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Rh The clinical facilities of the ordinary medical school are put together of scraps, the general character of which have now been described. They offer a medical clinic here, an obstetrical clinic there, a skin clinic somewhere else. Faculties numerically out of all proportion to the number of students are assembled in order to piece out the quilt: Fordham University has 72 instructors for 42 students; the New York Medical College for Women has 45 instructors for 24 students; the Toledo Medical College, 48 instructors for 32 students; the Oakland College of Medicine and Surgery, 42 instructors for 17 students. As the hospitals are scattered, time is wasted in going to and fro. All told, our 150 medical schools have resulted, among other things, in some 4000 professorial titles.

Imagine the engineers that would be produced if students were sent to a series of shops to see things done, -as far as they could be seen without interfering with the workmen! In no two of these hospitals is exactly the same kind of teaching privilege granted; and the privileges granted are highly precarious: the hours are arbitrarily limited, and number of beds is usually too small. Nowhere do they approach the ideal which the school might readily institute in its own hospital. They fall short, however, in varying degrees. In St. Louis the situation is lamentable. The City Hospital has a medical and surgical staff who "do no teaching," and a teaching staff who "do no doctoring." Each of the half-dozen schools in the town has one afternoon; the instructor must go out to the hospital the day before to select two cases for demonstration,—an amount of trouble which the better men are reluctant to take. The instruction consists in pointing out features and suggesting what ought to be done: in surgery, it may have been done already; in medicine, there is no telling. In either case, the entire process remains purely hypothetical. These opportunities are not infrequently treated as they deserve: at the St. Louis College of Physicians and Surgeons it was stated: "This is hospital day; lots of them don't go." In the County Hospital at Los Angeles, the main reliance of two university departments of clinical medicine,—one of them (the University of California) requiring for admission three years of college work,—students are not permitted to handle