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nature than of a qualitative, more increase in years and weeks of instruction than improvement in quality of the instruction given in those years and weeks.
These quantitative phases may be well considered under three headings—preliminary education, length of the session of instruction, and number of sessions prerequisite to graduation..
1. PROGRESS IN PRELIMINARY EDUCATION
There was apparently no inquiry, certainly no requirement, as to preliminary education for entrance to all dental schools in the years from 1840 to 1884, although individual schools definitely connected with universities did, as early as 1878, make some inquiry of prospective students in regard to previous education.
When the National Association of Dental Faculties was formed it recommended, at its first meeting in 1884, that a preliminary examination be required covering a “good English education” unless a diploma were presented from a reputable literary institution or other evidence of literary qualification given. One wonders just how much this “good English education ” meant until we find in the course of the deliberations of this body nearly a decade later a very considerable debate and successful resistance when it was proposed to advance the preliminary education to require the completion of the grades of the grammar school.
Not until 1896 was there, even nominally, an entrance requirement by all member schools of the National Association of Dental Faculties of an education equivalent to ability to enter the high school. At this date nearly all medical schools were requiring highschool graduation for entrance.
In 1899 further prescribed, although by no means rigorously enforced, entrance requirements became effective by demanding completion of the first year of high school previous to entering the dental school.
In 1903 a further increase to two years of high-school work before entrance was adopted by the National Association of Dental Faculties, to become effective in 1904, and accompanied by an increase in the professional course from three to four years. This increase of the length of the professional course was rescinded within a few months.
In 1907 the National Association of Dental Faculties again advanced for its members the entrance requirements to completion of three years of high-school work, and in 1910 to high-school graduation. This latter was an apparent advance but not necessarily a real advance, because there were many high schools with but a two-year or three-year course and graduation from these fulfilled the requirement. Not until 1917 was the necessary stipulation added that graduation must be from a high school with a four-year course.
Throughout this period of more than 20 years, from 1896 to 1917, while the specifications for preliminary education were gradually advanced, there was always included in the stated requirement the vitiating modifying clause “or equivalent.” The equivalence frequently was so liberally interpreted as really to mean only a certificate of good moral character and the payment of fees, the latter, at least, always being relentlessly insisted upon. The National Association of Dental Faculties was paying little attention to those factors which determine the quality of instruction in the schools, but was satisfied with quantity only. Even the quantity requirements affected only the member schools and were to a large extent merely published requirements rather than enforced requirements, for as late as 1909 the president of the association in his annual address said:
It has long been a practice among the members of this body to accept students with certain conditions to be removed during their college course. This practice appears to be just and proper.
Later disclosures showed that from 1896 to 1916 in many of the schools there was resort to various subterfuges to secure “credentials” for the required amount of preliminary education for candidates who actually lacked formal schooling to the extent set down in the printed rules. It apparently was not appreciated that the purpose of entrance requirements is to assure the capability that will enable the student to secure from the outset of the professional course the complete benefit of the instruction offered him, and that without complete enforcement of preliminary education the professional course must totter on an unstable foundation.
From discussion in the proceedings of the National Association of Dental Faculties we learn that it was also a common practice to accept students some weeks after the instruction had begun and to permit them to leave the school a considerable period before the close of the session, and also, on occasion, to permit a student to take two of the years of instruction concurrently in a single year. Thus, with no attempt at control of the quality of instruction, the quantity was abbreviated by liberal entrance conditions, coupled with carelessness in their enforcement, by abbreviated attendance, and by telescoping the curriculum.
By 1912 the Dental Faculties Association of American Universities was coming to exert considerable influence. For several years its members had been requiring high-school graduation for entrance, and in most cases graduation from a four-year high school. Its influence was indirectly reflected upon the better schools that were members of the National Association of Dental Faculties, and in 1916 that association also adopted graduation from a four-year high school as a minimum entrance requirement. The university dental schools were also looking forward to further advance, expecting to demand some college work for entrance, with the aim of bringing the preliminary education required of dental students to an equality with the two years of undergraduate college work required to enter medical schools.
The war stopped further advance, but it also clearly showed the need for a dental profession with a better general education upon which the professional training should be built.
At the end of the war the Dental Educational Council had become the most powerful agency in dental education. In 1921 many of the university dental schools began the enforcement of an entrance requirement of one year in a college of arts and science, with certain specified subjects. The Dental Educational Council, following this example, in 1923 adopted a resolution that this entrance requirement would be demanded of all schools seeking an A classification after January 1, 1926. In 1924 this requirement was extended to include also all schools of B classification. Since only A and B schools are likely to be recognized by State boards, this means that all reputable schools will in the future require one predental year of undergraduate college work. However, this does not bring the preliminary requirements in dental schools to an equality with the two premedical years of college work demanded by all reputable medical schools.
