684 



SCIENCE. 



[N. S. Vol. XI. No. 279. 



struction of a medical school of the first 

 rank is likely, in the immediate future, to 

 be organized. I say in the immediate future 

 for what changes are in store for us in the 

 course of the next few decades it is equally 

 impossible to foresee and useless to specu- 

 late. 



RELATION OF MEDICAL SCHOOLS TO UNIVER- 

 SITIES. 



One of the most hopeful signs of the 

 times in the field of medical education is 

 the growing tendency of the better schools 

 to ally themselves to universities and of 

 universities to establish medical depart- 

 ments. Of the great advantages to med- 

 ical education which may be expected from 

 this union it is unnecessary for me to speak, 

 for they formed the subject of a thoughtful 

 discourse delivered by the last president of 

 this congress at Yale University in 1888.* 

 The twelve years that have elapsed since 

 he spoke have brought accumulating evi- 

 dence of the soundness of his views. In 

 fact, it is difiScult to see how a private med- 

 ical school of the joint stock company type 

 can ever, in the future, rise to the first 

 rank, for such a school is not much more 

 likely to attract endowments than a cotton 

 mill, and without endowments the enor- 

 mous expenses of a modern first-class med- 

 ical school cannot possibly be met. 



Great as are the benefits to a medical 

 school of thus forming a department of a 

 great university, the advantages of the 

 union are not wholly on one side. Besides 

 the increase of prestige secured to the Uni- 

 versity by the broadening of its functions, 

 the establishment of a medical school as 

 part of the university organization greatly 

 facilitates the instruction of those students 

 who, without any intention of becoming 

 physicians, seek in the study of the medical 

 sciences a means of general culture and 

 mental discipline. 



* New Englander and Yale Beview, Sept. , 1888. 



The relations between the governing 

 body of a university and its medical faculty 

 in matters of administration are often de- 

 fined by custom and tradition rather than 

 by statutory provisions, and vary consider- 

 ably in difierent institutions. In general, 

 two methods of government may be dis- 

 tinguished. Either the initiative is left 

 with the teaching faculty, the governing 

 body exercising simply a veto power, or 

 the governing body acts directly without 

 necessarily asking advice from the faculty 

 or its members. The former method of 

 government is most likely to be found in 

 those cases in which a well-established 

 medical school has allied itself to a univer- 

 sity for the sake of the mutual benefits that 

 may ensue from the union, and the latter 

 method in those cases in which a university 

 has completed its organization by the crea- 

 tion of a medical department. Both meth- 

 ods have certain advantages and neither is 

 without its drawbacks. In all cases men 

 are more important than methods. On 

 the one hand, the collective judgment of a 

 teaching faculty on matters relating to 

 medical education, is likely to be of more 

 value than that of a governing body which 

 may not, and generally does not, include 

 physicians among its members. On the 

 other hand, personal and selfish considera- 

 tions are perhaps more apt to sway the 

 judgment of a faculty than that of a 

 body of trustees, especially when the ques- 

 tion is that of the appointment of teachers. 

 That this is not a serious danger, however, 

 the experience of Germany seems clearly to 

 show, for in that country, as Dr. Farlow 

 has recently pointed out, the faculty ' has 

 more power in regard to appointments and 

 the general policy of the university ' * than 

 with us, and yet we find there the custom 

 of calling professors from one university to 

 another, fully established ; a custom which 



* Presidential address. Am. Soc. of Naturalists, 

 Deo., 1899. Science, Jan. 5, 1900. 



