfrom hospital administrators, chiefs ofservice in teaching hospitals, and, whereavailable, hospital directors of medicaleducation. A list of about 100 of theprincipal teaching hospitals has beendrawn up and questionnaires are nowbeing prepared by means of which it ishoped to secure the desired data. If theresults of the current survey are available before the next Annual Meetingof the Association of American MedicalColleges, they will be circulated to thedeans, to the participating hospitals andto others who may be interested, in thehope that better-informed discussion ofthe subject can then be held at theannual meeting.

ACTION: The annual report of theCommittee on Medical Care Plans wasaccepted without revision.

REPORT OF THE COMMITTEE ONMEDICAL EDUCATION FOR NATIONALDEFENSE

STANLEY W. OLSON, chairman: Aftersecuring approval of the delegate bodyof the Association of American MedicalColleges at Atlantic City in October1953, for the expansion of the programknown as the MEND program, a telegraphic poll was taken of all schools todetermine the number who were interested in participating. The results wereas follows:

Interest in participating 43Not interested 2Undecided 23

In February 1954, a "staff study" wasprepared for the use of the AssistantSecretary of Defense, Frank Berry (seeAppendix A). This was reviewed bythe Armed Forces Medical Policy Advisory Council and unanimously rejected.

A gesture toward expansion wasmade late in the spring when Dr. Berryoffered the sum of $140,000 over theperiod of the next two years to expandthe program into several additionalschools. It was clearly stated at thattime, however, that there was no intentto continue the support beyond a twoyear period. In conference with Dr.Hinsey and Dr. Smiley, a decision wasreached to request that this fund beused for the extension of the presentlyoperating pilot programs for two years,this guaranteeing support for a total offour years, or during the cycle of oneentire medical school class.

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Dr. Olson presented the MEND program before the Section on MilitaryMedicine and Surgery at the conventionof the American Medical Association inSan Francisco in June. This paper wassubsequently discussed by Dr. Ravdinfrom the University of Pennsylvania, amember of the Armed Forces MedicalPolicy Council Advisory Committee, andJoseph Hinsey, chairman of the Executive Council of the Association of American Medical Colleges.

Informal information suggested thatas a result of this presentation and thesubsequent discussion, that there was amore active interest in the project bythe Assistant Secretary of Defense. Inany event, about August 1, 1954, hewrote to Dr. Olson suggesting that theDepartment of Defense might be interested in sponsoring symposia by therepresentatives of the Armed Forces andsubsidizing travel of faculty membersof the medical schools to attend conferences of this type. In effect, this represented support for approximately halfof the program as it is now being carriedon in the pilot schools, but left undecided the quite important decision regarding the coordination of the program,both at the national level and the locallevel.

A meeting was held on September 9,1954, attended by Frank Berry, JohnYoumans, Admiral Morrison, AdmiralHogan, General Hays, General Powelland Dr. Olson. Dr. Berry reiterated hisinterest in sponsoring travel for facultypersonnel and in encouraging the representatives of the Armed Forces toarrange programs of a stimulating nature for these representatives. He madecareful inquiry into the need for a coordinator at the national and local levelsand seemed quite interested in a proposal that a sum of $7,500 be allotted toeach school for a coordinator for alimited period of three or four years,the time which was estimated to berequired to firmly establish the MENDprogram in the curriculum of any givenmedical school. He called attention tothe fact that his advisory committee wasmeeting in joint session with the advisory committee to the Research andDevelopment Section of the Departmentof Defense, and that he would be gladto put to them any specific propositionwhich the MEND Committee might wishto formulate.


Appendix A

"STAFF STUDY" Presented to the Assistant Secretary of Defense (Health & Medical) February26, 1954

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A meeting of the MEND Committeewas also held on September 9, 1954, atwhich time the following proposal wasformulated for presentation to the ArmedForces Medical Policy Council on September 12, 1954:

1. That the MEND program be expanded to a minimum of 10 additionalschools and a maximum of 15 additionalschools, during the academic year 195556;

2. That each school concerned withthe program is allocated the sum of$7,500 for a coordinator for a maximumperiod of three or four years;

3. That there be made available bythe Department of Defense travel fundsfor the representatives of the participating schools on approximately the samebasis that is currently available, andthat this be envisioned as a continuingresponsibility, not terminating after ashort period of time;

I. STATEMENT OF THE PROBLEMPhysicians today must be ready to

serve effectively in the armed forces,in civil defense situations, or in both.The plain fact is that the young medicalgraduate is not being educated or trainedto assume this obligation.

In order to correct this grave deficiency, the Joint Committee on MedicalEducation in Time of National Emergency herewith submits a proposal forconsideration by the Secretary of Defense.

Facts Bearing On The Problem:A. The medical ROTC program of the

United States Army and the UnitedStates Air Force has proved to be anineffective mechanism for preparingmedical graduates for military serviceand is being discontinued as of June 30,1954. The armed forces appear to haveno suitable mechanism to replace themedical ROTC program.

B. It has been the policy of the Armyand the Air Force to give a short introductory course to reserve officers asthey begin their tour of active duty.Because of the short time available, suchorientation programs for reserve medi-


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4. That there be a national coordinator, for whose activities a sum of approximately $25,000 per year would bemade available.

5. Expansion to the remaining schoolswho wish to participate would be madeas rapidly as possible in the light ofthe experience attained with the expansion during the first year.

Information obtained from Dr. Youmans indicates that the proposal hadfavorable reception by the Armed ForcesMedical Policy Advisory Committee.The one item which was brought intoquestion was the need for an amountas large as $7,500 per year per schoolfor a coordinator, and the sum of $4,000per year was suggested as adequate.No formal action has been taken withrespect to the expansion of the program,however, and it is likely that there willbe further discussions at the annualmeeting of the AAMC.

cal officers are aimed primarily at theteaching of organization and methodsused in the Armed Forces.

Large areas dealing with the application of principles of medicine andsurgery as they are encountered in themilitary and civil defense situation areleft untouched by both the medicalschools and by the military organizationsin their initial indoctrination. Somemethod of accomplishing this latter objective in the undergraduate medicalcourse would enable the reserve officerto function as an effective medical officerwithin a short time after the commencement of active duty.

C. Experience in civil disaster situations has shown that the physician withwartime military experience understandsthe principles of care of mass casualtiesbetter than the physician who has nothad such experience. Because the likelihood of major civil disaster has increased sharply in recent years, there isgreater urgency to instruct the youngphysician to meet the responsibilities hewill face in the event of such disaster.

D. At present close liaison exists between the Armed Forces and medicalschool faculties only in certain areas:

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1. In connection with graduate education:

Civil consultants in many cities assistin the organization and conduct of residency programs in military hospitals.

2. In connection with research:Numerous research contracts have

been negotiated by the Armed Forceswith civilian medical investigators.

3. In connection with policy formulation:

Many civilian consultants serve in anadvisory capacity to the Armed Forces.

There is, however, almost no liaisonbetween the Armed Forces MedicalServices and medical school facultieswith respect to the content of the undergraduate curriculum.

