243 



of these received a diploma at the end of the session, the number of 

 graduates would be 525, or one to every 66,666 of the general popu- 

 lation. 



It is estimated that there are 20 millions of inhabitants in the 

 United States. The number of graduates in 1847, at twenty-four 

 of our medical schools, was 1188, or one to every 16,835 of the 

 population. But these returns are only from about two-thirds of 

 the schools. The annual number of medical graduates in the country 

 cannot be far from 1500, or one to every 13,838 of the population. 

 On the supposition that these calculations approximate to accuracy, 

 it will be perceived that the proportional supply of graduates in 

 medicine in the United States, is five times as great as in France. 

 This, of course, does not include the licentiates and under-graduate 

 practitioners in either country. 



From all these considerations, the inference is inevitable, that our 

 present ratio of supply of medical men is greater than is demanded 

 by the exigencies of the people. 



Whence follows this result, but from the facility with which the 

 medical degree is obtained? In all stages of his progress, the student 

 meets with too few obstructions in his path. 



The fault, therefore, lies primarily with private teachers, inasmuch 

 as the pupil takes his initiative steps with him. Let them commence 

 a reform by exercising greater circumspection in the reception of 

 students into their offices. If they would adopt the recommendations 

 of this Association in regard to preliminary education, and follow 

 them faithfully, or, even much more nearly than they have done 

 heretofore, a great and important progressive movement would be 

 achieved. 



The medical colleges follow next in responsibility. Your com- 

 mittee are well aware that some of the brightest ornaments of our 

 profession are among the teachers in these institutions, and they 

 would readily accord to them all due praise as to a body of learned 

 and skillful men, diligent in their important calling, and ardently 

 desirous to advance the prosperity of the profession. It would, 

 however, be claiming too much for them, to suppose that they are 

 so unlike the rest of mankind as not to be insensibly influenced in 

 their views by their own position, or that, in their zeal for teaching, 

 they might teach too many and receive pupils deficient in that im- 

 portant preparatory instruction, both theoretical and practical, which 

 should be derived from their private instructors. 



Were the preliminary qualifications requisite to an admission into 



