THE PRESENT ASPECT OF MEDICAL EDUCATION. 591 



pally of laymen, and instruction in "First Aid to the Injured "is 

 given to policemen, firemen, and enthusiastic young ladies ! Very 

 many laymen also interest themselves most liberally in the establish- 

 ment and management of hospitals and dispensaries. 



All these activities, directed toward improving the public health 

 and alleviating sickness and suffering, are most gratifying and com- 

 mendable, and call for increasing thoroughness in methods of educat- 

 ing physicians, for, without the co-operation of the public with scien- 

 tific men who devote their lives to the study of these subjects, much 

 benevolent energy as well as time and expense are wasted or misap- 

 plied. Is it not clearly of vital moment that the public for its own 

 protection should see to it, by legislation or other means, that the 

 medical schools of this country are of the highest order ? A dozen 

 well-trained and properly qualified physicians will be of vastly more 

 benefit anywhere than a hundred " M. D.'s " who have slipped through 

 some of our so-called medical " colleges " in the easy manner that is 

 still quite possible. It is disgraceful, and yet it happens constantly, 

 that men are graduated by prominent medical schools or colleges in 

 this country without ever having listened to an abnormal heart- 

 sound, seen a case of measles, or been present at a confinement. 

 " But," it is asked, " why should the general public take any interest 

 in medical education ? Why not let doctors manage their own 

 * shops,' as they always have done, unaided by public support ? " 



The answer is that, so long as a medical college is dependent en- 

 tirely upon the fees of its students for support, the highest educational 

 good can not be attained. The question concerns endowment. A 

 review of a few facts and statistics will demonstrate this need. 



The medical profession in the United States, like many branches 

 of industry, is at present suffering severely from over-repletion. There 

 are more doctors, in proportion to the population, than in any other 

 country in the world. The laws of supply and demand tend to lead 

 many men toward those schools where they can soonest secure their 

 diplomas with least expenditure of time and money (and too often of 

 energy). The schools become overcrowded, and new ones spring up 

 with alarming rapidity. A century ago, with a population of 3,000,000, 

 there were two medical schools. To-day, with a population of 50,000,- 

 000, we have eighty-seven medical schools,* distributed through twen- 

 ty-eight States and the District of Columbia. Of these schools, thirty- 

 nine have been opened within fifteen years, and twenty-one (or about 

 twenty-six per cent) within five years past. With them are associated 

 over 1,300 instructors (many of whom offer their services gratuitous- 

 ly) and over 10,000 students, while about 3,600 new doctors are annu- 

 ally " turned loose upon the community," as the daily press courteously 

 expresses it. Forty-six per cent of the schools offer only a two-years 



* The writer would be understood as referring only to " regular " schools in this arti- 

 cle ; there are very many others. 



