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Rh who must get their medical education after they get out of the institution. In many of these ill manned and poorly equipped institutions there is to be found a large measure of devotion, but the fact remains that such devotion is usually ill placed, and the individual who gives it loses sight of the interests of education and of the general public in his desire to keep alive an institution without reason or right to exist.

It will, however, be urged by weak schools that the fact that an institution is ill manned and poorly quipped is inconclusive; that in the time devoted to the examination of a single school it is impossible to do it justice. Objection of this kind is apt to come from schools of two types,—ineffective institutions in large cities, and schools attached to colleges in small towns in which clinical material is scarce. In my opinion the objection is without force. A trained observer of wide experience can go directly to the heart of a problem of this character. The spirit, ideals, and facilities of a professional or technical school can be quickly grasped. In every instance in which further inquiry has been made, the conclusions reached by the author of the report have been sustained.

The development which is here suggested, for medical education is conditioned largely upon three factors: first, upon the creation of a public opinion which shall discriminate between the ill trained and the rightly trained physician, and which will also insist upon the enactment of such laws as will require all practitioners of medicine, whether they belong to one sect or another, to ground themselves in the fundamentals upon which medical science rests; secondly, upon the universities and their attitude towards medical standards and medical support; finally, upon the attitude of the members of the medical profession towards the standards of their own practice and upon their sense of honor with respect to their own profession.

These last two factors are moral rather than educational. They call for an educational patriotism on the part of the institutions of learning and a medical patriotism on the part of the physician.

By educational patriotism I mean this: a university has a mission greater than the formation of a large student body or the attainment of institutional completeness, namely, the duty of loyalty to the standards of common honesty, of intellectual sincerity, of scientific accuracy. A university with educational patriotism will not take up the work of medical education unless it can discharge its duty by it; or if, in the days of ignorance once winked at, a university became entangled in a medical school alliance, it will frankly and courageously deal with a situation which is no longer tenable. It will either demand of its medical school university ideals and give it university support, or else it will drop the effort to do what it can only do badly.

By professional patriotism amongst medical men I mean that sort of regard for the honor of the profession and that sense of responsibility for its efficiency which will enable & member of that profession to rise above the consideration of personal