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Yale System thriving, says new deputy dean

Yale Medicine Magazine, 1998 - Fall


Although it is alternately misunderstood, revered, tolerated and adored, the Yale System is alive and well, Robert H. Gifford, M.D., deputy dean for education, told alumni gathered in the Hope Building during reunion weekend. Dr. Gifford noted that “the wheel has simply come ’round again” and cited F.P. Underhill, who chaired the school’s curriculum committee in 1922. “The student,” Dr. Underhill complained at the time, “has become the defenseless recipient of an overwhelming mass of facts.”

Reaffirming the goals of Milton C. Winternitz, M.D., who served as dean of the medical school from 1920 to 1935, Dr. Gifford said, “Memorization of a ‘mass of facts’ was far less important than a well-rounded education in fundamental principles, training in methods of investigation and acquisition of the scientific habit of mind.” Burdening the students with a heavy curriculum discourages independence and initiative and leaves little time for electives, independent thought or reading in the library, Dr. Gifford said.

Underlying the Yale System is the presumption that graduate students are mature individuals with a strong motivation to learn. As a result, attendance is not taken at lectures, small group teaching is emphasized and there are no grades or class rankings. Although examinations remain anonymous, a qualifying exam must be passed in every course and all students must write a thesis based on original research in order to graduate. According to Dr. Gifford, the school still adheres to these principles, but the number of lectures has gradually increased. And honor societies such as Alpha Omega Alpha, which recognizes only the top students in each class, have somewhat undermined the Yale System’s traditional opposition to class rankings, he said.

The freedom accorded to students brings with it a responsibility that is at times ignored, Dr. Gifford said. He took students to task for what he described as a “cavalier” attitude towards small group seminars which depend on student to student interaction. Attendance, he said, tends to drop, particularly around the time of the second year show in February and national board examinations in the spring.

While most of the faculty support the system, he said, a minority “look at it with some derision as a way for students to slip by without academic rigor, to be self-indulgent, spoiled, entitled to do anything they want.”

Dr. Gifford also took on the issue of payment of faculty who assume major teaching burdens. Most faculty, those who give lectures or moderate seminars, receive no remuneration, and that is appropriate. “But asking someone to be a course coordinator, to organize a new course, to chair a curriculum committee, to organize and run a new course is a very different matter,” Dr. Gifford said, “and, in my judgment, should be accompanied by partial salary support.” He proposed enlarging an educational fund so that those who shoulder unusual time commitments to teaching can receive a portion of their salary for their efforts.

Noting the curriculum requires attendance at too many lectures, Dr. Gifford called for more case-based conferences as an alternative.

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