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Ira M. Rutkow, MD,MPH,DrPH

Arch Surg. 2001;136:479.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

IN 19TH-CENTURY AMERICA, medical education tended to be a haphazard affair. Various pathways were possible, including medical school, apprenticeship, house pupilship, and European study. Some led to the granting of a medical degree; others provided clinical experience but no formal study. Medical licensure was often laissez-faire in nature with neither a degree nor even a modicum of training a necessary prerequisite. In retrospect, it is easy to be overly harsh in evaluating this situation. However, the country was experiencing a growth spurt unparalleled in its existence. With an expanding populace, scattered over frontier territory, the rudimentary education and training that most physician/surgeons received was better than none at all. Quacks, empirics, and other medical miscreants ran amuck, and the obtaining of adequate health care could be a hit or miss proposition. In truth, medical science was not yet substantively advanced in its ability to treat most . . . [Full Text of this Article]

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