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SCIENCE. 



[N. S. Vol. XVII. No. 437. 



overcrowding it, and steadily reducing the 

 opportunities of those already in the pro- 

 fession to acquire a livelihood. The evil 

 of an overcrowded profession is a sufficient 

 cause of complaint, but the cause thereof 

 is the important point for us to consider 

 and, if possible, remove. To correct the 

 evil, the ease and facility with which a 

 medical degree may be secured in this 

 country must be diminished. As before 

 stated, there are now 156 medical schools 

 in this country. Of these, 30 are sectarian, 

 and 136 are so-called regular schools. 

 Fifty-eight are medical - departments of 

 universities, of which twenty-four are state 

 institutions. The relation of the medical 

 school to the university in inost instances 

 is a nominal one only. In but few of them 

 is the control of the faculty, or the finances 

 of the medical department, vested in the 

 university proper. In a very few of them 

 the sciences fundamental to medicine are 

 taught in the university. In the majority 

 of these schools these departments are 

 duplicated in the medical department, and 

 are taught by members of the medical 

 faculty. In most instances, too, the teach- 

 ers of the fundamental branches are physi- 

 cians who devote but a part of their time 

 to teaching. They teach without a salary, 

 or for a nominal one only. Their remuner- 

 ation is obtained by private practice, to 

 which they must devote their best energies, 

 to the detriment of their value as teachers. 

 The clinical department of these schools is, 

 in most instances, wholly inadequate. The 

 majority of such schools depend on the gen- 

 eral hospitals situated near them for the 

 privilege of the use of clinical material. 

 Necessarily, these clinical advantages have 

 great limitations, inasmuch as they can not 

 be fully controlled for the purpose of 

 proper bed-side teaching, or for scientific 

 investigation. Some of the medical schools 

 which are connected with state universities 



are situated in small cities where it is im- 

 possible to command an adequate amount 

 or variety of clinical material. The con- 

 nection with a university, which many of 

 the schools enjoy, is, therefore, almost 

 valueless in a pedagogic sense. The major- 

 ity do not differ materially from the private 

 or proprietary schools in their value as 

 teaching institutions. Ninety-eight of the 

 medical schools in the country are private 

 corporations, organized, maintained and, 

 as a rule, owned by the faculty. If, in 

 earlier years, these institutions were sources 

 of direct financial profit to the owners, 

 they have ceased to be so now— at least 

 most of them. The evolution of medicine 

 has made it necessary to extend tha labora- 

 tory method of teaching. As these schools 

 attempt to teach the whole curriculum, the 

 erection, equipment and maintenance of 

 the necessary laboratories have so increased 

 the cost of conducting the schools that they 

 are usually no longer self-supporting. The 

 temptation is in such schools to conduct 

 them on a plane which shall just comply 

 with the minimum requirements of the 

 various state bodies, which regulate medical 

 practice in the several states. They are 

 maintained ostensibly to teach medicine, 

 but in reality for the prestige which a pro- 

 fessorship affords the teacher in his private 

 and consultation practice. Proprietary 

 schools depend on general hospitals and dis- 

 pensaries for clinical material. What was 

 said of the status of clinical teaching of 

 the medical departments of the universities 

 is true also of the proprietary college. 

 These schools can not hope to improve 

 their present standards. The majority 

 attempt to maintain laboratories and 

 other expensive means of teaching which 

 a modern medical education demands. 

 But in how many are the laboratories 

 worthy of the name? What kind and 

 variety of instruments and apparatus do 



