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Eur J Cardiothorac Surg 1999;16:S6-S10
© 1999 Elsevier Science NL

Surgical education in changing times

Division of Cardiothoracic Surgery, University of California, Davis Medical Center, Sacramento, CA 95817, USA

Key Words: Education • Surgery

The first 300 words of the full text of this article appear below.

	1. Before thoracic surgery

 
With due respect to Asia, Africa and other cultures wherein there have undoubtedly been important happenings in surgical educations, I shall focus upon the United States and its European heritage.

The ‘art of surgery‘ was recognized at the time of Hippocrates [1,2]. In the beginning surgery was totally integrated into medicine as a whole and it was taught by apprenticeship, without curricula or standardization or formal evaluation. Hundreds of years passed until surgical papers were segregated into separate sections in scientific publications. Meetings devoted exclusively to surgery did not emerge until about the 1890s.

Europe was the cradle of knowledge and excellence in surgical education for Americans in the late 1800s until approximately the start of World War II. It has been estimated that during the period from 1870 to 1914 there were 15 000 US undergraduate and postgraduate students in German medical schools alone. There were also many Americans studying in centers of excellence such as Vienna where the great Chicago surgeon Arthur D. Bevan noted that Billroth ‘...taught surgery as a successful football coach teaches his squad...by training them in the actual work itself'[2].

In the youngest days of America as a British colony, medical education was fragmented and sporadic. The first American surgical textbook was a manual of military surgery in 1775.

After the Declaration of Independence in 1776 there was little attention paid to medical education until formal medical education began at the Medical College of Philadelphia in 1865. At the start surgery was taught under the aegis of a professorship that also included responsibility for anatomy and midwifery as well as surgery. Eventually, Philip Syng Physick became the first professor of surgery as a separate and distinct discipline.

New York, Boston and Baltimore were the centers of surgical excellence in the original . . . [Full Text of this Article]