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ACTUAL BASIS OF MEDICAL EDUCATION
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but also the important item of the foregoing of earning during this period, he is the proud possessor of his Ph.D. and is ready to enter his profession. The next five years he spends as instructor. In his thirty-second year he reaches assistant professorship. He is now in his thirty-seventh year, having been an assistant professor for five years. His average salary for the ten years has been $1325. … At thirty-seven he is married, has one child, and a salary of $1800."[1] In Germany "the road to a professorship involves a period of training and of self-denial far longer and more exacting than that to which the American professor submits;"[2] in France "there are no pecuniary prizes whatever in their calling for even those who attain its highest posts."[3] What is even more to the point,—the posts of instructor and assistant in small colleges situated in out-of-the-way places can be readily filled at slender salaries with expensively trained men. Of course there are compensations. But the point is that a large financial inducement is not indispensable, provided a man is doing what he likes. In most sections the country doctor has better worldly prospects. The fact stands out that it is not income but taste that primarily attracts men into scholarly or professional life. That granted, the prospect of a modest income does not effectually deter; and not infrequently the charm of living away from large cities may even attract.

Our limited experience with physicians trained at a high level sustains this view. We have thus far produced relatively few college-bred physicians; large cities have bid high for them, without, however, bagging all. Johns Hopkins graduates in medicine, to take the highest quality the country has produced, are already scattered through thirty-two states and territories. As if to prove that money is not the sole deciding consideration, a dozen have gone as missionaries to the Orient and several into the army and navy. In this country there is a Johns Hopkins man practising at Clayton, Alabama, with 1000 inhabitants; at Fort Egbert, Alaska, with 458; at Gorham, Colorado, with 364; at Chattahoochee, Florida, with 460; at Fort Bayard, New Mexico, with 724; at Sonyea, New York, with 300; at Blue Ridge Summit, Pennsylvania, with 50; at Wells River, Vermont, with 660; at Fairfax, Virginia, with 200; at Fort Casey, Washington, with 300; at Kimball, West Virginia, with 2000; at Mazomanie, Wisconsin, with 900. They have scattered to the four winds, and inevitably.<ref>Western Reserve men (three years of college required for entrance) are to be found in Cochranton, Pennsylvania (population, 724); Solon Springs, Wisconsin (population, 400); Kinsman, Ohio (population, 824); Rawson, Ohio (population, 552).</re> No single influence controls: home, money, taste, opportunity, all figure. When we have produced as large a number of well trained doctors as Germany, they will be found in our villages, just as one finds them over there. Minnesota, closed after 1911 to all low-grade graduates, Kansas and North and South Dakota, agricultural states, Con-

  1. Statistics from twenty leading universities, discussed by Guido H. Marx in address, The Problem of the Assistant Professor, before Association of American Universities, January, 1910.
  2. Carnegie Foundation, Bulletin II., p. vii.
  3. Bodley: France, vol. i, p. 54.