THE QUALIFICATIONS and PREPARATION of MEDICAL MISSIONARIES and NURSES BOARD OF MISSIONARY PREPARATION 25 Madison Avenue, New York PRICE 10 CENTS BOARD OF MISSIONARY PREPARATION Professor Frederick L. Anderson, D.D. Reverend James L. Barton, D.D. Professor Harlan P. Beach, D.D. David Bovaird, M.D. Professor O. E. Brown, D.D. Professor Ernest DeWitt Burton, D.D. Miss Helen B. Calder Professor Edward W. Capen, Ph.D. Professor W. O. Carver, D.D. Reverend Wm. I. Chamberlain, Ph.D. Reverend George Drach Reverend James Endicott, D.D. Professor Daniel J. Fleming, Ph.D. Dean H. E. W. Fosbroke, D.D. Miss Margaret E. Hodge President Henry C. King, D.D. Professor Walter L. Lingle, D.D. Right Reverend Arthur S. Lloyd, D.D. Reverend R. P. Mackay, D.D. President W. Douglas Mackenzie, D.D. Professor Paul Monroe, Ph.D. John R. Mott, LL.D. Reverend Frank Mason North, D.D. Principal T. R. O’Meara, D.D. President C. T. Paul, Ph.D. Professor Henry B. Robins, Ph.D. Professor T. H. P. Sailer, Ph.D. Miss Una Saunders Professor E. D. Soper, D.D. Robert E. Speer, D.D. President J. Ross Stevenson, D.D. Fennell P. Turner President Addie Grace Wardle, Ph.D. Reverend Charles R. Watson, D.D. Reverend Stanley White, D.D. President Wilbert W. White, Ph.D. President W. Douglas Mackenzie, D.D., Chairman Fennell P. Turner, Secretary Reverend Wm. I. Chamberlain, Ph.D., Treasurer Reverend Frank K. Sanders, Ph.D., Director 25 Madison Avenue, New York The QUALIFICATIONS aud PREPARATION of MEDICAL MISSIONARIES aud NURSES THE REPORT OF A COMMITTEE APPOINTED BY THE BOARD OF MISSIONARY PREPARATION Rev. Frep P. Haccarp, D.D., Chairman Rev. JAMEs L. Barton, D.D. Rev. CHARLES R. Watson, D.D. PROFESSOR Haran P. Beacu, M.A., D.D., F. R. G. S. Miss HELEN B. CALDER C. O. F. Stumpr, M.D. Joun C. Berry, M.D. Joun M. T. Finney, M.D. W. W. KEEN, Ph.D., Sc.D., M.D., LL.D. ELLEN C. Potter, M.D. J. G. Mumrorp, M.D., F. A. C. S. Horace D. ARNOLD, M.D. RICHARD P. STRONG, Ph.D., M.D. WiLi1AM J. WANLEssS, M.D. WiLu1AM H. Jerrerys, M.D. Pau, W. Harrison, M.D. RutH Hume, M.D. Epwarp H. Hume, M.D. PRESENTED AT THE THIRD ANNUAL MEETING IN KANSAS CITY, MO., JANUARY, 1914, PUBLISHED IN THE THIRD ANNUAL VOLUME OF THE PUBLICATIONS OF THE BOARD. REPRINTED MARCH 19, 1918. Board of Missionary Preparation 25 Madison Ave., New York City THE QUALIFICATIONS AND PREPARATION OF MEDICAL MISSIONARIES AND NURSES In their study of the material from which this report has developed, the committee have had in mind prospective can- didates for appointment as medical missionaries, and secre- taries and members of mission Boards to whom these candi- dates may ultimately make their applications. Effort has been made (1) to ascertain what the requisites for effective medical service are from the point of view of the mission field; (2) to outline a definite course of pro- cedure for those who propose to enter this service, and (3) to state the whole case in such a way as to help mission Boards to apply, with practical unanimity, the principles found to represent the consensus of opinion of those quali- fied to speak on the subject. The bases of the report were the following: Report of Commission V of the Edinburgh Conference on the Preparation of Missionaries. Reports of the Council on Medical Education of the American Medical Association. Report on Medical Education in the United States and Canada by the Car- negie Foundation for the Advancement of Teaching, Bulletin Number Four, 1910. Report of the Continuation Committee Conferences in Asia, 1912-1913. Recommendations of the Medical Missionary Association of China. Replies to a questionnaire (see pp. 103-105, Third Report, Board of Mis- sionary Preparation) sent to about one hundred and fifty representatives of the following classes: Medical missionaries in active service. Medical missionaries on furlough or retired. General missionaries specially interested in medical missionary work. Medical practitioners at home. Professors in medical colleges. Secretaries of mission Boards. The report has been cast in a form that will permit its publication as a pamphlet for use by mission Boards in cor- respondence with medical missionary candidates and as a 3 a PREPARATION OF MEDICAL MISSIONARIES guide to such candidates in preparation for their work. It was felt that what was needed was not an elaborate treatise or discussion but a brief compendium of facts, principles, and suggestions that would form a sort of hand-book for the guidance of those interested in medical missions. I. THe RELATIVE PosITION oF MEDICAL MISSIONARY WorK Perhaps no better statement regarding this can be given than that contained in the recommendations of the Medical Missionary Association of China adopted in its Triennial Meeting at Peking, January 13-17, 1913. This, with other recommendations, was presented to the Continuation Com- mittee of the Edinburgh Conference through Dr. Mott, on the occasion