own folly in so doing. Let them reinforce the high school by the opposite policy; they will soon perceive the needlessness of the exceptions which they still suggest, and often even require. How much longer will the southern people, generously spending themselves in the effort to create high school systems, continue to handicap their development by allowing medical education legally to rest on an ante-bellum basis?
The duty of the southern universities at this juncture is clear. They are equally bound to assist the development of the secondary school and to furnish the southern people an improved type of physician. They do both if, while actually enforcing the standard above advocated, they provide the best medical training obtainable at that level. As a matter of fact, a highly useful doctor can be trained on the high school basis if his defects, frankly admitted, are made the occasion for more, instead of less, efficient instruction. The weak southern schools apologize for their wretchedness by alleging the shortcomings of the student body. But the shortcomings of the students are a call for better, rather than an excuse for worse, teaching. On the whole, a southern university will for a time probably do best to put its strength unreservedly into the improved instruction of a larger body of students at the high school level, rather than to train a smaller body on a somewhat higher basis. What with the other influences working to discredit the proprietary medical school, if Tulane, Vanderbilt, and Texas furnish actual high school graduates with an education as good as that of Toronto or of McGill, they will soon get control of the field, they will educate the southern public to look to them for their physicians, and they will induce the state legislatures to support a position undeniably reasonable, so that when they at last make the upward move, there will be no low-grade medical schools to profit by the step and to make it a pretext for the continuance of commercialism in medical education.[1]
The state of Texas has taken a sound and yet conservative position. Beginning with 1909, it has decreed a gradual annual rise of standard that will shortly result in making its four-year high school the legal basis of medical education. Cautious elevation thus avoids all danger of breaking with the state school system. The statute is not free from defects, for it provides for the acceptance, at their face value, of the medical student certificates of reciprocating states; but the Texas state board, having dealt vigorously with the worst of the Texas schools, will in all probability make effective use of the power in its hands. Other southern states must inevitably follow. It is of course important that they should not move faster than their educational facilities; but it is equally important that they should not move any more slowly. Thus far, Texas alone has made an effort to keep pace.
The situation is even clearer, in so far as it touches the rest of the country. We estimate[2] that outside the south 1500 doctors annually graduated will provide for
