MEDICAL EDUCATION. In ancient times almost all medical teaching was given by masters to their pupils without the use of formal schools. But the names of Hippocrates and Galen, who were in classical days in great repute, show that the teachers of medicine were held in honor. Almost all the surgeons and phy sicians were slaves, and Greek and Latin comedy is full of jests aimed at the doctor. In the Middle Ages and the Renaissance much of medical education was formal and traditional. With the emergence of the great European uni versities in the twelfth and succeeding centuries, medical education gradually ob tained a distinct place.
Thomas Linacre (c. 1460-1524) is popularly regarded as having been the first to give the study of medicine a uni versity status at Oxford. In Scotland a medical school was founded at St. Andrews in 1411, and at the University of Edinburgh in 1582.
In the United States the earliest medi cal schools took their origin from oc casional lecture courses. At the opening of the Revolution it is estimated that there were in the thirteen colonies 3,500 practitioners, of whom about 400 had medical degrees. In our early history many doctors were educated at Edinburgh, but more obtained their train ing by serving as apprentices under well known physicians. In 1750 Dr. Thomas Cadwallader was lecturing in anatomy in Philadelphia, where in 1765 the medical department of the College of Philadelphia, later the University of Pennsylvania, was founded. In 1767 the medical department of Kings College, later Columbia University, was opened, followed in 1782 by the foundation of the medical department of Harvard and in 1798 and 1820, respectively, of Dart mouth and Bowdoin. In the middle of the nineteenth century many proprietory schools of medicine had been established, in which the teachers divided all fees and conducted the administration on purely commercial lines.
During the past thirty years American medical schools have been vastly im proved. For example, at one time the degree of M.D. was granted to the stu dents who had attended for one year a course of lectures; later the period was extended to two years, then to three, and now universally to four and in some eases to five. At the same time the ruality of men entering medical schools has been improved until now some schools require for admission the bac calaureate degree, and all schools of repu tation, at least the equivalent of two years in college. This has meant a diminution both in the number of schools and students, but a very marked gain in quality. For example, in 1906 the United States had 162 medical schools, or over half the world's supply. In 1920, through the elimination of door schools and con solidation, this number has been reduced to 86. In 1904 there were 28,142 medical students; in 1920, only 13,554. But higher enrolments are in prospect, and medical schools of a high grade can satisfactorily teach 17,000 or 18,000 stu dents, which number will in all proba bility supply the demand for some years to come. For statistics show that in August, 1919, the United States had one physician to every 720 people, as com pared with one to 1,500 in Great Britain. There is, therefore, no scarcity of phy sicians in the United States, but a very imperfect distribution of the supply.
There are to-day medical schools in 37 of the 48 States and in the District of Columbia. The States that have no schools—Rhode Island, New Jersey, Del aware, Florida, New Mexico, Arizona, Idaho, Montana, Nevada, Wyoming and Washington—have medical schools in close proximity or are sparsely settled. From the standpoint of abundant clinical facilities and large hospitals and dis pensaries, the centers of population have obvious advantages as sites for medic& schools, and the tendency is very clearly in that direction.
Medical education, thus, has fairly kept pace with the great advance in medical science and art which has been achieved in the past forty years. Medi cine can now be regarded as a science. Knowledge in its domain is obtained by following the methods of science, and the application of this knowledge has been of incalculable value to mankind. For merly medicine was concerned merely with the treatment of the sick individual, and the measures directed toward this were empirical and traditional. The fact that most diseases were self-limited and tended to recovery was not appreciated, and treatment, though not usually harm ful, had little or no effect on the disease. With the new knowledge, the preven tion and medical care of disease has been placed on a rational basis and a new con ception of the relation of medical ser vice to society has arisen. Modern medicine seeks, first, to prevent disease, this being made possible by knowledge of the causes of disease and the mode of ac tion of these causes; second, the recog nition of disease in its early stages when cure can most easily be effected; third, the care of the patient during the criti cal period of disease; fourth, the allevia tion of suffering and the prolongation of life in incurable disease. To the attain ment of these aims medical education is directed. No department of education has experienced such advance both in methods and ideals as has medicine in the past thirty years, and although all countries have shared in this advance, it has been particularly marked in Amer ica. Medical schools in the United States are now among the best in the world. Changes affecting a few of the best schools were slowly inaugurated, but the great advance began in 1902, when the American Medical Association formed a Council of Medical Education. This council made a thorough examina tion of all the medical schools of the country and graded them according to the facilities for education which each possessed. All facts ascertained were published and the primary effect was the elimination of the numerous inferior schools and the combination of others. At about the same time the different States demanded a license for the prac tice of medicine, which was granted after examination of the candidate by a board of examiners, and the results of these examinations, with the names of the schools at which the candidates had studied, were published. Education was further improved by the formation of jiedical faculties in the various univer sities, thus giving medicine the advantage of association with other departments of science and participation in university ideals, and scientific research in medi cine, to which formerly but little atten tion was given, has become a dominant ideal.