of the recent China National Conference held under the auspices of the Continuation Committee: “Medical Missions are not to be regarded as a temporary expedient for open- ing the way for and extending the influence of the Gospel, but as an integral, co-ordinate and permanent part of the missionary work of the Christian Church, as was emphasized in the resolutions passed by the Shanghai Conference of 1907.” Il. Tue Atm or MepicaL Misstonary WorkK The aim of medical missions is to assist in the develop- ment of the Kingdom of Heaven on earth through the prac- tice of the gospel of healing, an agency endorsed by Jesus himself. As the Medical Association of China has expressed it, the purpose is “to bring the blessings of healing to the souls and the bodies of the people.” The triple command is to “preach, teach, heal.” Of the six items mentioned by Jesus in his reply to the messengers of John, five have refer- ence to healing. Medical missions constitute an important part of the social service which the Church is now beginning to perceive is her culminating task in the world’s redemp- tion. PREPARATION OF MEDICAL MISSIONARIES 5 III. Wuo SHouLp ENGAGE IN MEpICcCAL MISSIONARY Work? Only those should undertake this work who are fully qualified for it. Others might render effective service, but mission Boards today cannot wisely appoint those who are not prepared according to the very highest standards of the medical profession. But the medical missionary must also be a Christian man and imbued with the missionary spirit. It is not deemed necessary that he should have a theological training or be as fully prepared for evangelistic work as the ordinary missionary. But he should be so much in sympa- thy with the evangelistic work as fully to appreciate its im- portance, to hold his own work in proper relation to such effort, and to perform consistently his part in helping to realize the object of all missionary endeavor. It would be a mistake to appoint as a medical missionary a doctor who is not prepared in the spirit of Christ to devote himself to the work of his fellow men. It would be an equally great mis- take to appoint those with a strong missionary spirit but without the professional qualifications. “I should prefer a combination of the first-class physician and a moderate evangelist to a good evangelist and a poor physician.” In other words, a medical missionary must be fully qualified to practice his profession, and also have a warm Christian heart and the ability to make his work as physician an effec- tive exposition of the Gospel. While the roster of medical missionaries will reveal the names of men with inferior academic and medical training who have become highly successful missionaries and phy- sicians, the almost unanimous opinion of medical mission- aries themselves is that in the future only men and women of refined tastes, of well-bred manners, of broad culture, of good minds and with the best possible equipment should undertake the life of a medical missionary. 6 PREPARATION OF MEDICAL MISSIONARIES IV. PREPARATION CONSIDERED NECESSARY FOR MEDICAL MISSIONARY CANDIDATES BEFORE THEY ENTER MEDICAL COLLEGE Every medical school has its own entrance requirements. The American Medical Association, through its Council on Medical Education, is seeking to harmonize these require- ments and at the same time to raise the general standard. The minimum pre-medical preparation suggested by the Council is: “At least a four year high school education, and in addition at least one year of college work, including at least eight semester hours each of physics, chemistry, bi- ology, and German or French.” This suggested require- ment for admission will be found elaborated in a pamphlet entitled “Standards of the Council on Medical Education of the American Medical Association.” * Virtually all who re- sponded to the questionnaire of the Committee favored an even higher standard than that outlined in the foregoing, the majority advocating a full college course before the medical school is entered. There is a strong tendency among medical schools to adopt the full college standard for the matriculates, although it is considered important that phy- sicians should not prolong their period of preparation to such a degree as to cause them to begin their active practice too late in life. If choice must be made, a fifth “hospital year” would be preferable to the last two years in college. The Report of the Carnegie Foundation for the Advance- ment of Teaching urges two years of college as the minimum requirement. The volunteer for medical missionary service should realize the need for better preparation than if he were planning to remain at home. Only a full college course can give him the foundation necessary for his future studies and work. 1 Address The Secretary, 535 North Dearborn Street, Chicago, Illinois. PREPARATION OF MEDICAL MISSIONARIES 