December 12, 1913] 



SCIENCE 



835 



the exploitation of the uninformed by pri- 

 vate institutions that pretend to prepare, 

 but do not really fit, students for the life 

 work which they are aiming to pursue. 

 Nowhere is the necessity for establishing 

 standards and fixing the conditions of rea- 

 sonable preparation for professional work 

 more essential than in the medical school. 

 The poorly trained engineer fails to achieve 

 individual success but usually never reaches 

 a stage of independent action in which his 

 lack of training becomes a menace to the 

 public. The poorly trained lawyer loses 

 his client's case, and the public is warned 

 by the evident lack of success on his part 

 to avoid seeking his assistance in important 

 matters. In so far as the interests of his 

 client are interwoven with the interests of 

 the community, he may do definite harm to 

 the general welfare, but that is a blow to 

 prosperity only, and because of the finan- 

 cial relation, the public is quicker to see 

 and to act in the situation than where more 

 subtle interests are threatened. The poorly 

 trained doctor, however, not only fails to 

 discharge his responsibilities to his patients, 

 but is in a very real way a positive menace 

 to the entire community. If he fails to 

 recognize communicable disease and to take 

 definite steps for its isolation, others must 

 pay the penalty. The poorly trained man 

 may be thoroughly honorable, and may 

 strive to the utmost to discharge his own 

 obligation, but if he has not the requisite 

 knowledge, his most conscientious efforts are 

 inadequate to protect the public. Conse- 

 quently, every individual in the common- 

 wealth is continually and vitally and per- 

 sonally concerned in the proper and thor- 

 ough training of every man who practises 

 the medical profession within its limits. 



The state must get the proper standards 

 of medical training from those who as its 

 representatives are giving medical educa- 



tion in the state univereity in the name of 

 the commonwealth, and the state must hold 

 these teachers, its representatives, respon- 

 sible that they set the standards of medical 

 education carefully, so as to protect all its 

 citizens from the consequences of poorly 

 trained or inadequately trained or wrongly 

 trained practitioners of medicine. Once 

 that the medical school of the state univer- 

 sity has established this standard and has 

 applied it without fear or favor to its own 

 students, the authorities of the state in 

 legislative and administrative circles must 

 for the protection of the commonwealth 

 adopt and apply those standards not only 

 to the students who receive training at the 

 hands of the state, but to all persons who 

 desire to enjoy the privileges of medical 

 practise within the limits of the state. No 

 nation could lay claim to membership in the 

 group of progressive civilized communities 

 that coined its own money on one standard 

 and permitted private citizens to circulate 

 money based on standards of their own 

 choosing; and yet there are apparently in- 

 telligent commonwealths in our union that 

 have seen one standard set for the educa- 

 tion of professional men in their own uni- 

 versities, and have permitted private insti- 

 tutions to adopt other standards of their 

 own making, to grant degrees of all sorts 

 without regard for their actual value, and 

 to turn loose upon the public professional 

 men whose certificates of proficiency are 

 no better than wild-eat banknotes. Nor is 

 this establishment of standards by the state 

 calculated to arouse resentment or opposi- 

 tion on the part of those private institu- 

 tions which are seeking without regard to 

 personal gain to discharge their obligations 

 to the public. The very appreciation of 

 such obligations and the renunciation of 

 personal gain which enters into the legal 

 organization of such institutions, make 



