The library of the Royal Society of Physicians in Budapest becomes today's Semmelweis Medical History Library.

OBJECTIVES: The 170-year history of the library of the Royal Society of Medicine in Budapest illustrates both that political and cultural context matter and that "medical" libraries, if they survive, in due course become primarily "medical history" libraries. METHODS: Two of the authors are on the staff of the Semmelweis Medical History Library; the third is a US scholar who makes frequent use of the library. Together, they avail themselves of archival and published materials-and personal experience with the collection-to establish the context that produced the original library, trace its evolution, and describe its present-day incarnation. RESULTS: A tale of transformation emerges that reflects how collections are likely to change. The authors present events and individuals in the life of the Royal Society's library and paint a picture of the value of today's Semmelweis Medical History Library. Unique treasures in the collection are described. CONCLUSION: The story told here is of how a particular nineteenth-century library became a twenty-first-century institution. The authors establish its peculiarly Hungarian context and potential value to librarians and historians from outside Hungary. The overall message is that general medical libraries everywhere are perforce likely to become medical historical libraries over time.

Reform and innovation: a repeating pattern during a half century of medical education in the USA.

INTRODUCTION: Medical education in the USA today is remarkably varied despite the shared mission of training doctors. SIX MEDICAL SCHOOLS: A brief introduction to 6 institutions illustrates the variety of education available, while providing some specific details of how schools differ and how the mandate of any particular school may differ from that of another. Private schools include Dartmouth Medical School, Duke University School of Medicine, and Mount Sinai School of Medicine. State-supported schools include the University of Arizona College of Medicine, Oregon Health and Science University School of Medicine, and Southern Illinois University School of Medicine. CHANGE: General remarks are made about changes over recent years in three separate areas of influence. NEW SCHOOLS: Forty new medical schools were established between 1960 and 1980; a brief explanation is provided of the reasons for this and how it was achieved. NEW DISCIPLINARY EMPHASES IN TRAINING DOCTORS: A few of the numerous new emphases that have been introduced into the medical school curriculum are discussed briefly. CURRICULUM REFORM: A small sample is given of ways in which particular medical schools have reformed their curricula over the years. What went into the most influential curricular reform is presented, along with mention of what are perhaps the most unusual curricular paths today. CONCLUSION: The paper concludes with an assessment of where reforms have brought US medical education by the beginning of the 21st century and what needs yet to be accomplished.

[Reform and innovation: medical education in the 20th century USA]. / Reform es innováció: orvosi oktatás a 20. századi Egyesült Allamokban.

Medical education in the USA today is remarkably varied despite the shared mission of training doctors, hardly surprising given that there are today 125 medical schools in the United States. In this paper, a brief introduction to six of those institutions--describing how they and their mandates differ--illustrates some of the variety of US medical education currently available, while providing some specific details of just how those six schools differ from each other. These are only samples, of course; the variety is far greater than can be made clear in such a short review. Three private institutions are included: Dartmouth Medical School (the nation's fourth-oldest medical school), Duke University School of Medicine (a 20th-century creation, in the South), and Mount Sinai School of Medicine (a newcomer in the crowded medical world of New York City). Three state-supported schools are also described: the University of Arizona College of Medicine (one of the nation's newer schools), Oregon Health & Science University School of Medicine (an institution that has gone through many permutations, thanks to a variety of mergers), and Southern Illinois University School of Medicine (another new school that has focused on serving its immediate locale while creating a national model for some kinds of student assessment). General remarks are made about changes over recent years in three separate areas of influence. One is the fact that forty new medical schools were established between 1960 and 1980; a short explanation is provided of the reasons for this and how this mammoth task was achieved. Secondly, a few of the numerous innovative programs and new emphases that have become part of the medical school curriculum in one institution or another are discussed briefly. And then, thirdly, a small sample is given of ways in which a few other particular medical schools have reformed their curricula in recent years; what went into the most influential of these curricular reforms is also presented, along with mention of what are perhaps the most unusual curricular paths today. The paper concludes with a summary assessment of where reforms in the second half of the 20th century have brought US medical education at the beginning of the 21st century as well as a sobering comment on the extent to which much remains to be accomplished in the delivery of health care in the United States despite the improvements in medical education. These observations constitute an important feature of the paper, because although much has previously been written on the history of medical education in the USA that provides a general picture of how physicians are trained there and contributes to an understanding of changes in that training, this article adds specificity to the general picture and makes absolutely clear that an astonishing degree of diversity exists in US medical education.

On being a surgeon, or the good old days of surgery.

The early US physician and medical educator, Nathan Smith, MD, was also--perhaps above all--a surgeon of considerable distinction. This brief look at the surgical side of his career presents some of the evidence for Smith's having been singled out so often as a seminal figure in early American medicine. For a number of years, the New England Surgical Society has presented to one of its members a Distinguished Service Award named to honor Nathan Smith. This article also provides insights into Smith's actual surgical practice. Here, readers can see how much surgery has changed while being reminded once again of what some important characteristics of outstanding surgeons are.