7 A large proportion of the responses emphasized the im- portance of giving special attention to Latin, German and French during the academic course, both from the point of view of the requirements of the medical course to be under- taken and the study of the language of the mission field to which the missionary may be assigned. The study of pho- netics also is advocated as a great aid to the ready acquire- ment of languages. To this may be added a course in peda- gogy. (See XI.) The Medical Missionary Association of China, at their meeting in February, 1913, adopted the following regarding the importance of the work of trans- lation, for which, naturally, special adaptation and prepara- tion would be required: “As medical books in Chinese are necessary in order to carry on the instruc- tion in our colleges and to provide medical literature for graduates, the associa- tion would urge on the Missionary Societies the need for arranging that suitable men should devote a large part of their time to the work of translating and preparing such books.” For special suggestions regarding the preparation of med- ical missionaries for other phases of the work, see XI. Fear has been expressed by some that the establishment of too high a standard of education may deter many from undertaking so arduous a task as is necessarily involved in securing full medical training. To a certain extent this may be true. Immediate needs for men may not be so easily supplied by the Boards, but it is believed that in the end it will be found that greater progress has been made and a larger supply of candidates furnished through adherence to a standard that undoubtedly will attract some who now hesitate to accept appointment to an inferior grade of serv- ice, where standards are low and equipment is meagre. The aim should be to lift and maintain at a high level the re- quirements for medical missionary service. Dr. Henry S. Pritchett, in his introduction to the Report of the Carnegie Foundation, 1910, says: 8 PREPARATION OF MEDICAL MISSIONARIES “No members of the social order are more self-sacrificing than the true physicians and surgeons, and of this fine group none deserve so much of society as those who have taken upon their shoulders the burden of medical education. On the other hand, the profession has been diluted by the presence of a great number of men who have come from weak schools, with low ideals both of education and of professional honor. If the medical education of our country is in the immediate future to go upon a plane of efficiency and of credit, those who represent the higher ideals of the medical profession must make a stand for that form of medical education which is calculated to advance the true interests of the whole people and to better the ideals of medicine itself.” Dr. Abraham Flexner, who wrote the report of the Foun- dation, makes this significant comment regarding the rela- tive cost to society (in the case of missionary doctors, the Church) of well-educated physicians and of those that are poorly equipped: “The proper method of calculating cost is, however, social. Society defrays the expense of training and maintaining the medical corps. In the long run, which imposes the greater burden on the community—the training of a needlessly vast body of inferior men, a large proportion of whom break down, or that of a smaller body of competent men who actually achieve their purpose? When to the direct waste here in question there is added the indirect loss due to incom- petency, it is clear that the more expensive type is decidedly the cheaper. Aside from interest on investment, from loss by withdrawal of the student body from productive occupations, the cost of our present system of medical education is annually about $3,000,000, as paid in tuition for fees alone. The number of high- grade physicians really required could be educated for much less; the others would be profitably employed elsewhere; and society would be still further en- riched by efficient medical service.” The fact should not be overlooked that on the mission field the medical missionary will have to depend far more upon his own resources than at home. He will not be able to call in specialists in particular diseases, or experts to perform exceptional operations. He must be a master himself, capa- ble of doing anything that may be required of him. Failure or weakness means much more there than it would here. Confidence not simply in himself but in the profession and the missionary cause will be weakened by the results of the lack of knowledge or professional skill, As already indi- a a - PREPARATION OF MEDICAL MISSIONARIES 9 cated, the medical missionary will need an even higher de- gree of preparation for foreign work than for work at home. V. CuHoIcE oF A MEpDICAL SCHOOL Obviously the mission Boards are not in a position to de- termine what schools are standard. They