Jdlt 11, 1913] 



SCIENCE 



36 



the students with facts and theories, but it 

 should call forth his own individuality and 

 stimulate him to mental effort. He should 

 become accustomed to critical study of 

 leading authorities with occasional refer- 

 ence to first-hand information, and thus 

 implant in his mind a standard of thor- 

 oughness and a sense of the value of truth. 

 He then learns to state fairly the position 

 of those whose conclusions he most stoutly 

 opposes. He gains an insight into the 

 conditions under which original research is 

 carried on, which enables him to weigh 

 evidence, follow and criticize argument and 

 put his own value on authorities. 



The commission then recommends the 

 formation of faculties of arts, science, tech- 

 nology, economics, medicine, law, theology 

 and music out of the existing institutions 

 in London. "Whether this is practicable is 

 not for us to discuss, but their recom- 

 mendations of necessity include a consid- 

 eration of the whole university problem, 

 and this they do in a masterful way. The 

 tone of the report is the best, and for this 

 reason it should be considered carefully by 

 all American educators, especially at this 

 time when our universities are under fire. 

 In this review I shall confine myself to the 

 part on medical education — and largely to 

 the clinical side — as it has become the ques- 

 tion of first importance in America. One 

 fourth of the report, which is unanimously 

 adopted by the commission, is devoted to 

 medical education. What follows is largely 

 verbatim. 



In the case of the faculty of medicine, as 

 in the case of other faculties, the commis- 

 sion considers what steps it is necessary to 

 take in order to place the best teaching 

 upon a real university basis. They can 

 not, however, deal with the faculty of medi- 

 cine on exactly the same lines they have 

 followed in the case of other faculties, such 

 as those of arts and science. In these fac- 



ulties the provision for teaching of the 

 highest university standard may be defi- 

 cient, but the standard itself is not ques- 

 tioned. 



In the case of the faculty of medicine 

 there is no test to apply ; except as regards 

 pathology and hygiene the university has 

 not attempted to determine which of the 

 teachers of the subjects classed as advanced 

 medical studies are entitled to the status 

 of professors. The university could not do 

 so under its existing regulations for the 

 conferment of those titles, because none of 

 those teachers fulfil the requirements with 

 regard to salary, time and other conditions 

 of employment. What is more significant, 

 it is denied that the university ought to do 

 so. So far as clinical teaching is con- 

 cerned, another standard has been set up 

 in the past. The university professor, ac- 

 cording to the conception of the commis- 

 sion of him, can give instruction of the 

 highest university standard only if he is 

 actively engaged in the systematic advance- 

 ment of knowledge in his subject. But in 

 the case of medicine it is contended by 

 many physicians that whether for univer- 

 sity or other students the best teachers are 

 men who are engaged in the practise of 

 their profession, and have at most only as 

 much time for original research as remains 

 after the demands of their practise have 

 been met. 



The teaching of the intermediate sub- 

 jects, anatomy, physiology and pharma- 

 cology, should be of the highest university 

 standard, and should be provided in insti- 

 tutions closely related to the clinical de- 

 partments. 



The question of the reform of clinical 

 teaching was first definitely raised before 

 the commission in the evidence given by 

 Mr. Abraham Flexner. They had received 

 his report on medical education in the 

 United States, and they had been informed 



