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THE POPULAR SCIENCE MONTHLY 



men. The course is five years, and 

 students probably can gain as valuable 

 an education during this time as in 

 four years wholly devoted to engineer- 

 ing studies. Night schools, extension 

 courses, correspondence schools and the 

 like are all useful, but the plan of 

 working half the time at the university 

 and half the time in practise seems to 

 be superior to any other. There is no 

 reason why the system should not be 

 extended in other directions, as to 

 teachers in the public schools of a city. 

 The University of Cincinnati is cer- 

 tainly to be congratulated on having 

 inaugurated a movement which demon- 

 strates the peculiar usefulness of a 

 municipal university. 



THE ACTIVITIES OF THE CAR- 

 NEGIE FOUNDATION FOR THE 

 ADVANCEMENT OF TEACHING 



The Carnegie Foundation has pub- 

 lished a bulletin on medical education 

 in Europe, prepared by Mr. Abraham 

 Flexner, with an introduction by Dr. 

 Henry S. Pritchett, president of the 

 foundation, which, like its predecessor 

 on medical education in the United 

 States and Canada, issued two years 

 ago, is a document of considerable in- 

 terest. It appears that in the German 

 Empire, in Austria and in France there 

 is about one physician to each two 

 thousand of the population, in Great 

 Britain about one to 1,100, while in this 

 country there is one physician for 568 

 persons. The distribution is naturally 

 such that the supply of physicians is 

 relatively much greater in the cities 

 than in the country districts. This is a 

 difficulty which, as Dr. Pritchett indi- 

 cates, can probably be overcome only 

 by some sort of state support. It is 

 emphasized by the fact that the abler 

 physicians are likely to be drawn to 

 the cities, while it is in the country, 

 where hospital facilities and specialists 

 are lacking, that physicians are needed 

 who are able to meet every emergency. 



Mr. Flexner and Dr. Pritchett hold 

 that the supply of physicians in this 



country is excessive and demoralizing, 

 and place the blame on the large num- 

 ber and low standards of our medical 

 schools. It is not, however, certain that 

 in view of our greater wealth the sup- 

 ply is relatively larger than in Europe; 

 nor is it certain that conditions would 

 be greatly improved by suppressing the 

 weaker schools. If it were possible to 

 select in the right numbers the men 

 best fitted to become physicians and to 

 give them the best possible education, 

 this would clearly be the most desirable 

 state of affairs; but such ideal condi- 

 tions do not obtain anywhere in our 

 complicated civilization. Medical edu- 

 cation is already so prolonged and ex- 

 pensive that if requirements are fur- 

 ther increased the career will be open 

 only to the rich; it seems necessary to 

 train more physicians than are needed 

 in order that the best may be selected, 

 and it does not follow that those who 

 are unable to support themselves as 

 physicians are the worse for having had 

 a medical education. It would be well 

 if more children were born to fit parents 

 and fewer to those who are unfit, and 

 the apostles of eugenics are performing 

 a useful service in preaching from this 

 text. But the Carnegie Foundation 

 places itself in the position of the prac- 

 tical eugenicist who would put unfit 

 parents out of the way. This is a deli- 

 cate and difficult undertaking, which 

 (me is scarcely prepared to entrust to 

 Dr. Pritchett and Mr. Flexner. 



The proprietary schools without 

 proper laboratory and clinical facilities 

 are probably being eliminated about as 

 rapidly as is desirable. The American 

 Medical Association publishes annually 

 a list of those which are inadequate, 

 and the Carnegie Foundation has given 

 wide publicity to the deficiencies of 

 these institutions. Such information is 

 desirable, but it may be that the Car- 

 negie Foundation is not the best agency 

 to exploit it. Thus the foundation re- 

 fused to give pensions to the professors 

 of the University of Illinois at Urbana 

 on the ground that its medical school in 



