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William Richards Castle William Roscoe Thayer.

The Harvard graduates' magazine online

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A new president is elected each year, but the secretary, and treasurer
usually hold office for several years, as it was considered that this would
insure greater efficiency. Certain committees are specified in the consti-
tution, one on Nomination of Overseers ; another on Nomination of New
Officers (made up of all previous presidents of the Association) ; another
on Service to the University ; and one on Scholarships. To the latter
committee one new man is added or renamed each year, so that the work
goes on with continuity. Other committees are appointed from time to



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474 The Associated Harvard Clubs. [March,

time at the discretion of the president The Coancil is made up of the
officers of the Association and one delegate from each constituent dab.
The Coancil recommends new business, passes on new members, fixes
dues for the Association and selects the place of annual meeting.

The secretary is the mainspring of the organisation. In recent years
the detail of his office has accumulated to such a degree that, at the last
meeting, a motion was passed to consider ways and means to relieve the
congestion. It is probable that a paid assistant will be voted for at the
next meeting, as there is ample work to keep one usefully busy. In past
years numerous avenues of development have not been given attention
because a mass of roatine presented the secretary from giving time to
the details of new work. Incidentally, much of the present detail is red-
tape work which could be well eliminated without any ill results. It has
been continued year after year because certain regular attendants at the
annual meetings insist on strict parliamentary rules and procedure, an
insistence which, at times, has delayed matters for a year and has entirely
stopped interesting discussions from the floor of the meeting.

As at present constituted there is the Harvard Alumni Association and
the New England Federation of Harvard Clubs, not to mention the Pacific
District of the Associated Harvard Clubs (the latter is a subdivision of
the Associated Harvard Clubs, but has its own officers who act under the
general officers of the Association). All of these organizations overlap to
a certain extent and wasted effort is the result. At first the Associated
Harvard Clubs was considered a Western organization ; in fact, there
never has been a president from New England, and with two exceptions
the presidents have all come from west of the Alleghenies. Recently the
Association has become truly national, even international in scope, and
the time now seems ripe for an expansion of energetic activities.

The advantage of the Associated Harvard Clubs is in its democracy.
Graduate affairs in Cambridge are delightfully democratically undemo-
cratic. Were it not for class reunions there would be little to attract the
average graduate from a distance to come to Commencement Class re-
unions and athletic contests alone save us from the sterile graduateship
of Western Universities. The naive pageantry of University affairs is
properly scholastic and mildly interesting once in a decade, but the de-
greeless Harvard man or the holder of a degree from a professional
school intuitively feels that he has no place in these ceremonies. The stage
is all set in advance and the graduates form the necessary background
for the benefit of the eminent ones who sit on high. At these cut^nd-
dried meetings of the graduates there is no spontaneity, tliere are no
suggestions, no criticisms, — the same people talk and act year after year.
Symbolism is rampant in Cambridge.



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1916.] TTie Associated Harvard Clubs. 475

Hie University makes no effort to stimulate graduate activity. It is,
therefore, fortunate that the Associated Harvard Clubs has provided, de-
veloped, and directed the inherent enthusiasm of her graduates.

And these meetings of the Associated Harvard Clubs ! — after all is
said and done, the social end, for most, is the raison d*%tre of the meet-
ings. In spite of the evident desire and intent to have serious discussions
and really to consider the problems of the University, and in spite of the
necessary attitude of the officials of the organization that the good times
are merely incidental, the social phase is all-important to the average
attendant. As one dignified judge remarked at a recent meeting, "At
this time of life I have only two definite engagements, the meeting of
the Associated Harvard Clubs and my own funeral.*' These meetings
of the Associated Harvard Clubs offer a democratic leavening to the body
of sedately proper graduates, especially from New England, and at the
same time present a focus for the ebullition of enthusiasm of the younger
Harvard men. These meetings also keep a lot of men who cannot attend
their class reunions in touch with Harvard ; and the printed reports, sent
broadcast over the land, are messages to isolated men who rarely hear,
otherwise, of the good times of Harvard gatherings.

