Excerpt from The Presbyterian Hospital Bulletin, Vol. 26: January, 1916

The Presbyterian Hospital of Chicago is recognized as one of the best institutions for the care of the sick in the country. This is due not only to the efficient care given to the sick and injured in the attempt to restore them to health, but also to the fact that there is an esprit de corps in the institution, which embraces every worker in the hospital. This means that the main function of the hospita.l - the at tempt to heal the sick and injured - is efficiently carried on.

If one inquires why the above conditions exist at the Presbyterian Hospital it will be found that it is answered chiefly by saying that the Presbyterian Hospital is a teaching institution in the fullest sense of the word. The pupils of the Training School for Nurses receive their practical training in the wards. The medical students receive their clinical instruction in the amphitheaters of Rush Medical Col lege, affiliated with the Presbyterian Hospital, and also in the wards and it is of this last method of medical teaching that I wish to speak.

While there are two or more methods of medical ward teaching, the one adopted by the Presbyterian Hospital is that of placing the senior medical student, whose previous medical training prepares him for the work in hand, in the ward as a so-called clinical clerk. This term is one which originated in England, where the chief part of the practical medical training of the student is gained in the wards of the hospitals. As a clinical clerk he is obliged to wear a gown, or uniform, which will render him indistinguishable fro-m other workers in the hospital and at the same time safeguard against any possible com munlcation of disease from one individual to another in and out of the hospital. His work is supervised by the resident physicians and also_by the interne staff. Necessarily his work is observed and ar ranged for also by the attending physicians and surgeons. He serves for a sufficient time daily and for a period of time in months (in the Presbyterian Hospital it is three months) to enable him to become of real value in the care of the sick with whom he comes in contact. At first he is allotted but one or two beds, but later as his efficiency 1n creases he may be assigned to more beds. Under the direction of the resident physicians he writes a history, makes. A physical examination and also the laboratory examinations of blood and excretions of each patient. His work is critically observed and he has the opportunity day by day to watch the clinical course of many diseases. He is not permitted to prescribe or to dictate the management of env patientbut the treatment and management is directed before him so that he is able to watch the result. He may aid the nurses and orderlies in giving tub baths for fevers, hot air sweats to patients who require that form of treatment and other measures of treatment which will be of great practical value to him as a physician. The constant presence in the wards of the resident physicians, the internes and the nurses and the daily presence of the, attending physicians and surgeons is a stimulus to the clinical clerk in his work and safeguards any possible objections which anyone may offer to the possible abuse of patients. Indeed, the more publicity given to hospital management, the less chance there is for any possible abuse, physical or other, to patients. The number of clinical clerks working in the hospital at any one time is not so large as to cause a disturbance or trouble of any kind in the work of nurses or others engaged in the care of patients. Very ill ward patients are not placed under the charge of clinical clerks.

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