II. PROPOSED SOLUTIONIt is proposed that the medical school

faculties be acquainted with the problems of military medicine and surgeryand with the methods used in militaryand disaster situations in order thatthey may effectively incorporate theseconcepts into their courses.

Facts Bearing on the Proposed Solution:Since October 1951, the Joint Com

mittee on Medical Education in Timeof National Emergency of the Association of American Medical Colleges andof the Council on Medical Educationand Hospitals of the American MedicalAssociation has worked closely with therepresentatives of the Armed Forces, thefederal Civil Defense Administration,the United States Public Health Serviceand the office of the Assistant Secretaryof Defense (Health and Medical) andhas developed a considerable amount ofexperience in meeting the problems under discussion by means of a series ofpilot programs in five medical schools.

These five pilot programs, involvinga total of 1,800 students, have been carried on at a cost to the government of$15,000 per year for each school, or$41.50 for each student. A recent pollof the 79 medical schools in the UnitedStates indicates that 50 schools are nowready to introduce a similar programwhenever funds become available. Onlytwo schools have expressed disinterest.The remaining 27 schools, for a varietyof reasons, have requested that theydelay their decision. It is anticipatedthat a majority of these will implementthe program after it has been fully re-

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viewed by the appropriate faculty representatives. These 50 schools whichhave expressed willingness to cooperateteach 13,000 of the 21,000 students enrolled in medical schools in the UnitedStates. By way of contrast, informationfrom the Office of the Surgeon Generalof the United States Army indicates thatin 1952-53 there were 48 medical ROTCunits giving instruction to 4,151 medicalstudents at a total cost of $1,441,000,computed on the basis of $153.06 peryear for each student enrolled in thebasic course and $774.06 per year foreach student enrolled in the advancedcourse.

At a cost of $15,000 per school thecost of 50 programs would require$750,000 per year. In addition, certainfunds would be required for the ArmedForces and the federal Civil DefenseAdministration to provide appropriateinstruction for faculty members of themedical schools, for teaching aids andfor the necessary travel.

It is estimated that there are at least30 members of the basic science facultyin each school which would be involvedin this operation. For 50 schools thiswould mean a total of more than 1,500teachers. Most of these teachers atpresent have had neither military experience nor such contact with theArmed Forces as would make themaware of the material which they mightappropriately teach in emphasizing theprinciples of military medicine andsurgery.

The clinical faculty in each school isa much larger group. Most of them underthe age of 55 have had military servicebut very few of these hold reserve commissions. Their contact with a programdesigned to acquaint undergraduatemedical students with newer information about military medicine will makethem more useful as a potential reservefor further military service or for civildisaster responsibility.

Experience has made it clear thatthe approach used in the pilot programsis entirely acceptable to the faculties;that it is very well received by the students; and that it meets the criticalapproval of the responsible officers ofthe Armed Forces Medical Services andthe federal Civil Defense Administration.It has been formally approved by theExecutive Council and the delegate bodyof the Association of American Medical


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Colleges, by the Council on MedicalEducation and Hospitals and by theBoard of Trustees of the American Medical Association. The National HealthResources Advisory Committee of theOffice of Defense Mobilization has reviewed the program and indicated thatit should be administered through theDepartment of Defense.

III. IMPLEMENTATION OF THEPROPOSED SOLUTION

It is the considered opinion of theJoint Committee on Medical Eucationin Time of National Emergency thatcertain fundamental principles consistent with sound medical education haveemerged from experience in the pilotprograms and that these principles mustgovern the further development of theprogram:

1. The program should be integratedinto the regular curriculum and begiven by the regular faculty.

2. Funds must be available to securethe services of a faculty member in eachschool to serve as a coordinator whocan assist the departmental chairmanand the administration in structuringthe program.

3. There must be close cooperationamong the representatives of the federal government and the coordinatorsfrom the several schools.

4. Faculty members must have anopportunity to learn what is being accomplished by the Armed Forces andcivil defense in the areas of their specialinterests.

5. Teaching aids such as films, specialmilitary reports and technical manualsmust be made available.

It is hoped that instruction in additional schools can be begun October 1,1954.

The Joint Committee on Medical Education in Time of National Emergencyproposes to assume responsibility for theorganization and supervision of the expanded program. A full-time executivesecretary of the joint committee, working out of the office of the Association ofAmerican Medical Colleges, will be employed to provide active assistance, toarrange informal meetings with coordinators from the several schools andto assess the effectiveness of the program. It is believed that this can beaccomplished with a budget representingapproximately 5 per cent (or less) of


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the amount granted to the schools. Agrant of this purpose could be negotiatedbetween the government and the Association of American Medical Colleges.

The experience of the five pilot schoolswill be of great value to the other schoolsin formulating their own programs. Theinformation developed and distributedby the Joint Committee regarding thecurriculum in time of national emergency will serve as a useful guide toeach of the departments.

Each school of medicine will be responsible for the development of its ownprogram, while the medical departmentsof the Armed Forces, the federal CivilDefense Administration and the UnitedStates Public Health Service will beresponsible for making available suchfacilities and information as will bestpromote the objectives of the program.

The costs to the Armed Forces, thefederal Civil Defense Administrationand the United States Public HealthService for their activities in supportingthe program should be determined bythe appropriate representatives. Thenecessary administrative directives toenlist the active assistance of these organizations shOUld be developed.

IV. DISCUSSIONInsofar as may be judged from what

has been achieved in the pilot programscarried out in five medical schools, certain tangible results may be reasonablyanticipated from an expanded program.These involve (a) the favorable modification of basic attitudes of faculty members and students, (b) the developmentof an economical training program forthe armed forces and for the federalCivil Defense Administration, (c) thecreation of an awareness among themedical graduates of their responsibilityto be prepared to deal skillfully withproblems of mass casualties.

Medical school faculty members haveshown considerable interest in the contributions which the Armed ForcesMedical Services are making to our understanding of medicine. As they become familiar with these contributionsand with the officers responsible for theadvances, they develop a better understanding of the role the Armed Forcesare playing in medicine today. This attitude influences to a considerable degreethe attitude of the student so that hethinks of the Armed Forces Medical

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Services as an organization whose medical standards are equivalent to thoseof the medical school.

It is reasonable to assume that thisattitude of mutual respect between themedical school and the Armed Forceswill be of great benefit with respect tothose students enrolled in the proposedArmed Forces medical scholarship program and with respect to those studentswho will serve as reserve corps medicalofficers on active duty. It seems likelyalso that if the general aspects of a military career can be made more attractivethan at present, that these student attitudes may well mature into decisionsto remain with the medical corps asregular officers.

It has been demonstrated that theMedical Education for National Defenseprogram serves as an efficient method oftransmitting new information developedby the Armed Forces to faculty members, students and practicing physiciansmore quickly than has been the patternin the past.

Finally, it may be stated that the program will provide a readily availablegroup of trained medical students whocould augment the resources of the CivilDefense teams in each of the communities with medical schools where theMEND program is in operation.

V. CONCLUSIONS1. There seems to be little doubt that

some well planned effort to prepare fora national emergency must be made.

2. The program known as MedicalEducation for National Defense has beenshown to be a program that is effective,economical and acceptable to students,faculty and military and civil defenseauthorities.