The last meeting included Harvard men from 1849 to 1918, with one
or two youths still in preparatory school ; and they mixed ; title and posi-
tion were forgotten. At the San Francisco meeting it was delightful to
hear Toastmaster Thomas (known to us only as " Uncle Bill ") introduce
the representative of the University as " Billy '* Lawrence, rather than
as the Right Reverend, the Bishop of Massachusetts; and "Billy"
Lawrence's straightforward talk of what Harvard and Harvard men had
been doing during the past year, did more good and created more whole-
some enthusiasm for Harvard than would result from a score of Phi Beta
Kappa addresses or baccalaureate sermons. So, too, it is good for Harvard
men (regardless of class, residence or degree) to meet the President of
the University face to face and to talk with him and to him ; and it is
equally good for the officials of Harvard University thus informally to
meet men who rarely go back to Cambridge but who bear the stamp of
Harvard, and to discuss with them the needs and purposes of the Uni-
versity.

In the last number of the Oraduates' Magazine appeared a statement,
credited to the late John D. Long, about his bashf ulness toward certain
men of his class. Younger Harvard men entertaining similar feelings
would do well to attend a meeting of the Associated Harvard Clubs.
After they have golfed, picnicked, drunk, smoked, and talked with a
group of fellows, — whether from the classes of '69, '85, or '16, — they
will suddenly realize that the men whom they used to look up to with fear



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476 The Asaociated Harvard Clubs. [March,

are also human beings. Such acquaintancesLips continue and grow. Har-
Tard lives in her loyal graduates ratlier than in her bricks and stones.

One great defect in the organization of the Associated Harvard Clubs
is the casual manner of discussing matters at the annual meetings. It is
patent to men who attend these meetings that the debate is usually
spontaneous, and lacking in thoughtful preparation. Too much is left to
luck. As a result a great part of it is trivial, and matters of real import-
ance, when reported by some committee, are too often accepted as finished
business, wiUi little or no discussion from the floor, although most of the
reports merit earnest consideration. Fortunately, the committees have
done good work, but often they are appointed late in the year and their
reports are inadequate. With coounittee members widely separated, it is
impossible, moreover, to make a report except by correspondence, so the
chairman usually does the work and his views are those offered in the re-
port of the committee.

When there is discussion too much of it is of the so-called ^' jollying ''
kind ; items of minor interest often sidetrack important questions. If the
same men attended consecutive meetings, there would doubtless be con-
tinuity in the transaction of business, but with most of the men local
residents, attending for the first time, there is a tendency to inject into
' a national assembly the local viewpoint. One way in which this fault
might be corrected would be to adopt the practice of the American Bar
Association. That organization prints the reports of committees before
the meeting and distributes them. Members of the organization know in
advance what topics are to be reported and come prepared to give their
views, with the result that the meetings have been decidedly more stim-
ulating and better legislation has been obtained.

There also is a need of having live, active topics for investigation and
discussion, — preferably such topics as will necessitate investigation on
the part of constituent clubs. It is well known that clubs which have
most internal activities are clubs which arouse most enthusiasm, which
have the best type of members, and which do the best work for the Uni-
versity. Of course it is unreasonable to expect that the clubs should con-
fine their efforts to serious problems only, but good times should not be
the sole excuse for existence. The two phases can be combined into a
good working combination.

Except in a hazy, indefinite way, the Associated Harvard Clubs, as
organized, does not have authority over the constituent clubs. As a result,
much effective work is not done. With a paid assistant to the secretary,
work could be undertaken which is now impossible, and a general stimu-
lation of activities would result Until the Associated Harvard Clubs,
furthermore, can induce the various clubs to act independently on the



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1916.] How Medical School Graduates Fare. 477

resolutions adopted at the annual meeting, little additional headway can
be expected and much effort will be wasted. There are many activities
on which the Association can work in the immediate fnture. A few are :

1. Inci-eased efficiency through regular assistants to the general offi-
cers, such assistants to carry out the instructions of the officers and
attend to all routine business.

