458 



SCIENCE 



[N. S. Vol. XXVI. No. 667 



sional education in the United States, and 

 make recammendations for its improve- 

 ment. The council has held three confer- 

 ences, the last one of which was in Chicago 

 in April. 



An important feature of this conference, 

 which was attended by eighty-four dele- 

 gates from various schools, societies and 

 examining boards, were the reports made 

 by the chairman, Dr. A. D. Bevan, and the 

 secretary. Dr. N. P. Colwell, on the re- 

 sults of a personal inspection recently 

 made of the one hundred and sixty medical 

 schools of the country, with respect to their 

 facilities for doing the work for which they 

 are chartered. Many of these schools were 

 found to be sadly lacking in everything 

 considered essential in an educational insti- 

 tution, and exist merely as commercial 

 ventures. It may be safely said that fully 

 one half of our medical schools have no 

 moral right to exist. Some of these are an 

 actual menace to the public good. The re- 

 port of the chairman took up also the ques- 

 tions of curriculum and standards in medi- 

 cal education. It emphasized the fact that 

 the most serious problem confronting the 

 schools of medicine in this country to-day 

 is that of the entrance requirements. 

 Various recommendations for the advance- 

 ment of these were made. 



Leaving out of consideration the fraudu- 

 lent commercial concerns masquerading as 

 schools or colleges of medicine, it can not 

 be questioned that many of the really 

 meritorious institutions are attempting to 

 do more in four years than can be suc- 

 cessfully accomplished with the student 

 body as now constituted. In the last two 

 or three decades scientific medicine has 

 made enormous strides, and the majority of 

 entering students are not properly equipped 

 to take advantage of all that is oiJered 

 them, especially in the newer pathology 

 and etiology. The developments in physio- 

 logical chemistry and bacteriology have 



brought new ideas into the science, and to 

 comprehend them, and make practical use 

 of them the young man beginning the study 

 of medicine must bring to his work a far 

 better preparation than was thought neces- 

 sary ten or fifteen years ago. It has fre- 

 quently been suggested that in order to 

 give more time for this training a fifth year 

 should be added to the medical curriculum ; 

 in other words, the course should be made 

 to cover five years in place of four, and in 

 the freshman year the work should be 

 wholly scientific. In principle this sug- 

 gestion is not bad, but, unfortunately, few 

 medical schools seem willing to accept it. 

 On the other hand, the great majority of 

 medical teachers insist that the work of the 

 medical school should be in the line of 

 professional, and not preparatory, study, 

 and that all really general or preliminary 

 work should be done before the medical 

 school is entered. The extent of this pre- 

 liminary work is now the problem to settle. 

 An ideal condition would seem to be this, 

 that the student should complete a four 

 years' course for the bachelor's degree be- 

 fore taking up the medical course of four 

 years, but few institutions are prepared to 

 make such a requirement, and the situation 

 in Johns Hopkins Medical School and Har- 

 vard Medical School can not be duplicated 

 elsewhere in this country for some years. 

 In fact, it is often asserted that the con- 

 ditions of medical study in these schools 

 are not the ideal conditions, and although 

 excellent, are not in every way desirable. 

 This view, which I may say I do not fully 

 agree with, is based on certain facts which 

 must not be lost sight of. These are some 

 of the facts : It is everywhere apparent that 

 the most highly educated physicians are 

 not always the most successful in the prac- 

 tical treatment of disease. Over-education 

 creates in many men a sort of therapeutic 

 skepticism which is a decided drawback in 

 every day practise. In spite of our great 