3. After careful consideration it appears that the Department of Defenseshould assume responsibility for expansion of the program.

4. It is urgent that the matter be givenearly consideration if any expansion isto take place in the academic year 19541955.

ACTION: The annual report of theCommittee on Medical Education forNational Defense was accepted withoutrevision.

REPORT OF THE COMMITTEE ONPUBLIC INFORMATION

JOHN L. CAUGHEY, chairman: With

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the assistance of representatives of theMedical Section of the American CollegePublic Relations Association, the Committee on Public Information handledpublicity arrangements for the 64th Annual Meeting in Atlantic City. The reports of the meeting published in leading newspapers indicated the potentialvalue of the Annual Meeting as a meansof calling public attention to the activities of the Association and to the vitalrole of medical education in the development of good community health services.

At the 1953 meeting, the committeestrongly recommended that a public information section be formed in the central office of the Association. In November 1953, the committee was informedthat this proposal had been discussedby the Executive Council, and that thedecision was reached that the new associate secretary, soon to be appointed,would assume responsibilities in the public information area.

Several members of the Committee onPublic Information participated in themeetings of Medical Section of theAmerican College Public Relations Association in New York in June 1954. Atthis time arrangements were made, withthe help of Dr. Smiley, to secure the cooperation of the ACPRA group in handling publicity at the 65th Annual Meeting in French Lick. Leota Pekrul, of theUniversity of Colorado, is chairman ofthe Medical Section of the ACPRA thisyear.

Although the committee has no specific recommendations to present, it isactively interested in the following problems:

(a) Improvement of the exchange ofpublic information ideas among medicalschools.

(b) Preparation of exhibits, movingpictures and other aids for the educationof university and hospital trustees, civicgroups and the public about the manyresponsibilities and functions of a medical school in the community.

(c) Development and support of adequate training programs to providecompetent medical public relations personnel to meet the demand which is being created by the increasing awarenessof medical schools, hospitals and medicalsocieties of the need for good communications with the public.

ACTION: The annual report of the


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REPORT OF THE COMMlnEE ON TEACH·ING INSTITUTES AND SPECIAL STUDIES

GEORGE PACKER BERRY, chairman:Organization: At the 64th Annual

Meeting of the Association of AmericanMedical Colleges, held in Atlantic Cityduring October of 1953, two committeeswere combined to form a new standingcommittee, the Committee on TeachingInstitutes and Special Studies. The present report is the first to be submittedby this new committee. It has beenprepared under the direction of thechairman by the director of studies, whoserves as the committee's secretary.

The Executive Council believed thatuniting the several activities of the Committee on Student Personnel Practicesand the Committee on Teaching Institutes would provide a strong device formeeting the interwoven problems of students and teachers. All concern the medical curriculum.

To assure the closest integration ofthe work of this new committee withthe Association's other activities, thepresident, the president-elect and thechairman of the Executive Council serveas members of the committee. In addition to George P. Berry, who has accepted the responsibilities of the chairmanship, and John M. Stalnaker, director of studies who serves as the secretary and directs the work of the staff,the committee numbers 11.

Finances: The expenditures made forthe committee and its staff during theyear 1953-54 totaled almost $112,000, ofwhich amount $72,000 was spent forgeneral operations and $40,000 for expenses directly connected with theteaching institutes. During this year expenditures were incurred for both thefirst and second Teaching Institutes. TheNational Heart Institute gave $45,000 tohelp defray the costs of the first Teaching Institute, and $25,000 for the second.In addition, the National Cancer Institute gave $25,000 for the second Teaching Institute. The Commonwealth Fundand the National Heart Institute areeach contributing $25,000 for the thirdTeaching Institute. The Markle Foundation supported the general work ofthe committee by a grant of $50,000 forthe year. Both the Markle Foundationand the Commonwealth Fund are sup-


65th Annual Meeting

porting the general operations of thecommittee for 1954-55.

With the formation of the new committee, a change was made in the accounting practices of the Associationwhereby a balance of over $90,000,which remained on June 30, 1953, in arestricted account for the Committee onStudent Personnel Practices, was transferred to the Association's general fund.Testing revenues, previously credited tothis committee, were also transferred tothe general fund during the year 195354; these amounted to almost $50,000.Funds for the operation of the committee are now derived from the Association's general fund. The expendituresfor the year 1953-54 were about $9,000less than the approved budget.

Teaching Institutes: In a brief reportof the committee's activities, space doesnot permit a review of the philosophyof the Teaching Institutes or even oftheir principal accomplishments. TheTeaching Institutes are a major educational activity of the Association. Thefirst Teaching Institute on Physiology,Biochemistry and Pharmacology washeld in Atlantic City, during October of1953, and was attended by 136 invitedparticipants, representing 96 medicalschools in the United States, Canada,Puerto Rico and the Philippines. Thecomplete report was published as a supplement to the July number of the Journal of MEDICAL EDUCATION. Under thebrilliant chairmanship of Julius Comroe,this Institute accomplished results, thesignificance of which will long be felt.The co-chairman, Dr. Berry, in his preface to the published report, describesits philosophy and principal achievements.

As the present report is being written,the second Teaching Institute-pathology, microbiology, immunology andgenetics-is about to be held under thechairmanship of Douglas Sprunt andco-chairmanship of Robert A. Moore.The several preparatory committeeshave worked imaginatively and diligently on the plans. Many individualshave been involved in the preparationand analysis of information for use atthe Institute. The success of any suchundertaking depends upon the work ofmany persons at the professional leveland of the detailed statistical and administrative work by the staff of thedirector of studies. At the present time

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everything indicates another successfulTeaching Institute.

Information to Colleges: The committee continues to work with the undergraduate colleges in an effort to interestthe colleges and their best students inmedicine. The "Admission RequirementsBooklet," now in its fourth edition, hasbeen more than doubled in size andotherwise significantly improved. This1955 edition is being sold to help defraythe substantial costs of preparation andpublication. It is becoming an indispensable source of reference for facultyadvisors and for the undergraduate students. The more it is used, the fewerwill be the misunderstandings about theprocess of going from college to medical school. Further improvements areplanned for 1956; if the sale of publication justifies, a more comprehensive report on medical education will be included.

Again this year the undergraduatecolleges received from Mr. Stalnaker'soffice the distribution of the scores oftheir students on the MeAT. While thecolleges greatly appreciate these distributions, some continue to ask for individual scores. These colleges were sentlists, by name, of their students who hadapplied to medical school and the successachieved by each student. Many lettersof commendation were received aboutthese lists. Equally numerous and favorable were the comments on the reportssent to the colleges listing each studentwho entered medical school in 1949-50,where he went to medical school andwhat his progress was during next fouryears in medical school. Further reportsof a similar nature are planned for thecolleges.

No other professional or graduateschool sends to the undergraduate colleges the detailed information now supplied to them by the medical collegesvia the Association. This is true bothqualitatively and quantitatively. From afull understanding between colleges andmedical schools comes a steady flow ofable and fUlly qualified students-thetransition from college to medical schoolshould become even smoother and moreattractive.

