Page:Carnegie Flexner Report.djvu/49

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ACTUAL BASIS OF MEDICAL EDUCATION
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do not belong to the "approved" or "accredited" class: their diplomas and certificates are not, therefore, entitled to be received in satisfaction of the announced standard. They are nevertheless freely accepted. At Tufts, for example, the first year class (1909–10) numbers 151, of whom only little more than half submit credentials that actually comply with the standard; of the others, 30 are accepted from non-accredited schools on the strength of diplomas and certificates entitled to no weight on the professed standard of the Tufts Medical School.[1] This is a common occurrence. It is defended on the ground that "we know the schools." That is, however, quite impossible. The wisdom of Solomon would not suffice to determine the actual value of credentials so heterogeneous in origin and content. Universities dealing with far less various material organize registration and inspection bureaus for their protection and enlightenment. But not infrequently the medical departments of these very institutions, pretending to stand on the same basis as the academic department, refrain from seeking the aid of the university registration office. The medical department of Bowdoin is on the college campus, yet its authorities accept certificates that the college would refuse; the medical departments of Vanderbilt, Tufts, George Washington University, Creighton (Omaha), Northwestern, the Universities of Vermont and Pennsylvania,[2] are in easy reach of intelligent advice which they do not systematically utilize. In striking contrast, the medical department of the University of Texas at Galveston refers all credentials to the registration office of the university at Austin, the action of which is final.

If the standard were enforced, the candidates in question, not offering a graduation diploma from an accredited high school, would be compelled to enter by written examination. But the examination is, as things stand, only another method of evasion. Neither in extent nor in difficulty do the written examinations, in the relatively rare cases in which they are given, even approximate the high school standard. Nor are they meant to do so. Colleges with medical departments of the kind under discussion do not expect academic and medical students to pass the same or the same kind of examination: a special set of questions is prepared for the medical candidates, including perhaps half the subjects, and each of these traversing about half the ground covered by the academic papers. At Tufts, the medical matriculate attempts six papers, representing, all told, less than two years of high school work; and he is accepted on condition if he passes three.[3] Papers of similar quality are put forward at Boston University; those at Bowdoin are more extensive and more difficult, though still below the supposedly equal academic standard. The written examinations held under the authority of the state boards in Kentucky, Pennsylvania, Missouri,[4] are of

  1. Those still remaining are commented on below.
  2. The academic authorities here pass on the college year.
  3. Of the class above mentioned 38 were admitted by examination.
  4. A St. Louis cramming establishment, conducted by the wife of a teacher in a local medical school, offers to prepare in a single year, according to the Missouri standard, a boy who has never had any