can do no less, however, than accept the judgment of such a body as the American Medical Association and appoint missionaries only from those schools that maintain an agreed standard. The Council on Medical Education has classified the medical schools of America as follows: Class A Plus—Acceptable Medical Colleges. Class A—Colleges lacking in certain respects, but otherwise acceptable. Class B—Colleges needing general improvement to be made acceptable. Class C—Colleges requiring a complete reorganization to make them ac- ceptable. Men and women proposing to invest their lives on the mission field cannot afford to jeopardize their work because of imperfect training in an inferior school. Candidates should consult with their respective Boards before selecting a school in which to conduct their studies. It is definitely recommended that only graduates from Class A Plus and Class A schools or those from the corresponding classes in- dicated in the report of the Carnegie Foundation should be appointed medical missionaries. VI. THe MepicaLt CouRSsE There is practically unanimous testimony on the part of those consulted that no one should be appointed to medical missionary service who has not had at least four years of professional training. A majority favor a course of five years. In regard to this point, also, a few fear that with so high a standard the needs of the field will not be adequately 10 PREPARATION OF MEDICAL MISSIONARIES met. This may be true so far as mere numbers are con- cerned, but the ultimate results of the adoption of the higher standard must be better than would be possible under the lower. All agree, also, that the regular course should be followed throughout without deviation for special studies that might seem better to fit candidates for their work. To the regular medical course certain additions may profitably be made. (See VII.) In this connection reference may appropriately be made to the question of some medical training for non-medical missionaries. It may be assumed that everyone applying for missionary appointment will at least have acquired what is now generally taught in the public schools regarding physi- ology, hygiene and first aid to the injured. In addition to all this the non-medical missionary, especially if he has apti- tude for it, may very profitably do some reading along medi- cal lines, preferably under the guidance of a physician friend. Better still, he might take a brief special course of lectures and training in subjects relating to the care of health and the treatment of minor ailments and injuries. Such a course of preparation will be found especially helpful to mis- sionaries who are to be located in frontier stations and in sections such as are to be found in Africa, where physicians and hospitals are either very few in number and widely scat- tered or lacking altogether. It should be clearly understood that these suggestions are not offered to encourage prospec- tive medical missionaries to substitute a short-cut prepara- tion for full medical training, but to call the attention of others to the desirability of having this additional equip- ment. Candidates for appointment to other than medical work will do well to take up this question in correspondence with their respective mission Boards. PREPARATION OF MEDICAL MISSIONARIES 11 - VII. Suspyects To Wuicu SpeciAL ATTENTION May PROFITABLY BE GIVEN Mission fields differ greatly in their conditions and the demands they impose upon those who serve in them. Defi- nite consideration should be given to special equipment which may be needed in particular cases. Information re- garding this can be obtained through the mission Boards. The following list of subjects will serve as a general guide. The items are arranged in the order that expresses the aver- age judgment of medical workers: Class A. 1. Surgery. 2. Tropical diseases. 3. Obstetrics. 4. Diseases of women and children. 5. Stomach and bowels. 6. Respiratory organs. 7. Skin. 8. Eye. 9. Ear, throat, nose. Note—Nos. 3 and 4 are especially urged for women physicians. To the above is added a supplementary list in which some items are comparatively new, as details in a missionary’s equipment. They are, however, rapidly increasing in im- portance. Class B. . Microscopy and bacteriology. . Preventive medicine. . Hygiene. . Sanitation. . Pharmacy. . Dentistry. . Orthopedics. Caution.