the public interest. They originated as didactic schools, and as such were quite as well off in small communities as anywhere else. They find themselves now compelled to teach clinical medicine by practical methods. They cannot command the necessary material nor the financial resources required to procure it. Why should either the students or the public make a sacrifice merely to enable them to continue, when it is easily possible for both to do better? The argument that these small schools train all-round doctors who go out into the country, prepared to do everything, is refuted by the obvious fact that schools, unable to command obstetrical cases, contagious diseases, and the ailments that throng dispensaries, are not really sending out the type of practitioner which, by their own admission, the rural districts need.
Whether even Boston will or should continue to support two regular schools—Harvard and Tufts—is decidedly doubtful. The enrolment of Tufts, even on the high school basis, is much swollen. The strict enforcement of that standard—and why should it not be enforced?— will greatly reduce the attendance. The inevitable elevation of requirements will still further cut it down. The school has no resources but fees; out of them it cannot possibly provide for the legitimate demands of the near future. It is difficult to see how the department in question can avoid being seriously crippled; for its remarkable prosperity has depended to no slight extent on the inducement held out by low entrance standards. Its only hope of escape is through endowment, first, so that it may develop its laboratories independently of fee income, next, that it may secure its own hospital. Why should such an expensive step be recommended? If New England is in future to be supplied with high-grade doctors, the quickest and cheapest road to that end is to complete Harvard and to develop Yale, rather than to maintain several more or less imperfect institutions. Whatever may once have been the case, local competition needs no longer be relied on to expose defects and to stimulate improvement. Keen scientific and educational emulation over a wide area provides a sharper incentive and involves no waste. It is, therefore, of supreme importance that higher standards be legalized in New England and that the clinical independence of the Harvard Medical School be established. The medical department of Yale is modestly working in the same spirit and to the same end. To these two institutions the future of medical education in New England may for many years to come be safely left.
New Hampshire
Population, 443,140. Number of physicians, 680. Ratio, 1:651.
Number of medical schools, 1.
HANOVER: Population, 1951.
Dartmouth Medical School. Organized 1798. The medical department of Dartmouth College.