2. The possibility of an amalgamation of graduate activities into one
comprehensive body, which wiU include every phase of graduate
life.

3. A systematic survey, from time to time, of conditions throughout
the country, to ascertain in what sections Harvard is weak and to
offset any tendency which may be unfavorable to the University.

4. Ways and means of perfecting the organization so that legislation
passed by the Associated Harvard Clubs will be followed up by the
constituent clubs.

6. Accumulation of a fund or endowment which will insure permar
nence of organization, and will provide for incidental and necessary
expenses without dependence on dues from the constituent clubs.

6. Perpetuation of the work of the Scholarship Committee by obtaining
guarantors, not year by year, but permanently, for each scholarship
offered by the Associated Harvard Clubs and by the constituent
clubs.

7. Collaboration with the University to provide representatives at reg-
ular functions of the smaller clubs, — which at present is impossible
through lack of coordination.

8. Development of the interest of graduates, not only in athletics and
class affairs, but also in the needs and ambitions of the University.

9. Presenting to every school in the country the opportunities of £Uu>
vard.

10. Development of a country-wide bureau of opportunities for Harvard
men ; not only for men just leaving college and seeking their first
position, but for placing Harvard men in places of great responsi-
bility wherever the highest g^de is required.



HOW MEDICAL SCHOOL GRADUATES FARE.

DB. A B. EMMONS, 2nd, '98.

What inducement does medicine as a career offer to a college gradu-
ate ? If he is to live in a large city, must he become a specialist ? Or can
he do general practice ? What other lines of usefulness are open ? Is it
worth while to get hospital experience ? If so, what kind and how many



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478 How Medical School Graduates Fare, [March,

yean are necessary ? How soon after entering practice can the doctor
expect to make office expenses ? — how soon a living, besides ? How soon
can he support a family ? Are doctors satisfied ? What qualities make
a man suitable for a doctor ? What 's the fun in it ? What is the oppor-
tunity in the future of medicine ?

Answers to some of these questions are suggested by the 317 replies to
a questionnaire sent to the graduates of the Harvard Medical School of
the classes 1901-10 inclusive, and recently published in pamphlet form.^
The report contains the stories of many of the men told in their own
words, and, as no names are given, considerable frankness is evident

These replies show great diversity of success and of opinion. Of those
who answered, 225 state definitely that the practice of medicine has proved
satisfactory to them, 16 that it has not The doctor's life, especially in
rural districts and small towns, is often very strenuous and is seldom
lucrative. This, however, is usually compensated by the devotion of the
patients, which is much less in urban districts. The unreasonableness and
ignorance of patients are perhaps the most trying part of practice and
require a large measure of patience.

To be a good general practitioner takes more brains, judgment, and
energy than to succeed in a specialty. Specialization, on the other hand,
requires more preparation, but brings bigger and easier returns. It is,
therefore, not surprising to find that only 36 men were doing general
practice, whereas 134 were doing general practice with a specialty, which
would probably, within a few years, become their only work ; ^ 142 were
already doing only special work. For this reason it can scarcely longer be
said that the majority of graduates of the Harvard Medical School must
go into general practice, nor that tlie chief aim of the School must be to
train ^he general practitioner. Rather must its aim be to train broadly
men of versatile capacity to meet the changing requirements of the pro-
fession, whether these requirements are those of general practice in a
rural district or those of a specially trained expert in a larger community ;
or to teach, or to enter public health work, or to develop new fields of
medical usefulness. An older practitioner of Boston, in a review letter,
sounds a note of warning when he says : ^' As time goes on and the par-
ental mode of government increases, the career of the family physician
will be no easier than it is at present Those entering the profession
should have more light on their future prospects than they have usually

1 Thifl pamphlet (114 pp.) may be obtained from A.*B. Emmons, 2d, Director for
Appointments, Harvard Medical School, Boston, or from the Harvard Uniyersity
Press, at 25 cents per copy.

^ A eanyasB of recent clanes (Boston Medical and Surgical Journal, Novembor,
1915) shows 58 per cent doing genwal praotioe soon after gradnation.



