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1.  Medicine or Science—A Study of Career Decisions 
Canadian Medical Association Journal  1967;96(14):1009-1018.
A study of the career decisions of all students in a single matriculation cohort was undertaken in 1965 at the University of British Columbia. Studied were 64 premedical students, 112 ex-premedical students and 87 science students who had completed at least their second year. It was found by means of a questionnaire that medicine remained the career of high prestige for the three groups of students. In general the values and needs of the ex-premedical student were more similar to those of the science student than the premedical student. The loyalists to medicine were found to be more committed, self-assured, and orientated towards people and service. In addition, the premedical student was more concerned about his academic achievement but was also more confident of his progress. He emerged at the end of his training as the committed student who had chosen medicine at an early age and had remained loyal to his chosen career goal.
PMCID: PMC1922737  PMID: 6020547
2.  Selection of Medical Students 
PMCID: PMC1922725  PMID: 20328877
3.  Use of a Hospital Emergency Service by Children and Adolescents for Primary Care 
This study was planned to determine the extent to which the emergency service of a large general hospital in Vancouver was providing a primary medical care function for children and adolescents. The data were collected during 14-day study periods in each season of the year. Medical data and physician urgency rating were obtained on all patients. Demographic and socioeconomic data and data pertaining to patterns of medical care were obtained by interview of a one-third sample.
The study identified a group of patients receiving primary medical care for non-urgent and non-traumatic conditions. This group resided close to the hospital and had lower socioeconomic indices than the remainder of the patients.
The trend to utilize the emergency department for reasons other than the accident and emergency function was confirmed. These findings will be incorporated in the planning of the New Children's Hospital in Vancouver with the provision of separate facilities for the care of non-urgent attenders.
PMCID: PMC1946299  PMID: 5348492
6.  Some Observations on Attrition of Students from Canadian Medical Schools 
Students who entered their freshman year for the first time in 1958 and in 1959, from all medical schools in Canada, and those entering the four Western schools in 1960 were studied from the time they matriculated until they either graduated or withdrew from medical school. The rate of attrition is about 15% of matriculants each year, with the lowest rate at the University of Western Ontario (1.7%) and the highest at the University of Ottawa (33.6%) over the time period studied. Attrition was classified as academic and non-academic. Significantly higher rates were found in the case of non-academic attrition for women and in the case of academic attrition for Commonwealth students. Significantly higher rates for both types of attrition were found for older students and students who had attended undergraduate colleges different from their medical school colleges. It would appear from available statistics that the factors which combine to produce attrition are the intellectual and personality characteristics of the student, school promotional policies and evaluation methods.
PMCID: PMC1936080  PMID: 6019678
7.  The Selection of Medical Students in Western Canada 
The methods employed in the selection of medical students for the 1964-65 class of freshmen at the four Western medical schools are described and recommendations are made for improving the procedure. The structure and functions of the various selection committees varied from school to school but their prime purpose was the same—the selection of “good students” who would later become “good physicians”. Not surprisingly, academic achievement and confidence in estimating this ranked highest in importance, and while non-intellectual characteristics ranked almost as high, committee members had no confidence that they could evaluate these qualities.
It is suggested that the ideal selection committee would be a “high-priority” committee consisting of six to eight members who would meet at least twice a year, have tenure of at least four years, be trained in interviewing applicants, consider Medical College Admission Test scores, review applications before each meeting, and establish research committees to investigate the students they choose.
PMCID: PMC1936007  PMID: 6019963
8.  Applications and Enrolments at the Western Medical Schools 
Canadian Medical Association Journal  1966;95(26):1368-1374.
All applicants and those who subsequently enrolled for the 1964-65 session in the Western medical schools were studied with the hope that it would encourage a national registration of applicants. Seven hundred and sixty-four applicants completed 865 applications for 288 places in four schools. Although the principal factor in selecting medical students in all Western schools is pre-medical performance, 49 “good-quality” (academically of good standing and under 30 years of age) resident applicants were not accepted in their own provincial school, and 49 places were filled with “poor-quality” students.
The loss of good applicants to the Western medical schools and the 20% overlap of each school's applicant pool with that of other schools suggests that objective standards of quality must be developed, and that a regular annual national assessment of applicants should be conducted by the Association of Canadian Medical Colleges.
PMCID: PMC1935886  PMID: 5928536
9.  The Response of Physicians to a Mailed Questionnaire 
Canadian Medical Association Journal  1966;95(25):1301-1306.
