INTRODUCTION
The present report on medical education forms the first of a series of papers on professional schools to be issued by the Carnegie Foundation. The preparation of these papers has grown naturally out of the situation with which the trustees of the Foundation were confronted when they took up the trust committed to them. When the work of the Foundation began five years ago the trustees found themselves intrusted with an endowment to be expended for the benefit of teachers in the colleges and universities of the United State Canada, and Newfoundland. It required but the briefest examination to show that amongst the thousand institutions in English-speaking North America which bore the name college or university there was little unity of purpose or of standards. A large majority of all the institutions in the United States bearing the name college were really concerned with secondary education.
Under these conditions the trustees felt themselves compelled to begin a critical study of the work of the college and of the university!in different parts of this wide area, and to commend to colleges and universities the!adoption of such standards as would intelligently relate the college to the secondary school and to the University. While the Foundation has carefully refrained from attempting to become a standardizing agency, its influence has been thrown in the direction of a differentiation between the secondary school and the college, and between the college and the university. It is indeed only one of a number of agencies including the stronger colleges and universities, seeking to bring about in American education some fair conception of unity and the attainment ultimately of a system of schools intelligently related to each other and to the ambitions and needs of a democracy.
At the beginning, the Foundation naturally turned its study to the college as that part of our educational system most directly to be benefited by its endowment. Inevitably, however, the scrutiny of the college led to the consideration of the relations between the college or university and the professional schools which had gathered about it or were included in it. The confusion found here was quite as great as that which exists between the field of the college and that of the secondary school. Colleges and universities were discovered to have all sorts of relations to their professional schools of law, of medicine, and of theology. In some Cases these relations were of the frailest texture, constituting practically only a license from the college by which a proprietary medical school or law school was enabled live under its name. In other cases the medical school was incorporated into the college or university, but remained an imperium in imperio, the college assuming no responsibility for its standards or its support. In yet other cases the college or university assumed partial obligation of support, but no responsibility for the standards of the professional school, while in only a relatively small number of cases was the school of law or of medicine an integral part of the university, receiving from it university standards and adequate