Applicant Statistics: Efforts continueto improve the study of applicants. Athorough understanding of the numbersapplying to medical school and the overlap in applications between the various

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medical schools can lead to a betterhandling of the problems of admission.In addition to the usual statistical studyof applicants, which appeared this pastyear in the .Journal of MEDICAL EDUCATION, a study of its applicants was reported in detail to each medical school:how many other applications the applicants filed, where else they appliedand what action was taken on theseother applications. Striking variationswere found to exist among the schools.The applicants to one school, for example, applied on the average to a totalof 1.5 medical schools each, while thoseof another medical school applied to10.6, seven times as many. The applicants to one medical school filed a totalof almost 12,000 applications to othermedical schools. Such multiple applications are continuing to complicate the admission picture, both for the studentand the medical school. A highly desirable applicant may file applications to10 medical schools and receive 10 offerson a place; he will necessarily go to butone school. At the other medical schoolshe has added to the burden of an alreadyoverworked admission committee.

The number of students applying tomedical school continues to diminish,but an upturn may be expected soon.

The applicant statistics can be madeto yield more significant information inusable form. Work in this direction isplanned. Studies on the quality of theapplying group, and a forecast of thenumbers who apply are under consideration.

Students in Medical Schools: Fromstatistics regularly compiled of studentsenrolled in medical school and theirprogress, studies of the undergraduateorigins of medical students can be made..Just released has been a thorough reporton the over 600 colleges that suppliedthe students who entered medical schoolsduring 1949-50. It is based on the fouryear record of this group in medicalschool. This particular investigation ofthe undergraduate origins of a medicalschool class is but a small part of amore extensive stUdy of the class thatentered in 1949. Only 8 per cent of thisclass dropped out, another 5 per centwere academically irregular in someway, but may still graduate, and 87 percent graduated on schedule-a remarkable record. Actually, more than 90 percent of this class have now graduated.


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Medical College Admission Test: Theadmission test is a responsibility of thiscommittee, being prepared, administeredand reported for the committee by theEducational Testing Service. It has nowbeen in use long enough to permit studies of significance to be made. Duringthe year several such studies have beencompleted and are currently in the process of being reported. The committeewill welcome suggestions concerninghow this valuable test can be made moreuseful.

The MCAT is a sound test; whenproperly interpreted it can be of greatvalue to admission committees in selecting students and to the dean's office inadvising students. The committee hopesthat scores on this test will be availablefor all admitted students.

The test scores are being extensivelyused in several continuing studies. Thus,the applicant study makes use of thetest data. Score distributions are sentto undergraduate colleges and the medical schools are given a summary of themean scores made by the students fromeach undergraduate college. The testscores are being utilized in an exploration of the students dropping out ofmedical school. The chances of a studentscoring under 300 on the science sectionof the test dropping out of medicalschool are eight times as great as for astudent scoring over 600. A special studyis now in progress showing the averagescore of applicants to one medical schoolfor the students from a given undergraduate college in comparison with applicants to all medical schools from thatcollege. The committee has under wayalso a report to each medical school onthe scores of its admitted students andthe relationship of these scores to dropouts. Other studies are in process or areplanned.

r Faculty Register: At the present timethe register of teaching personnel in

I medical schools is being brought up todate. A number of surveys are beingdrawn up to provide the basis for wiserlong-range planning. Consideration isbeing given to maintaining this registeron an annual basis and preparing yearlyreports. All groups interested in facultyrecruitment will be able to make use ofsuch information, especially if it is current. The government has special in-

\ terests in this work and has helped in\ the studies made thus far.


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Admission Procedures: Uniform mechanics and dates of admission havebeen drawn up and distributed to allmedical schools for suggestion. On thebasis of the suggestions, a revised codewill be prepared which it is hoped willbe accepted by all medical schools. Therecontinue to be excellent reasons forreasonable uniformity in the details ofadmission practices. The committee believes that such uniformity can be attained without loss of the unique characteristics of the several schools. Thecontinued competition for the best students and the continued practice of thestudents to apply to several medicalschools emphasize the need for someuniform traffic rules to preserve bothschools and students from harm.

The committee is discussing the possibility of a three-day meeting devotedto admission problems and procedures.If adequate financing can be arranged,an invitational conference of perhaps 50individuals will be held. The publishedproceedings should be useful to bothmedical schools and undergraduate colleges.

Studies in Progress: An investigationof the results obtained from the BriggsMyers personality assessment inventoryhas been continued. Until more positiveresults are forthcoming, this particularinstrument will not be incorporated inthe regular program. The study of oldermedical students is in progress. Thestudy of women graduates will be reported next year. A bibliography onwritings concerning admission to medical school is being assembled and annotated. The study of students droppingout of medical school will be continuedand periodic reports will be issued.

During 1953-54 considerable time wasspent on a careful analysis of questionnaires drawn up for the second TeachingInstitute. The administrative work forthis Institute was handled largely in thecommittee's office.

Work for Other Groups: The work ofregistration and operation of the National Intern Matching Program washandled by the committee's staff, butat the expense of the NIMP. The operation went smoothly and accw·ately.During the weeks that the NIMP program was at its height, almost all otheractivities of the staff had to be suspended.

The staff cooperated with the Rusk

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committee in obtaining informationfrom students in medical school. TheDepartment of Defense has been invitedto use the facilities of the committeeto collect the information it requiresfrom the senior students.

Work on the financial problems ofmedical schools was handled for theliaison committee.

Plans: Under consideration by thecommittee are studies of the actual undergraduate course work completed byaccepted students. Some explorations onforecasting applicant populations havebeen made; more extensive explorationsare planned. Consideration is being givenon how to estimate the quality, as wellas the quantity, of applicants to ourmedical schools.

The committee continues to recognizethe vital role to success in medicalschool played by student motivation, interest and application. Any practicalmeans for estimating their characteristics would prove to be of the greatestvalue to admission committees. Furtherwork is planned.

The committee would like to explorethe actual operations of the entire admission procedure at several medicalschools in order to develop more usefulmaterials for the direct use of the medical schools. Field studies are now underconsideration.

During the year 1953-54, the committee's staff has worked on student statistics for the use of colleges andmedical schools. During 1954-55, ithopes to divide this work into the perfection of annual and other recurringreports and work on special one-timestudies. The applicant studies, reportson admitted students made to undergraduate colleges, and the college originsof medical students are samples of recurring studies. The study of the costto the student of attending medicalschool, the study now in progress ofwomen graduates of medical schools areillustrations of one-time studies. Thestaff wants to make its extensive datamore widely available and to presentits many studies and reports in readableand convenient form. Efforts are beingmade in these directions and suggestionsare solicited.

ACTION: The annual report of theCommittee on Teaching Institutes andSpecial Studies was accepted withoutrevision.

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REPORT OF THE COMMITTEE ONVETERANS ADMINISTRATIONMEDICAL SCHOOL RELATIONSHIPS

R. HUGH WOOD, chairman: The onlyformal meeting of the committee thisyear was held in Atlantic City in October 1953. At that time there were veryfew questions raised, but they are included in the items discussed below,which have come to the consideration ofthe committee or its chairman duringthe year.

