OCTOBEE 30j 1914] 



SCIENCE 



625 



does not exist anywhere, even in Europe. But, 

 as far as I know, the Johns Hopkins Medical 

 School does not offer its new procedure as a 

 general plan to be used in all other colleges. 

 The Hopkins school follows lines of its own, 

 and with great success. When that school 

 was opened, about twenty-one years ago, the 

 entrance requirements were made very high, 

 indeed higher than at any place in the world, 

 and at a time when most of the colleges in 

 this country had very low requirements. The 

 wisdom of that venture is to-day self-evident. 

 Johns Hopkins Medical School is sending out 

 a high type of medical men into teaching de- 

 partments, into research institutes and into 

 general practise. The part of the plan which 

 does not permit the professor of clinical sub- 

 jects to practise for private gain does not de- 

 serve to be designated as " grotesque," as has 

 been done in the report of the Council on 

 Medical Education. It probably originated 

 in the desire to put the teachers of clinical 

 subjects on a university basis, and thus main- 

 tain a university atmosphere in the medical 

 school, an atmosphere which is essential to 

 the mode of life of the scientific men of that 

 school, and which is readily disturbed by the 

 mode of life of a head of a department " who 

 in a very limited amount of time devoted to 

 practise could obtain for his service much 

 more than the amount of such a salary." 



However, it seems to me that this part may 

 be weU omitted from a plan which is devised 

 to fit all or most good medical schools. The 

 evils would be satisfactorily mended when 

 study and teaching were the primary occupa- 

 tions of the head of a department. What he 

 does with his spare time should not be our 

 concern. We could not object, if he used it 

 for some hobby; we should be rather glad, if 

 he utilized it for practising medicine. 



The Council on Medical Education says in 

 its report that the Johns Hopkins plan " has 

 not been well received by the clinical teachers 

 and finds its supporters almost entirely among 

 the laboratory men." The council has, as 

 stated above, not yet made any definite sug- 

 gestions; but it is very emphatic on the one 

 point, namely, " whatever plan is adopted 



must make it possible for the clinical teachers 

 to remain the great authorities in their spe- 

 cial field both in the eyes of the profession 

 and of the public." I wish to say here with 

 emphasis that I have a profound admiration 

 for the great work which the council has done 

 in the short time of its existence. The results 

 which it has achieved in the elevation of 

 medical education of the United States are 

 manifold: the general demand for higher en- 

 trance requirements; the weeding out of unfit 

 medical schools ; reducing in general the num- 

 ber of medical schools and the number of unfit 

 practitioners in the United States; encourag- 

 ing full-time professors for the purely scien- 

 tific branches; demanding bedside instruction 

 in clinical subjects and the creation of labo- 

 ratories and the demand for laboratory work 

 in clinical departments. The personal com- 

 position of the council has been usually 

 good — authoritative indeed, as far as the 

 above-mentioned premedical and medical 

 education is concerned. But will the council 

 as well as the committee which it has ap- 

 pointed remain authoritative and unbiased 

 in their judgment also on the subject with 

 which we deal here? We have seen that the 

 two great evils of the present system consist 

 in the facts that for our present heads of 

 clinical departments instruction is only a sec- 

 ondary occupation and that on account of the 

 extensive work which their primary occupa- 

 tion demands they are unable to follow effi- 

 ciently the continuous progress of medicine. 

 I have no doubt that the ten clinicians which 

 make up the strong committee are " great au- 

 thorities in their special fields both ia the eyes 

 of the profession and the public," that is, they 

 are great practitioners and consultants. But 

 for this very reason they are just the men 

 who are not fit to be heads of departments in 

 medicine. Will the members of this com- 

 mittee and the members of the Council on 

 Education be unbiased enough to recognize 

 the fact that being a celebrated consultant 

 and being an efficient teacher of modern medi- 

 cine are separate capacities which frequently 

 exclude one another ? The frequent repetition 

 in the report of the council of the requirement 



