JUNE 21, 1912] 
or chemistry; the physician requires a broad 
knowledge of the general sciences of physics and 
chemistry. 
It is most important to have this state- 
ment of Miiller’s at a time when an effort 
is being made to place physics, chemistry 
and biology in the medical curriculum. 
With or without a fifth year it is a danger- 
ous policy. The experience of one school 
in this regard is enlightening. During the 
period of change from a high school to a 
two-year college requirement, conditioned 
men were cared for by allowing time in the 
first half of the first year to make up condi- 
tions. The procedure took eighteen hours 
a week from the time which should have 
been devoted to purely medical studies. 
In such an emergency as that of a change 
of policy, this was perhaps justifiable, but 
what university school with a four-year 
course can afford this arrangement as a 
permanent policy? And if we are to have 
a fifth year, progress demands that it 
should be a clinical or hospital year, and 
not a preliminary year for work which 
belongs to the college. The modern cur- 
riculum of a first-grade medical school de- 
mands a student’s full time and attention 
and no amount of general culture can make 
up for absence of prerequisites in physics, 
chemistry and biology. The school which 
allows mixed requirements, or low require- 
ments or conditions does so at the expense 
of efficiency; the good men suffer on ac- 
count of the slow progress of the poorly 
trained; the inefficiency of the teaching 
under such circumstances becomes noised 
about, and it comes to pass that the best- 
trained men go to schools which take only 
their kind, and thus eventually low stand- 
ards react on the school allowing them. 
But this is not all. Another factor, the 
state, is beginning to play an important 
part in determining the conditions pre- 
SCIENCE 
947 
requisite to medical education. Five’? 
states have passed laws demanding that 
for license to practise medicine an appli- 
cant must have had two years of college 
work as a minimum requirement, and 
four’? demand one year. This, we must 
admit, is only the beginning. As state 
after state adopts the same ruling, schools 
not demanding such preparatory study 
must see the territory open to their gradu- 
ates (and therefore the territory from 
which they draw students) gradually nar- 
rowed. Certainly, to-day, no school, and 
certainly no university school, can face 
with equanimity, this discrimination; and 
“disappointed indeed will be that student 
who, after having spent a large amount of 
time and money, finds on graduation that 
his diploma is not recognized in a large 
number of states.’’” 
Methods of Teaching.—Within the med- 
ical school itself the matter of educational 
policy is clear. Here there can be only one 
procedure, the constant and consistent em- 
ployment of the ‘‘do it yourself’’ or ‘‘learn 
by doing’’ method; the student must be 
taught to observe, experiment, reason and 
act for himself. This, I know, is trite, but 
the conditions out of which our present 
methods of medical education have emerged 
demand that this point of view be continu- 
ally emphasized. It is not long since the 
day of the two- and three-year course and 
the imparting to undergraduates of all 
medical instruction, outside of anatomy 
and inorganic chemistry, by lecture. The 
development of the laboratory branches, 
histology, pathology, bacteriology, physi- 
ological chemistry and pharmacology—and 
the cheapening of physiological apparatus 
1 Colorado, Indiana, Iowa, Minnesota and North 
Dakota. 
u Connecticut, Kansas, South Dakota and Utah. 
2 Jour, Am. Med. Asso., LVII., p. 1138, 1911; 
LVIIL., p. 487, 1912. 
