ground that peculiar conditions exist in the state; it is, however, not clear why a long narrow state is educationally in any different plight from a short broad one; in either' case, needless multiplication of medical schools is economically wasteful and professionally demoralizing.
The university has undertaken to dominate two detached clinical departments, manned by local practitioners. There is nothing in the' present status of detached clinical departments of this type.to encourage confidence in the outcome. Before too far committing itself to this policy, it is at least worth inquiring into the advisability of concentrating its medical instruction across the bay, where a population of over two hundred thousand affords sufficient clinical material, and where a compact, effective, and organically whole university department of medicine, with a faculty, laboratory and clinical, selected on educational principles, could be readily developed.
These considerations apply in some respects with equal force to the action of Stanford University in taking over the Cooper Medical College at San Francisco. It was well enough to offer the laboratory sciences at Palo Alto, where the resources and ideals of the university insure high-grade instruction; but the entrance of the university into the San Francisco field in all probability portends the division and restriction of whatever opportunities the city may hereafter create. Lane Hospital can be developed into a teaching hospital of adequate size only if very large sums are available for the purpose; its organization and conduct have been in the past pedagogically very defective; and the clinical professors so far appointed have been taken with one exception from the former Cooper faculty. With one university medical school already on the ground, a second—and a divided school at that–is therefore a decidedly questionable undertaking. There is no need of it from the standpoint of the public; it must, if adequately developed, become a serious burden upon the finances of Stanford University. If the experience of other schools and cities is to be heeded, the question arises whether Stanford would not do well to content itself with the work of the first two years at Palo Alto, and to coöperate with the state university in all that pertains to the clinical end.
The situation just presented deserves to be studied carefully by all interested in medical education. What has happened in California is likely to happen elsewhere. Scores of schools are' beginning a desperate struggle for existence. Their first impulse is to throw themselves into the lap of some prosperous university. The universities, not as yet themselves realizing that medical education is no longer either profitable or self-supporting, are prone to' complete themselves by accepting a medical department as an apparent gift; From the standpoint of the university this blunder will soon prove a serious drain, as increased expenditure on instruction and reduced income from fees reveal the actual state of affairs. From the standpoint of medical education and practice, the tendency in question is still more deplorable. The curse of medical education is the excessive number of schools. The situation can improve only as weaker and superfluous schools are extinguished.