—The foregoing list and others which follow contain many items to answer the questions of many people. Obviously no one can specialize in all subjects. With this broad outline of desirable equipment and possible needs one can better map out a course of preparation than if an average or minimum list were suggested. Good advice would be: Choose those subjects which seem to be essential and prepare in them as fully as possible; secure such additional equipment as previous training, tastes, and opportunity may indicate. NA Oh WD te PREPARATION OF MEDICAL MISSIONARIES There is unanimous conviction that every medical mission- ary candidate should, after graduation from medical school, act for at least one year (two are preferred by many) as an interne in some good hospital. A general hospital is better for both men and women condidates. VIII. Wuen SHOULD SPECIAL ATTENTION BE GIVEN TO THE SUBJECTS MENTIONED IN CLASSES A AND BIN SECTION VII? It may be difficult in most cases for the student to do spe- cial work in any department during his medical course; still, if his decision be made before he enter the course he can doubtless, with the suggested schedule before him, favor to some extent the subjects mentioned. In a majority of cases extra time will have to be given to these branches after com- pletion of the regular course. There is difference of opinion among those consulted as to when and under what circumstances this postgraduate specialization shall be undertaken. Some claim that during the two years of interneship all that is necessary can be ac- quired. Others believe that in certain branches, particularly tropical diseases, a definite postgraduate course should be attended. Still others hold that the best plan is to postpone all graduate work, exclusive of a year or two of interneship, until the first furlough period, when the missionary will be able to judge from his own experience what he most needs. Advice on this point should be sought by the new worker from those already on the field and from the Board at home. IX. LicENsE To Practice MEDICINE Every appointment to medical missionary service should be conditioned upon the passage of an examination by an examining board of some State or other authority. This is important both in the interests of the missionary’s standing PREPARATION OF MEDICAL MISSIONARIES 13 and as a protection to him in case he should be compelled to relinquish his work abroad and take up permanent practice in the homeland. X. BEGINNING WorK ON THE FIELD Under this head three questions have been asked: (1) Shall additional study be undertaken in hospitals on the field before medical missionaries take up their regular work? The opinion is expressed that this is neither neces- sary nor practicable. (2) Should the physician newly arrived on the foreign field spend some time under the direction of an experienced medical missionary before being put in charge of a hospital or assigned to the care of the medical work of a station? The majority seem to favor such a plan where practicable, but a lack of workers has rendered it impossible in most cases to follow the course indicated. (3) Should medical missionaries have equal opportunity with other missionaries for the study of the language? The answer to this question is obvious. All agree as to the very great importance, not only of affording opportunity for such study, but, in view of the peculiar temptation he will undergo to devote his whole time to the practice of his profession, that special provision should be made to insure to him this opportunity for language study. Until the language is learned its pursuit should be considered the first and most important duty. While engaged in this study the new re- cruit may practice his profession with moderation and ren- der such other assistance in the station as his time and strength will permit. It will be unnecessary for all physicians to go deeply into that literary study of the language that is expected of the ordained man, the educationalist, and the translator. On the other hand, the language study required of the medical 14 PREPARATION OF MEDICAL MISSIONARIES worker should deal in a thoroughly satisfactory way with technical language connected with the profession, and should also secure fluency for ordinary conversation and finish for social relationships. Mission Boards or their language com- mittees on the mission fields should provide special courses of language study for physicians. XI. PREPARATION IN OTHER DEPARTMENTS THAN MEDICINE The extent to which prospective medical missionaries shall prepare in other departments than medicine depends to a large degree on the answer to the question as to how much will or should be required of them in other forms of service. Wide difference of opinion prevails as to the medical mis- sionary’s relations to these departments and the amount of time, if any, he should give to them. These opinions vary from ‘Give attention to all in a general way” to “No time for any.” The enthusiast in behalf of medical missions, be- lieving in the co-ordinate character of the ministry of heal- ing, feels that if the medical practitioner performs his pro- fessional work well he has done all that could reasonably be expected of him. The evangelistic missionary, on the other hand, is inclined to believe that the mere practice of medicine is not and cannot be made sufficiently missionary