Simplified Comprehensive | Senior Living News in Hamden, CT

Simplified Comprehensive

December 16, 2016 No Comments

By: John E. Fenn

Published in Whitney Word – Volume 32, No. 5 – October 2016

It was June of 1949 as I anticipated beginning my senior year of high school and dreamed of college and then medical school, if all went well. I was fortunate to be offered a summer position as a volunteer in the research laboratory of Dr. Harry S. N. Greene, a leader in the Yale Department of Pathology and ultimately the chairman of that department. 

Dr. Greene was a recognized expert in the pathology and physiology of cancer, and at that time the potential for a given tumor to metastasize, or spread to another part of a patient’s body, was determined by the ability of a sample of the tumor to grow upon transplantation into an anesthetized experimental animal, usually a mouse or rat.  Accordingly, Dr. Greene’s laboratory was frequently the recipient of samples from the operating rooms of what was then Grace-New Haven Hospital. My task as a summer volunteer was to assist in the transplantation of those specimens.

In addition to Dr. Greene’s responsibilities as a clinical pathologist and researcher, he was clearly also a member of the Yale faculty, and as such he had educational responsibilities as well. During my first week in the lab at the beginning of July, a sad-looking medical student arrived to meet with Dr. Greene.  At that time, Yale medical students did not take routine tests to determine their academic progress, but rather they were only required to take the examinations provided by the National Board of Medical Examiners (NBME). These were scheduled at three times—after the first two preclinical years of medical school, then following the two (or three) years of clinical participation, and finally after internship, although most medical students completed internships at other institutions. In order for Yale medical students to progress from the preclinical first two years into the clinical years, it was necessary for the students to pass the first set of examinations in  their completed courses, such as anatomy, physiology, pharmacology, and of course, pathology.  The NBME passing grade was 75, but not at Yale.  The Yale School of Medicine had decided long ago that its students needed to achieve a grade of 80 in order to progress into the next years of study, the clinical years. If a student did not achieve that threshold grade of 80 he/she was required to take a so-called comprehensive examination designed and administered by the senior faculty in the appropriate department.  And now back to our story.

The sad medical student immediately walked up to Dr. Greene to greet him.  He quickly explained that he planned to spend the summer studying vigorously for his comprehensive exam in pathology in order to seek approval from the senior faculty that he was indeed qualified to progress in his education.  Under his arm he carried a pathology textbook, and he asked Dr. Greene if there was any other material that he should study during the summer months ahead so that he might take his comprehensive examination in mid-August, and still have some time to visit his family in California before starting his clinical years.  He was clearly an unhappy camper and very disappointed that he had missed the Yale threshold passing grade of 80 by a mere two points.

Taking the student by the arm, Dr. Greene marched him over to a desk in the corner of the laboratory, sat him down, took his textbook away, and promptly declared that the student was not going to spend the summer studying and that his comprehensive examination was to be administered that instant. The student’s facial expression and verbal response left no doubt that he was totally unprepared for such an important step in his career, and he begged Dr. Greene to give him time to study his pathology.  It was no use.  Dr. Greene had decided that the comprehensive examination was to be administered then and there, and the student was not going to spend his entire summer studying in New Haven.

The traumatized medical student had clearly lost the battle to the pathology professor, and he hung his head.  Whereupon, Dr. Greene rolled up his sleeve, pointed to a small freckle on his forearm, and queried of the student, “Is that leprosy?”

The confused student did not know what to make of the situation, but responded with a “No, Sir.”

Dr. Greene quickly replied, “You are correct.  You pass.  Go home and have a great summer!”

Words do not exist to describe the expression on the student’s face, but he promptly stood, shook Dr. Greene’s hand, and departed, no doubt for California.

We all went back to work.

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