During 1965, 1585 questionnaires were sent to physicians in British Columbia, Manitoba and Ontario to elicit information about persons who had died and in whom a chronic non-specific respiratory disease had been recorded on the registration of death. The response rate to the first letter of enquiry was 54.1%. This was improved to 76.5% when the enquiry was sent by registered mail, and to 90.6% by a registered special appeal. The final response rate was 93.8% for British Columbia, 92.8% for Manitoba and 89.5% for Ontario. Although response varied with the time of the year, there was no evident relationship between response rate and characteristics of the physician. Physician characteristics studied were place and year of graduation and the nature of practice. Acceptable and high response rates to mailed questionnaires eliciting clinical data from physicians can be obtained if the investigator's concern is demonstrated by sending the request in successive waves to the diminishing group of non-respondents.
PMCID: PMC1935852  PMID: 5928528
10.  The Incidence of Illness Among Young Children in Two Communities of Different Air Quality: A Pilot Study 
An epidemiological study of illness, causing an absence from school of grade one pupils, was conducted from January to June 1965 at two west coast areas, in order to study the community health effects of emissions from a large kraft pulp mill. Enquiry was made by telephone or home visit for each of the 2084 absences experienced by the 752 pupils and the symptoms, duration of illness, physician attendance and hospitalization were determined in each case. A series of indices of disease incidence and duration were prepared to account for school transfers and different communicable disease attack rates. In general the results were non-conclusive: the incidence of all illness and respiratory illness in the control community of Berryville lay midway between that of the two towns, Seaview and Upper Seaview, which comprised the study community; certain conditions, notably tonsillectomy, inflamed eyes, headache, feverishness and nausea, were, however, more frequent in the polluted area.
PMCID: PMC1935696  PMID: 5921749
11.  The Epidemiologist's Dilemma 
Canadian Medical Association Journal  1965;93(19):1019-1027.
Canadian epidemiology is currently in transition from being primarily interested in infectious disease to becoming active in investigating causes of non-infectious disease. Generally, epidemiologists limit their work to “field”, “basic”, or “theoretical” epidemiology. In all three fields there appears to be a shortage of qualified personnel which is likely to become even more acute because of new roles that epidemiologists will probably play in the future. A minimum of 40 full-time epidemiologists is currently required in Canada.
Departments other than departments of preventive medicine at medical schools and teaching hospitals are currently spending 79.5% of all funds allocated for non-microbiological epidemiological research in Canada. Since epidemiology is by its very nature population orientated, rather than clinically orientated, clinicians require consultative advice from epidemiologists at many stages of their research. Epidemiological facilities in departments of preventive medicine should therefore be strengthened in order to provide research training and didactic courses needed as the numbers of physicians, nurses and paramedical persons are increased.
PMCID: PMC1936459  PMID: 5831481
12.  The Chilliwack Respiratory Survey, 1963 
Canadian Medical Association Journal  1965;92(19):1007-1016.
The prevalence of chronic respiratory symptoms and of abnormalities in pulmonary function was determined by a survey of persons, aged 25 to 74, residing during May and June 1963 in a rural town, Chilliwack, B.C. Morning phlegm was reported by 26% of men and 13% of women. Chronic bronchitis was considered present in 21.5% of men and 11.3% of women. More serious obstructive lung disease, not related to heart disease, was found in 12.6% of men and 8.7% of women. These prevalences were higher than those found by the authors at Berlin, New Hampshire, U.S.A., in 1961. Demographic factors, such as birthplace, occupational class and measures of social stability, were not related to the prevalence of respiratory disease at Chilliwack. Some observer variation was found after analysis to be the result of non-randomization of respondents among the observers. An incidental observation was a high prevalence at Chilliwack of heart disease and hypertension under treatment.
PMCID: PMC1928461  PMID: 14282155
13.  The Chilliwack Respiratory Survey, 1963 
Canadian Medical Association Journal  1965;92(20):1066-1076.
Chronic non-specific respiratory disease was found by a survey at Chilliwack, B.C., to affect 29.3% of men and 18.0% of women between the ages of 25 and 74. The habit of current cigarette smoking was found to be the most important single factor associated with respiratory disease, and was found to be related to changes in simple measures of lung function. The authors were unable to confirm the existence of a threshold in lifetime cigarette smoking before respiratory disease occurred.
Comparisons were made with a population previously studied at Berlin, New Hampshire, U.S.A., in 1961. At Berlin, where pollution by SO2 and dust-fall had been thoroughly documented, the comparable prevalence rates for respiratory disease were 40.0% for men and 21.6% for women. When differences between the two populations as to age and number of cigarettes smoked daily were taken into account, the disease rates in these two communities were found to be quite similar. The Chilliwack sample did, however, have significantly higher values for the lung function tests.
