542 



SCIENCE 



[N. S. Vol. XXX. No. 773 



combined course two years of work are 

 counted for two degrees, another fact 

 which has brought criticism on the plan. 



It must be remembered, in discussing 

 entrance requirements, that it is not yet 

 proved whether one or two years of college 

 work beyond the two years demanded by 

 many medical schools as an entrance re- 

 quirement is of more advantage than a one 

 or two years ' earlier start in medical work. 

 It is very generally conceded that a knowl- 

 edge of physics, chemistry and zoology and 

 the ability to read French and German 

 medical literature, are very helpful to the 

 medical student of to-day who pursues a 

 quite definite curriculum of study, and this 

 knowledge can scarcely be obtained in less 

 than two years of college work. Beyond 

 this we are still experimenting, and gTadu- 

 ally by comparing graduates under vary- 

 ing entrance requirements we may satisfac- 

 torily solve the problem. It is very impor- 

 tant that this be done, and for this reason 

 I have discussed the combined course and 

 pointed out that it should be classified 

 where it belongs,— i. e., as two years of 

 college work for entrance to the medical 

 school. 



The problem is further rendered com- 

 plex by students transferring from one 

 school to another. A university, in fact, 

 may discriminate against its own students 

 if it requires a degree for entrance, does 

 not give a combined course and accepts 

 students with credit for advanced standing 

 who have had part of a combined course. 

 Under these circumstances a graduate of 

 its own collegiate department must spend 

 at least one, possibly two, more years be- 

 tween college entrance and graduation in 

 medicine than the student transferred from 

 the institution giving a combined course. 

 This actually happens in certain institu- 

 tions. So in the solution of our problem 

 students transferred from one school to 

 another must be carefully classified to 



prevent incorrect deductions from our 

 statistics. 



Making these allowances, we have now 

 very fair conditions, for comparing stu- 

 dents with various preparations, since 

 schools with good medical equipment are 

 making these different requirements for 

 entrance. The evident advantages so far 

 gained by demanding for entrance to the 

 medical school, a college degree with cer- 

 tain specified studies are: a more mature, 

 uniformly trained student easier to teach; 

 a decreased number of students receiving 

 more personal attention, and an increased 

 number of hours available for medical 

 studies gained by the relegation to college 

 of preliminary courses in physics, chem- 

 istry, zoology and botany, formerly in- 

 cluded in some form in the medical cur- 

 riculum. Opposed to these are certain dis- 

 advantages : the relatively old age at which 

 the medical man actually begins his life 

 work; the barring of medicine to men un- 

 able to secure the preliminary education 

 among whom will undoubtedly be men of 

 great potential ability; the possible lower- 

 ing of the standard of country practition- 

 ers, as the college-bred man tends to have 

 an aversion to country life and will leave 

 country practise to graduates of the poorer 

 medical schools which usually keep behind 

 the latter in their demands for preliminary 

 education. To-day the advantages appear 

 to outweigh the disadvantages, though it 

 does not seem advisable were it possible to 

 increase at once entrance requirements in 

 all schools to a college degree. To have 

 done so in certain schools has greatly bene- 

 fited medical education, but the future 

 may show that the pendulum has swung 

 too far or that it has not swung far enough. 

 We must regard the matter as still in 

 the experimental stage and every insti- 

 tution must seek to contribute towards its 

 solution. 



Having determined on a standard for 



