A medical school of the first grade must now possess a liberal endow ment, for it cannot be supported by the fees of the students; well-equipped laboratories for anatomy, physiology, medical chemistry, pathology, bacteri ology and preventive medicine, all di rected by men who devote their entire time to teaching and research; a close connection with one or more endowed and well-equipped hospitals in which the students have the privilege of bedside study and exercise in methods of diag nosis and treatment. Such hospitals serve three well-defined purposes: the cure of the sick, medical research by which knowledge is increased, and teach ing by which knowledge is disseminated. The requirements for admission in most of the medical schools are a high school education plus two years of college work, in which courses in physics, chemistry and French or German have been taken. The medical course is four years of nine months each, and the instruction is more or less divided into that of the sciences underlying medicine, such as anatomy, physiology, pathology, etc., which are given in the first two years, and the clinical instruction in medicine, surgery and obstetrics, which occupy the last two. The lecture system, though not en
tirely given up, holds a subordinate place in instruction, most of the time of the student being spent in laboratory work or in the hospitals, where he studies the products of disease and the physical and chemical methods used in diagnosis. After graduation the student serves an other year as an interne in a hospital, not necessarily connected with a school, where he has the care of the patients under direction. A student passing through such a course is fitted for gen eral service in medicine, but should he elect to enter into any of the main spe cialties of medicine, further training is necessary. The strongest criticism which can be made against the present system of medical education is that the student is too old when he graduates. The medi cal course is rarely begun before the age of twenty-one, which brings gradu ation and the hospital year to the age of twenty-six. This defect, if it be such, can best be met not by shortening the medical course, but by improving the character of the preparatory education, so that the student can acquire at the age of eighteen what he now has at twenty-one.