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this body last year ; and that years will be required to perfect all 

 which has been there commenced. 



Believing that the foundation of all our projected reform is a more 

 complete education of candidates for the doctorate, your committee 

 wish particularly to recall to the attention of this Association, the 

 resolutions submitted by the Committees on Preliminary Education 

 and the Standard of Acquirements for the Degree of M.D., at the 

 Convention in May last, and recommend farther measures, if they 

 shall be thought necessary, calculated to put the provisions of those 

 resolutions into practical operation. 



Most especially is it suggested, that the fourth and seventh of the 

 resolutions of the committee last mentioned, the former recommend- 

 ing that the certificate of no irregular practitioner shall be received 

 at the medical schools, and the latter urging the importance of cli- 

 nical instruction and attendance upon hospital practice, should be 

 again brought to the notice of the medical faculties of the several 

 institutions. (See Proceedings of the National Med. Convention, 

 &c, p. 74.) 



Before an association like this, it is unnecessary to adduce any 

 argument to prove that a knowledge of practical medicine can only 

 be attained by the agency of practical instruction. The physician, 

 like the artisan, can never become accomplished if he depends upon 

 books and oral instruction alone. The application of his own powers 

 of observation, dependence upon his own judgment and action, are 

 essential requisites, and the sooner his efforts are directed in this 

 course, the more rapidly will his knowledge increase. 



The committee think the private preceptors of pupils in medicine 

 should more generally give this practical direction to their studies, 

 by permitting them, as far as possible, to see the patients under 

 their care, and to witness post-mortem examinations. 



If private preceptors could be induced to adopt this suggestion, 

 the medical faculties of the schools might and ought to require from 

 each candidate for graduation, instead of the customary thesis, a 

 report of a number of cases of disease drawn up by him from his 

 own observation. 



But your committee are of opinion that an adequate course of 

 clinical instruction can only be obtained in hospitals, and that, 

 although the clinics may be advantageously added, they are an 

 inefficient substitute for hospital teaching, for in hospitals only can 

 the progress of disease and the results of medical treatment be ob- 

 served with full benefit to the student of medicine. The hospitals, 