PMCID: PMC1928278  PMID: 14281089
14.  The Chilliwack Respiratory Survey, 1963 
A study of the quality of the ambient air at Chilliwack, British Columbia, was conducted from May 1963 to April 1964. Measurements of dustfall, soiling, sulfation, hydrogen sulfide, oxidants and total hydrocarbons were made by a network of five sampling stations. The results of this survey indicated that Chilliwack was relatively free from any air pollution and would therefore be a suitable control for a study of the relationship between community air pollution and respiratory disease.
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PMCID: PMC1928025  PMID: 14285287
15.  The Premedical Student: His Progress 
Since September 1961, a prospective study of premedical and science students has been conducted at the University of British Columbia. On completion of their sophomore year, after a year of changes from one group to another or withdrawal from either group, only 82 students existed in the diminished Premedical cohort while 137 students existed in the augmented Science cohort. These two groups have now become similar demographically, and their academic potential, as indicated by achievement and ability tests, has also become similar in terms of their mean test scores. In academic performance the present Premedical cohort has displayed some superiority over the Science cohort in high school, freshman and sophomore years. The sophomore premedical mean grade was 66.0% compared with 63.7% for the Science cohort. The hypothesis is developed that these findings reflect a difference in motivation, and therefore that perception of ultimate career goals will motivate and affect academic performance of students in their undergraduate years.
PMCID: PMC1928565  PMID: 14278022
16.  “Markings” of a Class 
In 1954 the first class in medicine graduated from the University of British Columbia. This class of 57 men and three women left a statistical trail behind them which began before they entered medical school, and which now has extended 10 years into their professional postgraduate careers. This first class was made up largely of British Columbians of older age than subsequent classes. The overall achievement and aptitude of the class was high, as measured by premedical grades, intelligence tests and Medical College Admission Test scores. Interest tests at the time of admission indicated that the members of the class had major interest levels in the fields of science and social service or humanitarianism. The subsequent medical school performance of the class was exceptional. Of the class, 63.4% interned in teaching hospitals. By 1964 only 53.4% of the graduates were engaged in general practice. Most of the graduates are now practising in British Columbia.
PMCID: PMC1928560  PMID: 14278023
17.  The Chilliwack Respiratory Survey, 1963 
In order to ascertain the prevalence of chronic respiratory disease in residents of a rural town and to determine the relative importance of tobacco smoking and air pollution, a survey was conducted of 726 persons living at Chilliwack, British Columbia, in May and June, 1963. Over 95% of a random sample of adults was interviewed and performed simple tests of respiratory function. The sample was selected from a commercial census. An analysis of the demographic characteristics of the sample indicated that the group, aged 25 to 74 years, was reasonably representative for detailed study of chronic respiratory disease.
PMCID: PMC1928057  PMID: 14289136
18.  The Premedical Student: His Identity 
Canadian Medical Association Journal  1964;91(19):1011-1018.
A prospective study is currently being conducted of students who were freshmen at the University of British Columbia in 1961-1962. Three cohorts are being followed: 136 premedical students, 107 science students, and 136 persons comprising a sample of general arts students. At registration in 1961, the only demographic difference was that the Premedical cohort had a greater proportion of catholics and persons from upper occupational classes. Premedical students generally performed as well in high school as science students and better than general arts students, though the academic potential of science students as measured by achievement and aptitude tests was superior. Premedical students performed better on freshman examinations than the other cohorts, though a significantly larger proportion of science students (84.4%) actually passed into second year than of premedical students (75.0%). A disturbing observation was that by second year the Science cohort had recruited more than enough students to balance its losses, while the Premedical cohort had lost three times as many students as it recruited. The net effect was not much reduced by students who entered directly from senior matriculation or other universities, since these students were about twice as likely to enter the Science cohort as they were to enter the Premedical cohort.
PMCID: PMC1928090  PMID: 14222669
19.  Observations on the Classification and Distribution of Pulmonary Emphysema in Canada 
General principles of epidemiology are reviewed, using as an example the chronic non-specific respiratory diseases in Canada. Lack of agreement in definition and classification seriously hampers the use of governmental statistics to study the epidemiology of these diseases. Though Canada is experiencing a mid-century epidemic of deaths from emphysema, evidence is presented which suggests that provincial variation in this death rate is artificial and is likely apparent because physicians do not categorize deaths from this and related diseases in any similar fashion. Three-year-average age-standardized death rates by provincial areas for emphysema with or without bronchitis, asthma, chronic bronchitis and bronchiectasis are presented in evidence that provincial variation is largely obliterated when all chronic non-specific respiratory diseases are considered as a single nosological unit. Advantages and disadvantages of a recent clinical classification of these diseases are reviewed, and it is concluded that such a classification has a great deal to offer epidemiologists or clinicians studying the cause and natural history of these diseases.