in charac- ter to warrant the relief of a doctor from a definite share in other forms of activity. The fact is, there is no conflict here. Several fundamental principles should be laid down. (1) Only those should en- gage in missionary work, whether evangelistic, educational, or medical, who are called to be missionaries (see III). (2) Everything done in any department of the work should be definitely missionary in character, the expression of a mis- sionary purpose. (3) Economy and efficiency require that the major part of a missionary’s time and strength should PREPARATION OF MEDICAL MISSIONARIES 15 be devoted to that phase of the work for which he is best suited and for which he has made special preparation. If a missionary in one department is compelled to have oversight of other departments, it may follow that his principal task will be neglected; but a reasonable participation in the work of other departments will not only be to the advantage of these other departments, but help him personally as well. Such participation will keep him from developing a narrow or unsympathetic attitude. Furthermore, one may have the experience and ability to make a substantial contribution, in the way of counsel at least, regarding work in which he does not profess to be an expert. This would apply with equal force to missionaries in other departments as to their atti- tude toward medical work and workers. (4) The spirit of Christian fellowship and helpfulness, the importance of co- operative action, the need for unity in making plans and in the administration of the work alike demand the recognition of mutual relationships and responsibilities. The four departments of work to which additional prep- aration will enable him to contribute are: (1) Evangelistic; (2) Educational; (3) General oversight of churches, schools, etc.; (4) Miscellaneous station work and problems. He will certainly give special attention to the health of the other members of the station force, and will naturally find a place on the building and other committees for the oversight of practical affairs. The branches in which this preparation may be secured are as follows: (See Caution on page 11.) (1) The Bible, that he may be able to teach it. (2) Practical Christian work, that he may most tactfully lead men and women into a new spiritual life. Too much emphasis cannot be placed on the importance of the two subjects just noted. As to the Bible, the mission- ary should have a first-hand acquaintance with it as a source of power; an up-to-date knowledge of Bible interpretation 16 PREPARATION OF MEDICAL MISSIONARIES that will keep him from narrow or too literal views; a broad knowledge of its relations to modern thought that will help in bringing it to bear on the characteristic problems of the present day; an ability to teach the Bible effectively, which is not necessarily involved in the most thorough scholarship and which can be developed only through practice. Referring to practical Christian work the physician may do very little if any preaching; he may not engage in teach- ing, but his chief justification for being a missionary is that he is a representative of Jesus Christ. He cannot properly represent Him unless he knows Him and he cannot know Him without some knowledge of His word. It is not pri- marily a question of engaging in the more formal work of evangelization; it is a question of being, of living. It is not a question of knowing Christ in order to do something to some one, but of knowing Christ so that Christ is in the mis- sionary, a vital, living force of his being. With reference to this important matter, Dr. W. J. Wan- less of India said this at the Edinburgh Conference: “As to their spiritual training, it is desirable that every medical missionary should know Christianity, but it is very much more important that he should know Jesus Christ, that he should have had vital dealings with Jesus in his own life as his own personal Saviour, that he should have had some personal experi- ence of leading others to a knowledge of Jesus Christ. Every medical missionary should be prepared to take charge of the evangelistic work of his own hospital. It is not necessary that he should do it all, but he should be the one who is most interested in it. He is the one who should plan it, and he is the one who should take a very large part in it at all events.” (3) Psychology, that he may properly judge human nature and be able better to get on with his associates. (4) Sociology, that he may better appreciate and more readily help solve the social problems of the people. (5) Pedagogy, that he may most helpfully instruct his assistants and, if necessary, teach in a medical school. (6) History of Religions and Comparative Religions, that he may better understand the nature of the missionary’s task. (7) Church History, that he may know how best to help direct the organ- ized