cal work,—they cannot possibly give two; as for anything more liberal, there is no chance at all. Hence the step would shortly prove an obstruction to further progress. (2) Unquestionably, the day is coming when the medical school proper will want a fifth or hospital year,—a culmination that will be indefinitely postponed if the year in question is prefixed to the course and assigned to preliminary training. (3) Finally, the arrangement protracts our present educational disorganization. It proposes that the medical school should do the work of the college, just as it is either doing—or doing without—the work of the high school. Now the strength of an educational system is wholly a question of the competent performance of differentiated function by each of its organic parts. Our tardily awakened educational conscience and intelligence find themselves confronted with several independent and detached educational agencies,—high schools, colleges, professional schools. Obviously, they are not indifferent to each other; they belong in a definite order and relation. We now know perfectly well what that order, what that relation, is. And the solidity of our educational and scientific progress depends on our success in making it prevail. To no inconsiderable extent, inefficiency has been due to irresponsibility resulting from just this lack of organized relationships; and the cure for evils due to lack of responsibility is not less responsibility, but more; not less differentiation, but more.
The reconstruction of our medical education on the basis of two years of required college work is not, however, going to end matters once and for all. It leaves untouched certain outlying problems that will all the more surely come into focus when the professional training of the physician is once securely established on a scientific basis. At that moment the social rôle of the physician will generally expand, and to support such expansion, he will crave a more liberal and disinterested educational experience. The question of age—not thus far important because hitherto our demands have been well within the limits of adolescence—will then require to be reckoned with. The college freshman averages nineteen years of age; two years of college work permit him to begin the Study of medicine at twenty-one, to be graduated at twenty-five, to get a hospital year and begin practice at twenty-six or twenty-seven. No one familiar with the American college can lightly ask that this age be raised two years for everybody, for the sake of the additional results to be secured from non-professional college work. There is, however, little question that compression in the elementary school, closer articulation between and more effective instruction within secondary school and college, can effect economies that will give the youth of twenty-one the advantage of a complete college education. The basis of medical education will thus have been broadened without deferring the actual start. Meanwhile we are so far from' endeavoring to force a single iron-clad standard on the entire country that our proposition explicitly recognizes. at least three concurrent levels for the time being: (1) the state university entrance standard in the south, (2) the two-year college basis as legal minimum in the rest of the country, (3) the degree standard in a small number of institutions.