1. Non-Citizen Physicians inVeterans Administration Hospitals

The question of employing noncitizenphysicians as residents in VA hospitalshas been discussed by various groupsand individuals. In some instances thephysicians who seek these appointmentscome from schools which are known tothe AAMC and whose graduates areknown to be well qualified. The questionarises again in connection with affiliatedhospitals where residents regularly rotate through the VA and other hospitalsaccording to a scheduled plan of rotation. Some residents appointed in university hospitals are not citizens.

After thorough discussion with representatives of the Research and Education Division of the central office of theVeterans Administration, it was decidedthat it would not be possible to appointnoncitizen physicians as residents in VAhospitals. To make them full-fledgedappointees would require a change oflaw, and it was thought unwise to havesuch appointments made by deviousmeans. The question still remains as towhether or not a noncitizen physicianwho has been appointed as a residentin the university hospital may rotatethrough the VA hospital for part of hiseducational experience while remainingon the staff and being paid by the university hospital. At the writing of thisreport no final answer has been receivedfrom the Veterans Administration.

2. Stipend for Medical StudentsA few schools have raised the ques

tion as to whether or not medical students serving as clinical clerks in VAhospitals could receive a stipend forsuch service. This was disapproved bythe Veterans Administration, and theAdvisory Committee on Education of theVeterans Administration concurred inthis decision.3. Payment for Library Service


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Some schools have asked if it wouldbe appropriate for the Veterans Administration to reimburse the medical schoolfor library service to VA hospitals. Thismatter was considered and disapprovedby the Veterans Administration and theCommittee on Education.

4. Admission of Nonservice-ConnectedCases to Veterans AdministrationHospitals

(a) The policy of the AAMC remamsunchanged in this regard; the Association's interest and responsibility are research and education. It is not theresponsibility of the AAMC to determine eligibility for admission of patientsto VA hospitals. While most citizens,including the members of the Association, do not sanction free medical andhospital service for nonservice-connectedcases when these veterans are able topay, we believe it is not the prerogativeof the Association to attempt to enforcemeasures to prevent the admission ofsuch patients. It seems reasonable thatthe new form 10P10 should be given afair trial.

(b) Laws passed by Congress pertaining to the eligibility of veterans toVA hospitals have been liberalized repeatedly in the past several years, andit is the responsibility of the VeteransAdministration to carry out the mandates of Congress. Appropriations, however, always have not kept pace with theadditional numbers of veteran patientswhich the law declared eligible. Thisfact has posed budgetary problems tothe Veterans Administration which alsoare felt by the schools, since their opportunity for research and education isrelated directly to the funds availablefor patient service and the generaloperation of VA hospitals, including research and education.

(c) As has been pointed out before, aparadoxical situation exists in the matter of nonservice-connected patients inVA hospitals. If, as has been proposedby some medical groups, patients in VAhospitals were limited to service-connected veterans, the clinical cases available for education and research wouldbe so limited in variety as to threatenseriously a residency training program.The only reason for the participation ofmedical schools is education. If this became impossible because of a reductionin the number and variety of clinical


65th AnnuaL Meeting

cases, there would be no reason for theaffiliation of medical schools. If affiliation with medical schools should beterminated, this in turn would threatenthe quality of care given to veteran patients because of the almost certain reduction in number and quality of staffsin VA hospitals. These matters cannotbe left out of account as we plan andconsider the care of VA patients.

(d) On May 21, 1954, the Committeeon Federal Medical Service of theAmerican Medical Association requestedthat members of the AAMC veteranscommittee meet with them in Chicago.Gordon H. Scott, of Wayne University,and the chairman met with this group.Various problems concerning the Veterans Administration's medical programwere discussed. The question wasbrought up by the AMA committee asto whether or not a satisfactory residency program in VA hospitals couldbe continued if nonservice cases werenot admitted. The answer given by yourcommittee was that they would be seriously threatened and that probably mostresidency training programs in VA hospitals could be discontinued.

There was discussion of the feasibilityof having nonservice-connected veteranpatients cared for by local hospitals, withthe exception of psychiatric and tuberculosis cases Which, admittedly, communities are not able to provide for. Theopinion was expressed that communitiesshould undertake this service but thatmany communities are not prepared tomeet the problem even for nonveteranCItizens, and would in many instancesbe ill prepared to take care of the greaternumber of indigent patients. Withoutentering into the wisdom of providingmedical care to indigent veterans whosedisability is nonservice-connected, it canbe stated as a historical fact that it hasbeen the policy of the federal government of the United States to providesuch care to the limit of available hospital beds and facilities. Again, it is notwithin the province of the AAMC toformulate this policy.

5. Salary Increases for Full-Time Members of VA HospitaL Staffs

This committee has recommended tothe Veterans Administration that legalauthority should be sought to raise salaries of the full-time staff of VA hospitals.It is becoming increasingly difficult torecruit and keep high-quality service

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Reports from Related Organizations

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chiefs in all categories. There has beenno increase in these salaries since 1946,except for a 10 per cent cost of livingincrease granted to all Veteran Administration personnel sometime ago. TheAdvisory Committee on Education alsohas supported this recommendation.

6. Financial DifficultiesThe building and location of new VA

hospitals are the prerogatives of thefederal government and not the Veterans Administration. While many newhospitals have been completed andopened, appropriations for the Department of Medicine and Surgery have notkept pace with the additional numberof beds provided. This is true of appropriations both for general operating costsand funds for research and education. Areduction in the number of beds hasbecome necessary in some hospitals,while an adequate program of researchhas been difficult to initiate in new

(The following reports are condensedfrom reports submitted to the Association of American Medical Colleges atthe time of the Annual Meeting.)

NATIONAL FUND FORMEDICAL EDUCATION

CHASE MELLEN JR., executive vicepresident and director: In July 1954, thefund distributed $2,176,904.71 to thenation's 80 medical schools. This included $1,101,578 received from the American Medical Education Foundation.This brings the total number of grantsmade since 1951 to $6,941,057.50.

Progress is expected to continue. During the first nine months of 1954 thenumber of contributing corporationswas 783, compared to 592 in the sameperiod in 1953. Total contributors for1953 were 994 and the likelihood is thatthe total for 1954 will be well over thatfigure.

Through its Committee of AmericanIndustry, the fund now has committeesorganized in 68 industries and localcommittees in 26 cities. Approximately1,300 individuals, leaders in their in-

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hospitals and maintain in older hospitals.

7. Student Clinical Clerkship ProgramThe question has been asked of the

chairman of this committee as to whetheror not the Veterans Administration approved of the teaching of medical students as clinical clerks on the wardsof VA hospitals. This committee knowsof no instance in which medical studentshave not been welcomed in the wardsof VA hospitals. Apparently an erroneous report was prevalent also in somequarters that certain veteran organizations were opposed to this plan. Insofaras the committee knows, there has beenno objection from the American Legionor any other veteran organization onthis particular point.

ACTION: The annual report of theCommittee on Veterans Administration-Medical School Relationships was accepted without revision.

dustries or localities, are serving onthese committees.

