Medicine: For Specialists

Any one of the 166,000 doctors in the U. S. may call himself a specialist, and some 25,000 do. The American Medical Association takes the word of its members and lists them in the Directory as surgeons, or public health specialists, or obstetricians, sensitively differentiating ophthalmologists (eyes) and otorhinolaryngologists (ear-nose-throat) from ophthalmo-otorhino-laryngologists (eye-ear-nose-throat). Chief criterion for specialists, other than their say-so, has been membership in one of the multitude of learned societies in Canada or the U. S.. such as the American Association of Obstetricians. Gynecologists & Abdominal Surgeons, or the Central Society for Clinical Research.

Four years ago the men who have the power of professional life & death over U. S. doctors decided to make specialists specialists. The A. M. A.’s Council on Medical Education & Hospitals, the Asso ciation of American Medical Colleges, the American Hospital Association, the National Board of Medical Examiners and the Federation of State Medical Boards organized an “Advisory Board for Medical Specialties,” placed Dean Willard Cole Rappleye of Columbia in charge.

Comprising the Board were the heads of groups representing twelve specialties:

1) internal medicine (diagnosis), 2) sur gery, 3) pediatrics (children), 4) obstetrics & gynecology, 5) ophthalmology, 6) otolaryngology. 7) dermatology (skin) & syphilology, 8) psychiatry (mind, emotions) & neurology (nerves), 9) urology (kidney, bladder), 10) orthopedic surgery (bones, muscles), 11) radiology (X ray, radium), 12) pathology (diseased tissue).

For each of these specialties Dean Rappleye now has a board of examiners. So far, these examiners have given certificates of specialization to almost any physician in good repute who has practiced his specialty for five years or more. But from 1940 on, it was proposed that certificates would be awarded only if the candidate: 1) graduated from a school approved by the A. M. A.; 2) spent at least one year as interne in an approved hospital; 3) interned three more years in specialized clinics, dispensaries, hospitals or laboratories; 4) passed an examination in the basic medical sciences of a specialty, as well as in the clinical, laboratory and public health aspects; and 5) spent at least two more years in study or practice. In other words, after 1940 it was to take a man five years to become a doctor of medicine and five more to become a specialist.

Last week Dean Rappleye went to Chicago to the annual Congress on Medical Education & Licensure, conducted by the A. M. A., worried about a stumbling block to his plan: Young medical graduates who want to become specialists by 1940 have been unable to get medical faculties and facilities to teach them all that the twelve examining boards want them to know. There, his Commission of Graduate Medical Education, formed last December, impatient with the slow progress made by the A. M. A., appointed Wisconsin General Hospital Superintendent Robin Carl Buerki, onetime president of the American Hospital Association, to get educators and hospital administrators to provide the higher medical learning required. Dr. Buerki promised to do the job by 1942 if the regents of the University of Wisconsin, which controls Wisconsin General, gave him leave of absence.