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1916.] How Medical School Graduates Fare. 479

had in the past, thereby avoiding the misfits that are so distressing to all
parties concerned."

The old idea of ten years of general practice before specializing has
valae, bat wisely to choose one's special line early is desirable for the
opportunity it affords of making the preparation broad and thorough.
Furtheimore, since great proficiency in a single line can hardly be ac-
quired when the specialty is taken up seriously only at thirty-five or forty,
the old idea of general practice, as giving thorough and complete medical
preparation, might well be modernized by arranging to take, as a mini-
mum, one and a half years in a mixed medical and surgical service, fol^
lowed by six months to a year in a special line, this to be supplemented,
during the first years of practice, by district service or dispensary work.
These dispensary and district physicians' positions give excellent *^ gen-
eral practice " experience, and the fact that dispensaries have increased
in number from 100, in 1900, to 700, in 1914, proves that such positions
are not difficult to obtain. Thus would be corrected a want in the Medical
School expressed by many men for " more details," ^^ experience in the
little thingrg," «< practical therapeutics " (mentioned by 58 men), instruc-
tion in measures other than drugs, such as hydro-, electro-, mechanico-
ps} cho-therapeutics, and treatment of common diseases.

To some the growth of dispensaries may suggest ^* hospital abuse."
To the writer the root of this evil, where it exists, lies only in the free
service of the hospital or dispensary. The patient is educated to seek
service for nothing, instead of paying the cost, or whatever part of the
cost, he can manage to meet without undue hardship. Hospital or dispen-
sary semce is often the best obtainable and should be open to all who
cannot afford equally good private service, but today, in Boston at least,
he who is able to pay a moderate amount is discriminated against. He is
perhaps given the choice of private service at $100 or hospital service for
nothing. The doctor also loses, for he must give his service free.

The question of location is a vital one in the doctor's career. Most of
the dissatisfaction with the practice of medicine is traceable, directly or
indirectly, to overcrowding, but there seems to be, at present, no- method
of intelligently distributing physicians according to the need. It has re-
mained a question largely of individual fancy, resulting in the crowding
to large cities. 221 men state that general practitioners are not needed
in their several communities, 43 that there is need of good ones ; 185 say
no specialists are needed, and 69 say a need is certainly felt. 72 feel that
public health officers are needed in their community. Tlie Appointments
Bureau is attempting to solve this problem of distribution as regards
Harvard Medical Alumni, but it should be studied throughout the
country.



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480 How Medical School Graduates Fare. [March,

It has been estimated that doctors in America make on an average
$700 a year. If this is true, how mach money may an average man ex-
pect to make after graduation from the Harva^ Medical School ?

The following table answers this question and also compares the results
of this study with that of the graduates of the Harvard Law School.^

Tahle of amount of money earned



Ytarttrnt



iBt

2d.
3d.
4th
5th
6th.
7th
8th.
9th.

10th.

11th.

12th.

13th.



Harvard Law SchwA



DoUart



9664
1110
1645
2150
2668
3118
3909
4426
5321
5325



No. of men



694
609
497
411
317
249
162
112
62
40



Ixwoni Mtdtcal

School

{263 liMn)

Dollars



S623
909
1301
1681
2006
2410
2935
3227
3636
3789
4060
4275
4680



BarwardGradMOte
School of Butineu
AdmMtlralum
(94 men)



91450
1292
1576
1800
2144



Several men speak feelingly on the question of proper instruction in
<< medical ethics/' and on this subject the public also often wonder.
Specific mention is made of various evils, such as fee-splitting, lodge prac-
tice, ^'quacks," and patent medicines. But the greatest danger of all to
the individual and to the profession in general is commercialism. It is
evident that should a series of talks be given during the fourth year by
members of the medical profession and others best fitted to give to the
student a modem interpretation of the application of the principles of
professional ethics, it would be much appreciated and would aid the
young practitioner in his relations with other medical men and the laity,
and might also help to preserve the good name and standing of the
medical profession.