Perhaps the most significant development for the fund in the past year wasthe enactment of Public Law 685, conferring a federal charter on the fund.By granting such a charter, Congresstook official notice of the critical situation facing medical education in thiscountry and formally recognized thefund as the agency through which additional private support for the medicalschools could be mobilized.

Two new projects were authorizedby the board of directors this fall. Oneis the executives gifts division, throughwhich individual gifts of $8 or morewill be solicited from corporation executives, health and civic leaders and professional personnel other than doctors.The other is associate memberships, tobe offered to governors and trustees ofthe country's approximately 2,000 voluntary hospitals.

AMERICAN MEDICALEDUCATION FOUNDATION

HIRAM W. JONES, executive secretary:


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The American Medical Education Foundation has made substantial progresstoward creating a new and stable sourceof income for the nation's medicalschools. The foundation has gained consistently in stature during the past yearand is now generally accepted as a permanent source of income by medicaleducators.

From its inception in 1951 throughOctober 15, 1954, our program has produced $3,738,803 to aid the financiallydeficient medical schools in the U. S.In cooperation with the AMEF, the National Fund for Medical Education hasdistributed $6,941,057 in the form of unrestricted grants to the 80 approvedmedical schools in the U. S. since theinception of this joint venture in 1951.The national fund's most recent seriesof grants totaled $2,176,904; of this total,contributions from the medical profession amounted to $1,101,578. Donationsfrom individual members of the medicalprofession, national, state and local medical organizations and a small numberof laymen have accounted for slightlymore than 51 per cent of the total fundsreceived by the nation's medical schoolsfrom grants made by the national fund.

The financial support of the foundation's program by the American Medical Association unquestionably has insured its success during these formativeyears. With four grants totaling $2 million, the AMA deserves major creditfor the financial successes the foundation has enjoyed. Without these funds,the foundation could not have progressed to its present position for manymore years. The foundation now standson the threshold of future success andwith the continued support of the AMA,the realistic goal of $2 million annuallycan be attained.

In addition to the $500,000 grant fromthe AMA, during the first nine monthsof the current year the foundation hasreceived contributions from individualsand organizations which increased thetotal income to $1,005,000, an approximate 12 per cent increase over incomerecorded for the corresponding periodin 1953. During the first nine monthsof 1954, the foundation has recorded16,500 donations compared to 13,259 overthe comparable period last year.

The officers and directors of the foundation feel that, with the continued


65th Annual Meeting

support of all segments of the medicalprofession, the income of the foundation can be increased to the desiredsum of $2 million annually in the immediate future. While the $2 milliongoal will not be attained in 1953, weare hopeful that the income will exceed $1,250,000 by the end of December.

The leaders of the medical professionare firm in their belief that sufficientfunds are available through the mediumof voluntary contributions to meet thecontinuing need for additional fundsto augment the operating budget of ourmedical schools. Therefore, we againurge the AAMC and its individual members to redouble their efforts, both inand outside of the medical profession, topromote the foundation and the nationalfund as a worthwhile source for charitable contributions.

NATIONAL SOCIETY FORMEDICAL RESEARCH

RALPH ROHWEDER, executive secretary:Despite the disproportionate capacity ofthe antivivisection groups to produceliterature, films, exhibits and otherpropaganda materials, medical sciencewon every specific showdown fight in thepast year. All legislation adopted in thisfield was favorable to research. All courtdecisions rendered in this field were favorable to research. Moreover, a numberof principal animal welfare groupsabandoned former hostile policies andappeared to be seeking a compromise.

The NSMR has come to be regardedby members of the press as one of theimportant sources of information onmany aspects of medicine and science.As a result, the staff has had opportunity to help in development of manynews stories and features, as well asmagazine stories, every year.

In September a dozen television stations began to broadcast a weekly showproduced by the society. The showprobably will be carried by 50 stationsby the first of the year. Meantime, 264prints of the society's 20-second filmsare being used by television stationsacross the country. The films tell capsule stories about animals in research.

Some new exhibits have been addedto the stock available from the NSMR.There is a set of four silk-screen displays telling about medical progress andanimal experimentation. Another smaller

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set of displays is available in two styles.The society's movie, "Which Fate?" is

completed and circulating. A small number of prints have been ordered by interested organizations.

The society has continued to recruitnew members during the past year.These have included eight medical orscientific societies, four state medicalsocieties, 19 county medical societiesand 25 hospitals.

NATIONAL INTERN MATCHING PROGRAM

F. J. MULLIN, chairman: The thirdyear of operation of the National InternMatching Program was completed onMarch 15 with the placement of 6,051individuals. Some 10,729 positions wereoffered at 820 participating hospitals.

This program has now become thegenerally accepted method for placementof graduating seniors into the internshipappointments available in June and Julyof each year. Both in the number ofstudents and the number of hospitalsparticipating, 1954 represented a newhigh. The total number of internshipsoffered, however, dropped from the previous year by some 250. As a result theper cent of available internships filledin 1954 rose to 56 per cent.

The 1954 program was completed witha minimum of difficulty and it wouldappear that the program has now solvedsome of its initial problems and gainedthe general support of all groups connected with the internship. It is interesting to note that among the most activeindividuals supporting the program arethe student representatives on the boardof directors.

The one area in which development isneeded and planned is that of information. The program involves a complexprocedure and presents some problemsin explanation. In 1954-55 an NIMPrepresentative will attempt to explainthe program to seniors of any medicalschool requesting this service. A studenthandbook explaining the program is inpreparation-taking a student from theorigin of the program through its control and management down to what itmeans to him and how it works. Nextyear a similar publication is plannedfor the hospitals.

The NIMP is now on a sound financialfooting. Its three major organizationsthe American Medical Association, Amer-

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ican Hospital Association and Association of American Medical Collegeshave made loans to provide workingcapital. The fees are now covering allcosts, however, and allowing a slightsurplus to accumulate with which to repay the loans.

The statistical reports on the matching program provide a source of soundinformation. The last report, publishedin the Journal of MEDICAL EDUCATION inAugust 1954, summarized the results forthree years and provides many significant figures.

The policies evolved during the threeyears of operation have been arrived atjointly by the several interested associations and the students. These policiesappear to be sound and effective. Increased understanding and support havebeen gained looking toward encouragingstudents and hospitals to consider theinternship as a valuable educationalexperience.

The officers of NIMP express theirthanks to the students, the medicalschools and the hospitals for their activeand thoughtful cooperation in helping tosolve the difficult intern placement problem. The record of full accuracy in theoperation of the plan gives evidence ofan able staff. Especially, thanks is dueto John M. Stalnaker, the director ofoperations, and to E. C. Smith, who hasmanaged the work.

