Medical education facilities / prepared by Public Health Service, in cooperation with the Ad Hoc Committee on the Design of University Teaching Hospitals of the Association of American Medical Colleges, the American Medical Association, the American Hospital Association, and the Public Health Service.

  • United States. Public Health Service. Division of Hospital and Medical Facilities.
Date:
[1964]
Catalogue details

Licence: Public Domain Mark

Credit: Medical education facilities / prepared by Public Health Service, in cooperation with the Ad Hoc Committee on the Design of University Teaching Hospitals of the Association of American Medical Colleges, the American Medical Association, the American Hospital Association, and the Public Health Service. Source: Wellcome Collection.

    17/204 (page 1)
    Medical education facilities provide space for 3 interrelated activities—teaching, patient service, and research. Teaching during the first 2 years is centered in the medical sciences buildings; dur- ing the third and fourth years it is centered in the patient-care facilities of the teaching hospital. Research is an integral part of the activity of fac- ulty and students in all 4 years and requires special facilities. Schools should plan research facilities to accommodate the increasing growth in research activities. Great variation exists among schools in the nature and extent of each of these activities. Teaching may be limited almost entirely to the instruction of medical students, perhaps only in the first 2 years, or may include graduate students in the basic sciences, postdoctoral fellows, hospital house staff, nursing and dental students, and others in related health professions. Research and serv- ice may be at a minimal level consistent with ade- quate teaching or may be so extensive as to occupy a major portion of the school’s effort and the physi- cal plant. Increasingly the teaching of medical students is carried on in close conjunction with graduate teaching programs in the basic sciences, with the training of hospital house staff in the clinical years, and with other educational activities of the medical school and its parent university. Although the extent of patient service varies among medical schools, a school with 64 students in the entering class (and 60 in each clinical year) requires about 350-500 beds available for teaching, and a school with an entering class of 96 (and 90 in each clinical year), between 500 and 700 beds. More effective teaching will usually result if these beds are in 1 hospital and contiguous to the clini- cal science facilities. The size of the outpatient clinic depends on the program of the school and the service commitments of the hospital and not on the number of beds in the hospital. Approxi- mately 350 visits per day may be used for estimat- ing the size of an outpatient department in a teaching hospital. To insure a proper balance between clinical teaching activities and patient-service functions in a teaching hospital, it is essential that the medi- cal school effectively control the appointment of hospital staff and the selection of patients for the teaching service. Although university or medi- cal school fiscal control of the hospital has many advantages, such financial integration is not in- dispensable if hospital and medical school officials have common goals and mutual understanding. Medical school research budgets have increased about sevenfold over the last decade; an increasing proportion of medical schools have strong pro- grams of research and research training. In a typical schoo] today, a third of the space in the basic science facility is used for research activities or related graduate training. In addition, there may be research space in the clinical department areas and in the teaching hospital. Recent studies have called for a doubling or more of na- tional medical research expenditures over the next decade, which suggests that medical school re- search facilities must be planned for continued expansion. Essential to each of the 3 major activities of a medical school is the existence of an adequate library. Most medical library collections have more than doubled over the past 20 years, and in the near future a typical collection will probably include some 100,000 volumes and about 1,600 periodical titles. The size of the administrative staff will depend on the scope and magnitude of medical school functions. Variables affecting administrative staff needs are the size of the school, the breadth of teaching and research responsibilities, the com-