The fundamental theoretical teaching of the Harvard Medical School,
by both laboratory and clinical demonstration is logically supplemented
by practical training in the hospital. Of 316 men 234 took more than one
year : 65 men took three or more years. The value of this practical train-
ing after the fundamental training in the School is recognized by the posi-
tive statements of those men who took hospital services. It is even more
strikingly shown by the regrets of those who, for one reason or another,

^ Harvard Law Review, Jan. 1914, p. 260, and the School of Bosinees Adnunutnip
tion, Harv. Alum, Bull,, Jan. 12, 1916, p. 269.



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1916.] How Medical School Graduates Fare. 481

did not have this hospital experience. Such service is coming, furthermore,
to be a necessity, since already one State, Pennsylvania, stipulates a hos-
pital year as requisite before entering its examinations for admission to
practice. Nor is there any excuse for omitting this training since plenty
of good hospital appointments are to be had to supply all the gi-aduating
class, and some of the smaller hospitals are offering an honorarium to
secure good men.

To the man with ambition for a career in some scientific line the remark
that ^' science is its own reward " indicates that financial returns are slow
and seldom large. Therefore, a business course for doctors has many advo-
cates. Several men specially mention their lack of preparation in how to
manage practice in an orderly, systematic way. This might be accom-
plished, it is suggested, by " a chair in the Conduct of Private Practice."
Perhaps a few talks might answer.

Another interesting suggestion is that of giving a somewhat different
emphasis in their training to men who plan to teach or specialize from
that given to men who plan to practise general medicine. The latter
should have more time spent on the practical application to pra4^ice of
scientific medicine while the former must devote special study to scientific
details which will include the latest knowledge and theories.

One man suggests '^ a probation period " for first-year men, such as
prevails in schools for training nurses. This idea is already being carried
out elsewhere, and seems worthy of careful consideration. In a recent
addi'ess Dr. W. W. Chipman, Professor of Obstetrics at McGill, said in
part : " At McGill it is arranged that students of the first year in medi-
cine work under the eye of a special committee. This Personal Com-
mittee, as it is called, is chosen from their teachers, men of sympathy,
tact, and insight. Its chief concern is the weak student, or ^ waster ' ; to
encourage and advise him, to get to know him ' on the human side.' At
the end of the year if the man shows little interest in, or no aptitude
whatever for, the study of medicine, he and his parents are advised to
reconsider his choice of a profession. And already results have shown that
this step is wise. True it is, that this advice is given a little late, only after
the career has been chosen and begun. In consequence it may not be the
best of economics; still it is better late than never, and it permits the boy
the test of actual experience in the work, and may save him from the
hideous blunder of a mistaken choice. So it is that such a method de-
mands from each student a certain measure of adaptation to his chosen
work. To this extent it rids our medical schools of the ' chronic,' the unfit,
and it so ensures to the teacher, our chosen teacher, a student-material
in some degree worthy of his gift."

From our experience in the Appointments Bureau we suggest that each



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482 How Medical School Graduates Fare. [March,

man make a searching self-examination to determine his chief motive and
his temperamental fitness for entering medicine. It would be well carefully
to consider these in counsel with one's teacher and adviser and in this
counsel let it be remembered that graduates in practice conclude that those
who enter medicine primarily to make money are seldom satisfied.

The experience of nearly three years in the Appointments Bureau, where
men and different conditions of medical practice are studied and where the
individual problem is of primary consideration, leads to the conclusion that
matching the man and the job is not easy. The Bureau does not attempt
to assume this responsibility but tries rather to aid each man to study
himself and decide to what he is suited, and then to make a '^ permanent
plan " of his career. The temporary job for which he usually applies is
then a stepping-stone in his career. Out of the confusion a few rather
hazy, undefined distinctions have emerged. Men may be classified as to
temperamental fitness by their natural ability, imagination, or lack of it,
tact, real education, i.e., ability to use that which they have heard or seen.
One man fits general practice from his human understanding, tact, self-



Online LibraryWilliam Richards Castle William Roscoe ThayerThe Harvard graduates' magazine → online text (page 65 of 103)