In the 1994-1995 academic year the United States and Canada had 140 accredited 4-year medical colleges. That same year 43,029 men and 30,821 women were enrolled in these schools and 10,646 men and 7,009 women were graduated. Graduates, after a year of internship, receive licenses to practice if they pass an examination administered either by a state board or by the National Board of Medical Examiners. Physicians diagnose diseases and injuries, administer treatment, and advise patients on good diet and other ways to stay healthy.
The United States has two kinds of physicians, the Doctor of Medicine (MD) and the Doctor of Osteopathy (DO). Both use medicines, surgery, and other standard methods of treating disease. DOs place special emphasis on problems involving the musculoskeletal system, which includes muscles, ligaments, bones, and joints. Patients receive medical care from primary care doctors and specialists.
Primary care doctors include general practitioners, family physicians, general internists, and general pediatricians. Many women also use obstetricians-gynecologists as primary care doctors. Patients usually consult a primary care doctor when they first become ill or injured. Primary care physicians can treat most common disorders, and provide comprehensive, lifelong care for individuals and families. But medical knowledge has advanced so far that no physician can master an entire field of medicine. Primary care doctors may refer patients with unusually complicated problems to specialists with advanced training in a particular disease or field of medicine.
Specialists may even concentrate in one particular area, and become sub specialists. Each specialist in internal medicine, for instance, is an expert in diagnosis and no surgical treatment of adult diseases. But some internists take advanced training to become sub specialists in treating adolescents, heart disease, elderly people, cancer, or arthritis. For more information about the areas that specialists treat, see the table on Medical Specialties.
branch of education devoted to training doctors in the practice of medicine. In 18th-century colonial America, prospective physicians either apprenticed themselves to established practitioners or went abroad to study in the traditional schools of London, Paris, and Edinburgh. Medicine was first taught formally by specialists at the University of Pennsylvania, beginning in 1765, and in 1767 at King’s College (now Columbia University), the first institution in the colonies to confer the degree of doctor of medicine. Following the American Revolution, the Columbia medical faculty (formerly of King’s College) was merged with the College of Physicians and Surgeons, chartered in 1809, which survives as a division of Columbia University. In 1893 the Johns Hopkins Medical School required all applicants to have a college degree and was the first to afford its students the opportunity to further their training in an affiliated teaching hospital.
The growth of medical schools affiliated with established institutions of learning was paralleled by the development of proprietary schools of medicine run for personal profit, most of which had low standards and inadequate facilities. In 1910 Abraham Flexner, the American education reformer, wrote Medical Education in the United States and Canada, exposing the inadequacies of most proprietary schools. Subsequently, the American Medical Association and the Association of American Medical Colleges laid down standards for course content, qualifications of teachers, laboratory facilities, affiliation with teaching hospitals, and licensing of practitioners that survive to this day.