RESOLUTIONS

The following resolutions were submitted to the annual business meeting,October 20, 1954:

IAware of the rapidly broadening func

tions and ever more significant role ofmedicine in American life, those chargedwith the trust of dispensing funds for thebenefit of mankind, whether they beprivate funds or public, have realized theincreasing part being played by the Association in nurturing the activities ofthe medical schools of the United Statesand Canada. It is at the well springthe medical school-that strength andgrowth are constantly needed to providefor the nation the leaders of tomorrowin medicine and health. Medical education is fundamental.Whereas,

The John and Mary R. Markle Foundation during this year, as in other years,


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has made a substantial grant for the support of special studies and for the development of the Journal of MEDICALEDUCATION. This foundation has alsocommitted funds for the next fiscal year.Whereas,

The China Medical Board this year, asin past years, has made a substantialgrant for the general support of theactivities of the Association.Whereas,

The National Heart Institute has thisyear supported the first Teaching Institute, the second Teaching Institute, andis anticipating the assumption of partialsupport of future Teaching Institutes.Whereas,

The National Cancer Institute has thisyear made a substantial contribution tohelp in financing the work of the secondTeaching Institute.Whereas,

The Commonwealth Fund has made asubstantial contribution for 1954-55 andfor 1955-56, to be used in part for thesupport of the next two Teaching Institutes and in part for the general supportof the special studies of the Association,be it thereforeResolved,

That the Association of AmericanMedical Colleges record its appreciationand thanks for this vital help, makingpossible many of its contributions to ourmedical schools and to our nation,

That this resolution be spread uponthe official records of the Association,and

That this resolution of appreciationand thanks be suitably conveyed by thesecretary to the proper officials of theJohn and Mary R. Markle Foundation,the China Medical Board, the NationalHeart Institute, the National Cancer Institute and the Commonwealth Fund.

ACTION: The resolution was unanimously passed.

IIWhereas,

The date of final acceptance of theapplications of new students with thefiling of a nonrefundable deposit varieswidely among member institutions ofthe Association.Whereas,

This variation in acceptance datemakes it very difficult for the averagestudent applying to four or more medicalschools to make sure that he is making


65th Annual Meeting

the best choice of schools available tohim.Whereas,

This matter has been carefully studiedby the Committee on Teaching Institutesand Special Studies and its recommendations have had further study by theExecutive Council, be it therefore,Resolved,

That the membership of the Association of American Medical Colleges approves the following admission procedures:

1. No place in the freshman class shallbe offered to an applicant more thanone year before the actual start of instruction for that class.

2. Following the receipt of an offer ofa place in the freshman class, a studentshall be allowed at least two weeks inwhich to make a written reply to themedical school.

3. Prior to January 15, this writtenreply may be either a declaration of intent or a formal acceptance of the placeoffered. When the applicant has declaredhis continued interest within the twoweek period, the medical school agreesto hold a place for him until January15, unless he indicates that he has beenaccepted elsewhere and withdraws hisapplication. He may, of course, andoften will, enter into formal arrangements with the one medical school ofhis 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 and itis understood that nothing unethical isimplied when a student does so changehis mind. In such an event, the studentis obligated to send prompt written notification to every school holding a placefor him.

4. The payment of a nonrefundabledeposit shall not be required of any applicant prior to January 15.

5. When a student files a declarationof intent, a refundable deposit-not toexceed $10Q-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 to holda place in the freshman class after January 15, shall not exceed $100.

7. By January 15 each applicant for

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whom 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, an applicantoffered a place in a freshman 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, theAAMC office will compile a list of thestudents who have formally accepted aplace in the freshman class. This listwill be distributed about February 1 andwill be kept current by frequent revisions.

ACTION: This resolution was passedwith a dissenting vote of one.

66th ANNUAL MEETING

The 66th Annual Meeting will be heldat the New Ocean House, Swampscott,Mass., October 24-26, 1955.

1955 TEACHING INSTITUTE

The 1955 Teaching Institute on Anatomy and Anthropology will be heldOctober 19-22, at the New Ocean House,Swampscott, Mass. William U. Gardner,Yale University School of Medicine, willbe chairman.

INSTALLATION OF PRESIDENT

Vernon W. Lippard, president-electin 1953-54, was installed as president ofthe Association for 1954-55.

COMMITTEES

Appointments to committees and representatives to related organizationswere named for 1953-54 as follows:

(Chairmen listed first-affiliation listed in italics.)

AUDIOVISUAL EDUCATION

Walter A. Bloedorn, George WashingtonWilliam J. Darby, VanderbiltClarence E. de la Chapelle, N.Y.U. Post-

Grad.William W. Frye, LouisianaTheodore R. Van Dellen, NorthwesternW. Clarke Wescoe, KansasTom Jones, Illinois Emeritus, Consult

ant

BORDEN AWARD

William S. Tillett, N.Y.U.

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Joseph Markee, DukeArnold Rich, Johns HopkinsElmer H. Stotz, RochesterAshley Weech, Cincinnati

CONTINUATION EDUCATION

Norman B. Nelson, IowaRobert Boggs, N.Y.U. Post-Grad.Robert Howard, MinnesotaSamuel Proger, TuftsFrank Roberts, TennesseeThomas Sternberg, U.C.L.A.Grant Taylor, Texas Post-Grad.Douglas Vollan, Consultant, Council on

Med. Edu. and Hosps., AMA

EDITORIAL BOARD

John Z. Bowers, UtahWilliam B. Bean, IowaStanley E. Bradley, ColumbiaAlan Chesney, Johns HopkinsJames M. Faulkner, BostonRussell L. Holman, LouisianaChauncey D. Leake, TexasDean F. Smiley, Secretary

FINANCING MEDICAL EDUCATION

Joseph C. Hinsey, New York Hosp., Cor-nell

Walter A. Bloedorn, George WashingtonDonald G. Anderson, RochesterRobert A. Moore, PittsburghNorman Topping, PennsylvaniaJohn B. Youmans, Vanderbilt

INTERNATIONAL RELATIONS INMEDICAL EDUCATION

Francis Scott Smyth, California (S.F.)Coy C. Carpenter, Bowman GrayE. Grey Dimond, KansasMaxwell E. Lapham, TulaneRichard H. Young, Northwestern'Elizabeth T. Lam, Consultant, Com. On

Internat'l Exch. of PersonsHarold H. Loucks, Consultant, China

Medical BoardMyron Wegman, Consultant, Pan-Amer

ican Sanitary Bureau

INTERNSHIPS, RESIDENCIES AND GRADUATEMEDICAL EDUCATION

Currier McEwen, N.Y.U.Howard Armstrong, IllinoisD. W. E. Baird, OregonJohn Deitrick, JeffersonClarence E. de la Chapelle, N.Y.U. Post-

Grad.E. Hugh Luckey, CornellRichard W. Vilter, CincinnatiGeorge A. Wolf Jr., Vermont


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LICENSURE PROBLEMS

Charles A. Doan, Ohio StateCharles L. Brown, HahnemannGordon E. Goodhart, Southern Cali-

forniaJohn Hirschboeck, MarquetteJ. Murray Kinsman, LouisvilleArthur W. Wright, Albany

MEDICAL CARE PLANS

Dean A. Clark, HarvardFrank R. Bradley, Washington (St.