PMCID: PMC1921986  PMID: 14065074
20.  Clinical Studies of Tolazamide and Tolbutamide 
Tolazamide, a new oral hypoglycemic agent, was compared with tolbutamide, a related chemical compound, for stability of control of 12 patients suffering from maturity-onset diabetes mellitus. A short 12-week study was conducted which incorporated a cross-over design and the results were examined by variance analysis after dosage was individualized to the patient's requirements. Greater stability of fasting blood sugar was found on tolazamide; patients also had less glycosuria and lower fasting blood sugar on tolazamide. Tolazamide appeared to be between five and six times as potent as tolbutamide, mg. for mg.
No hepatic, renal, hematologic or symptomatic toxic reactions were observed during the total of 72 person-weeks of tolazamide therapy.
PMCID: PMC1921982  PMID: 14077815
21.  Factors Relating to Academic Performance of Medical Students at the University of British Columbia 
The performance of medical students enrolled at the University of British Columbia from 1952 to 1961 is reviewed and related to certain descriptive factors available to the screening committee at the time of application. Almost 40% of enrolled students had academic difficulty in medical school; 16.4% failed a complete year. Since 91% of students who failed out, did so after freshman medicine examinations, these grades were examined for significant association with certain intellectual and non-intellectural factors. Sex and year of registration were not significantly associated with freshman performance, but permanent home address was: students from other Commonwealth countries did not perform as well as Canadians. Significant correlations were observed between both pre-medical grades and Medical College Admission Test scores and first-year medicine marks. By multiple regression analysis four factors were found to be predictive: age, number of pre-medical years completed at the time of application, overall pre-medical grade average and “Science” M.C.A.T. score. From the resulting equation, 77.4% of the grades of medical students who completed their freshman year in 1962 were predicted within one standard error. Students on the whole were noted to perform consistently in pre-medicine and medicine.
PMCID: PMC1921932  PMID: 14069612
22.  A Decade of Experience with Medical School Applicants at the University of British Columbia 
During the decade 1952-1961, 2060 students applied for admission to the University of B.C. medical school. Only 1664 fulfilled the pre-medical requirements. This cluster of eligible applicants changed in size and characteristics as the medical school grew older; in general, the academic calibre of applicant cohorts improved as mean age fell and length of pre-medical training increased. A decline in the number of British Columbia applicants was to some extent balanced by an increase in other applicants.
Forty-three per cent of eligible applicants were accepted by the screening committee. In contrast to the applicant cluster, freshman classes contained a disproportionate number of B.C. residents. Acceptance, however, was strongly correlated with good pre-medical academic performance and all M.C.A.T. scores except those for “Understanding Modern Society”. Unfortunately, one-quarter of all accepted students withdrew before registration and had to be replaced.
These observations are interpreted in terms of student recruitment and the efficiency of the screening committee.
PMCID: PMC1921505  PMID: 14012835
23.  A Prospectus for Canadian Studies in Medical Education 
The need for factual information on all phases of medical education is widely recognized. In the United States the Association of American Medical Colleges has initiated an extensive program of research in medical education. No comparable program exists in Canada.
On the basis of studies of medical students at the University of British Columbia and the University of Saskatchewan, a prospectus for Canadian studies in medical education is suggested. Such studies might include an annual census of Canadian medical students as well as detailed studies of specific problems. Until such studies have been undertaken in Canada, only an incomplete picture of the various problems in medical education will be available.
PMCID: PMC1921501  PMID: 13966028
24.  Response to a Respiratory Survey 
Respondents to a respiratory survey of Berlin, New Hampshire, residents in 1961 have been studied to assess the relationship between co-operation and respiratory disease prevalence. Two hundred and forty-three unco-operative subjects, interviewed at home, had significantly more morning phlegm and a lower vital capacity than carefully matched subjects who attended the central clinic. Fifty-one volunteers had the same prevalence of respiratory disease symptoms and physiological abnormalities as carefully matched subjects drawn from a probability sample of the city.
It is concluded that respiratory disease prevalence will be underestimated if calculated from studies of co-operative subjects who attend a clinic. Case-finding by respiratory disease screening clinics will also miss many persons who suffer from chronic bronchitis.
PMCID: PMC1921209  PMID: 14012836
25.  Prevalence of Respiratory Disease in a Flax Mill in the United States* 
Studies were made on 161 flax-mill workers at work by means of a questionnaire similar to that developed by the Medical Research Council and by means of simple pulmonary function tests. Air samples were obtained at various working sites. In this group of workers the effect of cigarette smoking as a factor in the production of chronic non-specific respiratory disease far outweighed the occupational exposures to dust or the effect of age in the males. There were insufficient diseased females for statistical analysis.
PMCID: PMC1038194  PMID: 13892584

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