life of the churches. Dr. W. H. Jefferys of China, one of the most successful PREPARATION OF MEDICAL MISSIONARIES 7, medical missionaries, who is in charge of one of the largest hospitals, mentions three forms of repeated failures in medi- cal missionaries: “(a) They are not good doctors. (b) They are poor getters-on with their fellows and the natives. Given a good, sensible man, a knowledge of psychology will do the rest. (c) They are trying to stand for something they are supposed to have but do not possess—vital faith in the incomparable Jesus, a life in Him, a devotion to Him.” The following additional subjects have been suggested: (1) Sanitary engineering. (2) Hospital construction. (3) Hospital management (administrative work). (4) Bookkeeping. (5) Photography. (6) Public speaking. (7) Information or training in any mechanical pursuit. (8) Domestic Science (for nurses). One correspondent urges that “we must be careful not to make the candidate study so many things for so long a time that he may die before he reaches the field.” If the only choice were between poorly equipped missionaries and the non-evangelization of the world there would be occasion for pause in urging broad preparation, but such is not the case. Undoubtedly enough men and women can be induced to enter the work on the higher basis, and hence with more power to accomplish results, to more than offset any loss in mere numbers of workers. The true student, the candidate who has put his hand to the plow, will not be deterred by an array of possible or desirable additions to his equipment, but will resolutely set himself to the task of acquiring as many of these as his circumstances will permit. He will wisely seek counsel from the officers of some mission Board and lay out a course of action that for him will be best. Arbitrary rules to cover all cases cannot be laid down. (Note Caution on page 11.) Obviously some of the courses suggested are more impor- 18 PREPARATION OF MEDICAL MISSIONARIES tant than others. Sufficient knowledge of some of them will already have been acquired through specialization during the college course. A definite line of private reading would fur- nish all that would be desired in other cases. Since the majority of volunteers come from Christian homes or have had opportunity for Bible study and Christian work in their churches, colleges, Christian Associations or elsewhere, a foundation will have been laid for future Bible study and evangelistic effort. While, however, much knowledge of these and other subjects can be gained in connection with the pursuit of principal courses, definite plans, regular courses, and a fixed goal are to be preferred in each case. A theological course is not necessary for the medical mis- sionary, but a year or two spent in a missionary or Bible training school is very desirable; otherwise well planned courses in the subjects mentioned should be followed in con- junction with the medical studies. The fact is of course appreciated that a medical student could profitably give his entire time to his medical course; but it must be continually remembered that he is to be more than a physician—he is to be a missionary and hence his preparation should include more than medicine. The demand for the establishment of medical schools on the mission fields for the training of doctors and nurses emphasizes the importance of teaching as a function of the medical missionary. The China Medical Association ex- pressed themselves as follows on this point: “(1) That in establishing medical colleges and hospitals our sole object is to bring the blessings of healing to the souls and bodies of the people of China, and to give a thorough training in medicine and surgery to young men and women of education and intelligence, enabling them, as fully qualified doctors, to be of the highest service to their country. “(2) That we have no desire to create permanently foreign institutions, and that our aim and hope is that these medical colleges will gradually and ultimately be staffed, financed and controlled by the Chinese themselves. “(3) That we are desirous of bringing our teaching work into line with the regulations of the Ministry of Education, and in all ways to co-operate with PREPARATION OF MEDICAL MISSIONARIES 19 and assist the government of the republic in medical education, so that a strong and thoroughly equipped medical profession may be established in this great land.” It is desirable, therefore, that candidates should give some consideration to their qualifications for teaching, not only keeping this in mind during the pursuit of their medical studies but also taking such training for teaching as may be found practicable. While not all will become professional teachers, all who have fitness for the work of instruction will find abundant opportunity to engage in it. Obviously it will not be necessary or wise for all medical