Bulletin Number Three 1983

o f time, sympathy and understanding. The good physician knows his patients through and through. His knowledge is bought dearly, but he finds his reward in that personal bond which forms the greatest satisfaction in the practice o f medicine. The problem to be overcome in medical educa­ tion at present is how to inculcate the scientific attitude while maintaining the highest standard o f clinical skill and the most humanitarian concern for the patient as a person. I have no intention o f arguing for or against any particular type o f curriculum but some general ideas o f what we shall ask from our teachers o f medicine can be framed and expressed. The aim, first and fore­ most, shall be to educate, that is, to give the student not knowledge but the power to utilize knowledge. That he should know facts is obvious and that in his early days he cannot find these out for himself, but must be given them, is equally obvious; his and his teachers' primary purpose, however, must be that he learns how to learn for himself. Therefore the factual content o f the under­ graduate period does not have to be any particular percentage o f the total o f medical knowledge; it has to be chosen for its relevance to future learning, even more than for its relevance to future practice. Equally important, the student's progress must be assessed primarily on his ability to reason and utilize know­ ledge and not merely in terms o f the amount he knows. Similarly his clinical proficiency must be judged on the soundness o f his method, o f which the correctness o f the physical signs he elicits from the patient in an examination is but one indication. I f the object o f undergraduate education is achieved, then the gaps in knowledge and inadequacy o f technique w ill be made good in the postgraduate period. I f the object o f undergraduate education is not achieved then such gaps w ill probably remain forever, and the student w ill be largely denied the mastery o f new data as they unfold before his eyes and the critical evaluation o f new treatment as it is bound to be developed. These then should be our objectives: 1. The student must learn how to learn for himself. 2. He must acquire a scientific method o f thought, which is the power to reason and think critically. 3. He must achieve competence in clinical methods, which are the means o f obtaining information from patients. 4. He must gain an understanding o f the responsibility o f a professional person. 5. He must cultivate his inborn sensitivity and sympathies. Now research. Surely it is an ideal at which we shall always aim but which we seldom realize, that we should impart to the students a desire —a passionate desire if possible — to understand what he sees, the desire to know as far as it may be known the nature o f the phenomena that come under his observation, for it is only out o f this desire to understand and from this alone that can be born the urge to add to knowledge, to break new ground. How can this ideal best be achieved? Surely by those who are themselves seeking to advance knowledge. Anyone who puts his observations together to exemplify from them some law o f nature ， to detect some persistent pattern or some ordered recurrence in events is doing just this! It is in fact to those who look in clinical medicine in this spirit that nature gives the opportunities o f new knowledge, through their intellectual vigilance and being prepared to discern in the wide stream o f their experience the significant phenomena and events as they go floating by. I submit therefore that some infusion o f this reasoned excited curiosity, some interest in the relation o f stubborn facts to general principles, is a vital element in the endowment o f the true teacher o f medicine. The spirit o f enquiry is the vital element in the life o f the medical school. It can flow only from the teachers in the first instance and whether these are academic teachers or engaged in the private practice o f medicine does not seem to me to matter greatly. It is the spirit that counts, the interest in new observation, the capacity for the steady con­ templation o f facts, the g ift o f generalizing from them and an unwillingness to pu ff pompously and incuriously through life along permanent way o f the established arts and techniques. There does rest w ith me the profound conviction that the responsibilities o f the teachers o f medicine have never been heavier than now nor their oppor­ tunities greater. Each member o f the Department o f Medicine w ill keep constantly in mind that it is his individual duty to set an example o f medical practice, to advance knowledge as best he can and so t o train doctors that there w ill be among our pupils those whom we have inspired and fitted out to bring these ideals nearer to realization than we have been able to do ourselves. - J. Vallance-Owen Department o f Microbiology The establishment o f the Faculty o f Medicine comes at an exciting and challenging time in the development o f Clinical Microbiology. The problems o f infection w ithin both hospitals and the community have been increasing rather than diminishing, partly as aresult o f the expansion o f intensive care medicine, the wide­ spread misuse o f antibiotics, changing social and environmental conditions and the increase in inter­ national travel. Treatment has become more d ifficu lt because o f the worldwide emergence o f transferable antibiotic resistance, and the proliferation o f new RECENT DEVELOPMENTS 9