Louis)R. H. Kampmeier, VanderbiltHenry B. MUlholland, VirginiaJohn F. Sheehan, LoyolaAlbert W. Snoke, YaleMaxwell M. Wintrobe, Utah

PLANNING FOR NATIONAL EMERGENCY

Stanley W. Olson, BaylorMark R. Everett, OklahomaThomas R. Forbes, YaleStockton Kimball, BuffaloJohn B. Truslow, Med. Coll. of Virginia

PROGRAM

Vernon W. Lippard, YaleRobert A. Moore, PittsburghJohn McK. Mitchell, PennsylvaniaDean F. Smiley, Secretary

PUBLIC INFORMATION

John L. Caughey, Western ReserveFrancis M. Forster, GeorgetownJohn D. Van Nuys, IndianaHarold C. Wiggers, AlbanyJoseph B. Kelly, Johns Hopkins, Con

sultantMilton Murray, Medical Evangelists,

ConsultantRalph Rohweder, Nat'l. Soc. for Med. Re

search, ConsultantRa<ymond O. Torr, Nat'I. Fund for Med.

Edu., ConsultantWilliam N. Hubbard Jr., Secretary

TEACHING INSTITUTES AND SPECIAL STUDIES

George Packer Berry, HarvardPhilip Bard, Johns HopkinsD. Bailey Calvin, TexasThomas Hunter, VirginiaCarlyle Jacobsen, S.U.N.Y.Robert A. Moore, PittsburghRobert Murray, Western OntarioVernon W. Lippard, YaleW. Clarke Wescoe, KansasWilliam R. Willard, S.U.N.Y. (Syracuse)John M. Stalnaker, Secretary


65th Annual Meeting

VETERANS ADMINISTRATION-MEDICAL SCHOOL RELATIONSHIPS

Joseph Hayman, TuftsGeorge A. Bennett, JeffersonRobert Berson, VanderbiltGordon H. Scott, WayneFrancis R. Manlove, Colorado

Representatives to Related OrganizationsADVISORY BOARD FOR MEDICAL SPECIALTIES

Stanley E. Dorst, CincinnatiJohn B. Youmans, Vanderbilt

ADVISORY BOARD OF AMERICAN FOUNDATIONOF OCCUPATIONAL HEALTH

Gordon H. Scott, Wayne

ADVISORY COUNCIL FOR THE NATIONAL FUNDFOR MEDICAL EDUCATION

Walter A. Bloedorn, George WashingtonJoseph C. Hinsey, New York Hosp., Cor-

nellJohn B. Youmans, Vanderbilt

ADVISORY COUNCIL ON MEDICAL EDUCATION

Vernon W. Lippard, YaleRobert A. Moore, Pittsburgh

AMERICAN COUNCIL ON EDUCATION

Hayden C. Nicholson, ArkansasMarion Fay, Woman's MedicalWilliam Stone, MarylandJoseph L. Johnson, HowardEdward J. Van Liere, West VirginiaJohn T. Cuttino, South Carolina

COMMlnEE ON EVALUATION OFFOREIGN CREDENTIALS

Francis Scott Smyth, California (S.F.)Harold A. Davenport, Northwestern

COUNCIL ON NATIONAL EMERGENCY SERVICE

Stanley W. Olson, Baylor

FEDERATION OF STATE MEDICAL BOARDS

Charles A. Doan, Ohio State

FELLOWSHIPS SELECTION BOARD (WHO)

Walter A. Bloedorn, George Washington

NATIONAL INTERN MATCHING PROGRAM, INC.

E. Hugh Luckey, CornellGeorge A. Wolf Jr., VermontJohn M. Stalnaker, AAMC

JOINT COMMlnEE ON MEDICAL EDUCATION INTIME OF NATIONAL EMERGENCY

Stockton Kimball, BuffaloMark R. Everett, OklahomaStanley W. Olson, BaylorDean F. Smiley, AAMCJohn M. Stalnaker, AAMC

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LIAISON COMMITTEE WITH COUNCIL ONMEDICAL EDUCATION AND HOSPITALS

Stanley E. Dorst, CincinnatiVernon W. Lippard, YaleRobert A. Moore, PittsburghDean F. Smiley, AAMCJohn M. Stalnaker, AAMC

MEDICAL ADVISORY COMMITTEE ONINSTITUTE OF INTERNATIONAL EDUCATION

Duncan W. Clark, S.U.N.Y. (Brooklyn)Lawrence Hanlon, CornellRalph E. Snyder, N.Y. Med. Col.

NATIONAL BOARD OF MEDICAL EXAMINERS

John Deitrick, JeffersonRobert A. Moore, PittsburghB. O. Raulston, Southern California,

Emeritus

NATIONAL HEALTH COUNCIL

Jean A. Curran, S.U.N.Y. (Brooklyn)

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Aura Severinghaus, ColumbiaIra Hiscock, Yale

SUBCOMMITTEE ON MEDICAL EDUCATIONFOR NATIONAL DEFENSE

Stanley W. Olson, BaylorGeorge V. Byfield, IllinoisLawrence Hanlon, CornellStockton Kimball, BuffaloJohn Lagen, California (S.F.)John B. Youmans, Vanderbilt

COOPERATING COMMITTEE ON GRADUATESOF FOREIGN MEDICAL SCHOOLS

Charles A. Doan, Ohio StateJohn McK. Mitchell, PennsylvaniaJ. Murray Kinsman, Louisville

MEMBER OF INTERNSHIP REVIEW BOARD OFCOUNCIL ON MEDICAL EDUCATIONAND HOSPITALS

John Deitrick, Jefferson


Executive Council, 1956: GEORGE N. AAGAARD _

Executive Council, 1955: STOCKTON KIMBALL _

Oflice..s and Membe..s of Executive Council

OFFICERS OF THE ASSOCIATION

1954·1955

President and Council Chairman: VERNON W. LIPPARD Yale UniversitySchool of Medicine

_ University of Pittsburgh

_______________University of PennsylvaniaSchool of Medicine

Treasurer: JOHN B. YOUMANS Vanderbilt University School of Medicine

Immediate Past President: STANLEY E. DORST University of CincinnatiCollege of Medicine

Secretary: DEAN F. SMILEY _ _ ___ 185 N. Wabash Ave., Chicago 1, Ill.

Director of Studies: JOHN M. STALNAKER 185 N. Wabash Ave., Chicago 1, Ill.Executive Council, 1957: LOWELL T. COGGESHALL University of Chicago

Executive Council, 1957: THOMAS H. HUNTER University of VirginiaSchool of Medicine

_University of WashingtonSchool of Medicine (Seattle)

Executive Council, 1956: WALTER R. BERRYHILL _ University ofNorth Carolina School of Medicine

Executive Council, 1955: JOHN Z. BOWERS________________ __ University of UtahSchool of Medicme

University of BuffaloSchool of Medicine

President-Elect: ROBERT A. MOORE _

Vice President: JOHN McK. MITCHELL

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Staff

DEAN F. SMILEY_________________________ __ Secretary; Editor, Medical EducationJOHN M. STALNAKER _ _ 0 DIrector of StudiesJ. EDWIN FOSTER Director, Medical Audio-Visual InstituteWILLIAM N. HUBBARD JR. Associate Secretary

DECEMBER 1954, VOL. 29, NO. 12 77

AAMC minutes of the proceedings sixty-fifth annual meeting ... · C. Nash Herndon, associate...

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Transcript of AAMC minutes of the proceedings sixty-fifth annual meeting ... · C. Nash Herndon, associate...