missionaries to take a course in pedagogy, but those who have a special gift for teaching or who are likely to be designated for this work in medical schools should secure this preparation. XII. Tuer PREPARATION OF NURSES In general it may be said that many of the suggestions contained in the first part of this report apply with equal force to nurses. A four year high school course should be considered a minimum educational preparation. This should be followed by a nurses’ training course of at least three years. One of the leading medical educators in America, herself formerly a missionary, says: “Nurses should be well grounded in their profession, should have held executive positions at home and should have good general culture, that they may prove acceptable members of the social circle of the mission.” They should also have reasonable grounding in the items mentioned in the first list in section VII. Nurses, like medical missionaries, need better training for work abroad than for work at home. More and more the task of the trained nurse in mission fields will be to train native nurses and to act as superin- tendents of hospitals. This fact emphasizes the need for superior training in her profession, and also in subjects re- lated more particularly to the spiritual side of the work. 20 PREPARATION OF MEDICAL MISSIONARIES The work of the nurse is co-ordinate with that of other missionaries and forms an essential and permanent part of the Christian program. She is responsible not only for the training of the native nurses and thus must have good ped- agogical preparation, but she must be the executive to carry out the plans and orders of the medical missionary in charge, or, if she herself be superintendent, of the best, up-to-date plans for the conduct of a hospital. Thus she should have the training for independent leadership and also for the exe- cution of the detailed plans of another. Her close contact with the developing young native womanhood gives her rare opportunities. As medical missionary work becomes more highly specialized, the nurse will be in greater demand and her preparation will of necessity need to be with greater specialization. PUBLICATIONS OF THE BOARD The First Annual Report (1911) Of historical value, giving full details of the first year of organization. Paper, price 25 cents, postpaid. The First and Second Annual Reports (1911, 1912) A few copies bound in one volume. Valuable for completing sets. Paper, price 50 cents, postpaid. The Third Annual Report (1913) Rich in suggestions concerning the special training which evangelistic, educational, medical, and women missionaries should seek. It also con- tains a report on the use of the missionary furlough, a list of the institu- tions which offer special courses for candidates, and suggestions of valu- able courses of reading. Paper, price 25 cents, postpaid. The Fourth Annual Report (1914) Containing reports on preparation for different fields, such as China, India, Japan, Latin America, the Near East and Pagan Africa. It also includes full reports of the two important Conferences on Preparation of Ordained Missionaries and Administrative Problems. Paper, price 50 cents, postpaid. The Fifth Annual Report (1915) Including the reports of the two important Conferences on Prepara- tion of Women for Foreign Service and Preparation of Medical Mission- aries. Paper, price 50 cents, postpaid. The Sixth Annual Report (1916) Containing, besides the report of the Annual Meeting, the full report of the important Conference on Educational Preparation. Paper, price 50 cents, postpaid. The Seventh Annual Report (1917) Containing the minutes and proceedings of the Annual Meeting. Paper, price 25 cents, postpaid. CONFERENCE REPORTS The Report of a Conference on the Preparation of Women for Foreign Missionary Service. Paper, 25 cents. The Report of a Conference on the Preparation of Medical Missionaries. Paper, 25 cents. The Report of a Conference on the Preparation of Ordained Missionaries. Paper, 25 cents. The Presentation of Christianity in Confucian Lands. Paper, 50 cents. The Presentation of Christianity to Hindus. Paper, 50 cents. The Presentation of Christianity to Moslems. Paper, 50 cents. REPRINTS OF SPECIAL REPORTS Preparation of Ordained Missionaries (revised). 10 cents. Preparation of Medical Missionaries (revised). 10 cents. Preparation of Educational Missionaries (revised). 10 cents, Preparation of Women for Foreign Service (revised). 10 cents. Preparation of Missionaries Appointed to China. 10 cents. Preparation of Missionaries Appointed to India. 10 cents. Preparation of Missionaries Appointed to Japan. 10 cents. Preparation of Missionaries Appointed to Latin America. 10 cents. Preparation of Missionaries Appointed to the Near East. 10 cents. Preparation of Missionaries Appointed to Pagan Africa. 10 cents. iti " aN Mine me ne a ie {vt dha “Nd i Te cals