OCTOBEB 22, 1909] 



SCIENCE 



541 



medical activity that for which he is best 

 adapted. 



To the members of the faculty it is evi- 

 dent that to equip students for these vari- 

 ous phases of the medical career, a medical 

 school must possess extensive equipment 

 and large resources to which it receives 

 students with adequate preparation to 

 profit by the instruction offered. During 

 the past five years much progress has been 

 made in elevating the standard of medical 

 education by increasing the entrance re- 

 quirements to our medical schools. There 

 has been much discussion as to the best 

 preparation for the study of medicine. 

 Training in chemistry, physics and zoology 

 with a reading knowledge of French or 

 German are very generally deemed the es- 

 sentials of a satisfactory preliminary prep- 

 aration for medicine, because medicine it- 

 self is very largely a biologic science, using 

 the methods of these other sciences, and be- 

 cause in the study of anatomy, physiology 

 and medical chemistry much time is other- 

 wise consumed in teaching what the stu- 

 dent might readily have learned in college, 

 while the modern languages are needed that 

 the student may utilize more extensively 

 the literature of medicine. Just how much 

 general college training beyond these sub- 

 jects should be required has been largely 

 debated. No one would deny that the bet- 

 ter education the student has before he 

 begins medicine, the more he is apt to profit 

 by his medical studies, yet this may be 

 readily carried to an absurd point since 

 preliminary work consumes time and too 

 much of it would make the period of med- 

 ical study come too late in life. A college 

 course of three, at most, four years, in- 

 cluding work in physics, chemistry, zoology 

 and modern languages and leading to a 

 degree of A.B. or B.S., is at present re- 

 garded widely as an ideal preparation for 

 the study of medicine, but this is open to 

 the criticism that it gives us in the medical 



schools students of too old an average age. 

 Assuming that such a college A.B. or B.S. 

 course is an ideal preparation for medicine, 

 it has already been adopted in several med- 

 ical schools making the period between en- 

 trance to college and the commencement of 

 the practise of medicine a period of from 

 eight to ten years, divided as follows: col- 

 lege three to four years, medical school 

 four years, hospital one to two years. 



At present, after such preparation, most 

 men begin medical practise too late in life. 

 To start them earlier in their life work is 

 one of the great problems before us. This 

 can be done best, I believe, by, in some 

 way, lowering the age of entrance to college 

 —perhaps by changing instruction in the 

 preparatory schools. Another method of 

 lowering this age has been sought in the 

 so-called combined course by which the 

 A.B. degree is awarded at the expiration 

 of four years' work, two years' college 

 work, including physics, chemistry and 

 zoology, and two years' medical work and 

 the M.D. degree at the expiration of two 

 more years, a total of six years instead of 

 seven or eight years for the two degrees. 

 But do not let ourselves be deceived by this. 

 Reduced to plain facts this means two 

 years of college work, including physics, 

 chemistry and zoology, as an entrance re- 

 quirement to the medical school, and such 

 institutions as have the combined course 

 are to be classified in the group of medical 

 schools requiring only two years of college 

 work for entrance unless we attribute some 

 intrinsic educational value to the right ac- 

 quired by the students of adding A.B. after 

 their names— a thing which I take it no 

 one would claim. Rather does it seem to 

 me that these schools have succeeded in 

 rendering the A.B. degree of less value and 

 significance than formerly and have sacri- 

 ficed one or two years of college work while 

 seeking to conceal this fact by the award 

 of the two degrees, A.B. and M.D. In the 