Just as some schools have always been outside the standard regulations and lagged behind in every advance, so others have forged ahead and enforced more than the usual standard. There has never been absolute uniformity in requirement and enforcement of preliminary education, and probably never will be, but in time it will become stabilized close to a norm. It would be unwise for any one to predict in print what that norm is going to be or when it will be effective. It has been much discussed in recent years, and there seems a fairly general consensus of opinion among dental educators that the norm will be approximately two years of college work based on 15 units of secondary education. As to the time when it will become effective there is a great variety of opinion.
If one judges by past performances in the advance of entrance requirements, we find the increments after 1896 were at intervals of three, three, five, three, seven, and nine years, respectively, which would perhaps warrant a conjecture that the next general advance
in entrance requirements will be somewhere between 5 and 10 years after 1926. Meanwhile individual schools will independently advance, but the general advance will depend very greatly upon what comes to be the general acceptation of the number of years that are to be built upon the entrance foundation. This will be discussed in another relation.
There can be no doubt of the advantage of close uniformity in entrance requirements. In the individual school it is essential sharply to define the minimum. This stabilizes the intake of the partially finished product, which is to the dental school the raw material from which it must fashion the graduate ready for the profession. Too great variation makes for lack of assimilation into the school. Individuality there must be, but the base upon which the superstructure of the professional course is to be built must at least come up to a minimum level.
The question is whether the dental schools are, at this time, able to offer to an entrant a course of a quality that can advantageously use the information and training to be secured by a second year of work in the college of arts and science. When, in a later section, the quality of teaching is discussed, the opinion will be expressed that there is another problem fully as important as immediate further advance of entrance requirements. The problem of entrance requirements has such close interrelation with curriculum organization and improvement of quality of teaching that it can not be solved separately. These three major factors must be adjusted jointly.
2. LENGTH OF THE ANNUAL SCHOOL SESSION
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The first session of the Baltimore College of Dental Surgery extended from November 3, 1840, to the latter part of February, 1841, with the graduation of two of the five students on March 9, 1841. This designated time was four months, but it is fair to presume that, with Christmas holidays out, the exact period of instruction was 16 weeks, which was then the usual length of session in medical schools. The length of term in most medical schools increased after the Civil War to 20 weeks and about 1880 to 24 weeks. Apparently the dental schools did not follow the medical schools in this advance, as they appear to have been still on a four-months basis in 1884, when the National Association of Dental Faculties set the four-month session to be a standard beginning in the school year 1884–85. By 1888 the standard length of session had increased to 5 months, in 1896 to 6 months, in 1899 to 7 months. In all of these cases this was elapsed time and included the holiday vacation. Deducting this vacation, the weeks of instruction were, at the dates noted, 16, 20, 24, and 28. The next increase was in 1904, to 30
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teaching weeks. In many cases there were only five teaching days per week, but in 1910, when the increase to 32 weeks became effective, it also carried a specification of six days per week, exclusive of vacations. Thus in the 25 years from 1885 to 1910 the number of weeks of teaching in the school session was exactly doubled.
In the majority of the schools now there are 32 weeks of instruction, exclusive of the weeks set aside for examinations. In some schools the number of teaching weeks is 36.
3. NUMBER OF YEARS IN THE COURSE
The charter of the first dental school in 1840 specified that it should give a course consisting of at least one session of four months. When the Harvard Dental School was started in 1867 it specified that two sessions of four months each would be given, with required additional service under a preceptor. This was considered a very striking advance. The two-session curriculum was pretty generally adopted by the schools that were organized in the seventies and eighties, and not until the early nineties did the three-session course come to be at all general. In 1891–92 this became the rule in the National Association of Dental Faculties. There was then a period of 25 years before the four-session course became a rule, excepting that in 1903-4 an abortive attempt was made to increase to a four-session course, the decision being reversed within a few months after it was adopted. Meanwhile the length of session was gradually lengthened.
But the number of sessions in the professional school is not the whole story. For comparison of educational progress in dentistry one must count the number of years from completion of the grammar grades to the dental degree. If we assume that, even in the early history of American dental education, all students had completed the grammar grades, which we know is not true, we get the following number of years after completion of the grammar grades to gain the dental degree, current in the majority of the schools for the years specified: 1840-1869 One professional year of 16 weeks-total, one year. 1870-1891 Two professional years of 16 to 20 weeks each--total, two years. 1891–1899 Three professional years of 20 to 24 weeks each--total, three years. 1899–1902 One year of high school and three professional years of 28 weeks
each-total, four years. 1902–3 Two years of high school and three professional years of 28 weeks
each-total, five years. 1903-4 Two years of high school and four professional years of 28 weeks
each--total, six years. 1904–1907 Two years of high school and three professional years of 30 weeks
each-total, five years. 1907–1910 Three years of high school and three professional years of 30 weeks
each-total, six years.