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Becoming a PhysicianMedical Education in Great Britain, France, Germany, and the United States, 1750-1945$
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Thomas Neville Bonner

Print publication date: 1996

Print ISBN-13: 9780195062984

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195062984.001.0001

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Consolidation, Stability, and New Upheavals, 1920-1945

Consolidation, Stability, and New Upheavals, 1920-1945

13 (p.325) Consolidation, Stability, and New Upheavals, 1920-1945
Becoming a Physician

Thomas Neville Bonner

Oxford University Press

By the end of World War I, the basic structures of undergraduate medical education in both Europe and America were largely in place. Future practitioners on both sides of the Atlantic now began their training with a lengthy preparation in liberal studies, with special attention to physics, chemistry, and biology, then studied for two or more years in laboratory based courses in the preclinical medical sciences followed by a like period of clinical study, and finally spent at least a year in acquiring practical, hands-on training in a hospital. With few changes, except for the growth of postgraduate education, this basic pattern prevailed everywhere in the interwar years before 1945. In the transatlantic nations, in short, these were years of consolidation of patterns formed well before 1914. The study of medicine now consumed a minimum of five years beyond the school-leaving or college experience and frequently took six to ten years to complete. Except for the hospital schools of London, nearly every medical school in the Western world was attached to a university. Almost no school of medicine was without its teaching hospital where training students was a primary concern. Governments everywhere played an ever larger role in setting basic requirements and providing financial support of medical education. Physicians’ associations became more and more powerful and sometimes dominant in setting standards of education and licensure. And in these postwar years, the practice of medicine became an almost wholly middle-class occupation, exacting high standards of preparation and social expectation and open to only the most exceptional among the less affluent. The costs of study were rising so steeply that it was largely unavailable to the poor, even in the United States. The national differences of a quarter-century before, though evened out in many particulars, were still discernible in 1920. The war, after all, permitted no major changes in instruction, equipment, or curriculum in Europe, and reform efforts after the war were hampered by the need to restore and rebuild.

Keywords:   American Medical Association, Clinical training, Howard University, Internship, Johns Hopkins University, London Hospital, Meharry Medical College, Postgraduate study

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