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Rh (1) New England represents a fairly homogeneous region, comprising six states, the population of which is increasingly urban. Its population increased, 1908-9, somewhat less than 75,000, requiring, on the basis of one doctor to every increase of 1500 in population, 50 new doctors. About 150 physicians died. Seventy-five men would replace one-half of these. In all, 125 new doctors would be needed. To produce this number two schools, one of moderate size and one smaller, readily suffice. Fortunately they can be developed without sacrificing any of our criteria. The medical schools of Harvard and Yale are university departments, situated in the midst of ample clinical material, with considerable financial backing now and every prospect of more. It is unwise to divide the Boston field; it is unnecessary to prolong the life of the clinical departments of Dartmouth, Bowdoin, and Vermont. They are not likely soon to possess the financial resources needed to develop adequate clinics in their present location; and the time has passed when even excellent didactic instruction can be regarded as compensating for defective opportunities in obstetrics, contagious diseases, and general medicine. The historic position of the schools in question counts little as against changed ideals. Dartmouth and Vermont can, however, offer the work of the first two years with the clinical coloring made feasible by the proximity of a hospital, as is the case with the University of Missouri at Columbia; with that they ought to be content for the time being.

(2) The middle Atlantic states comprise for our purpose New York, New Jersey, Pennsylvania, Delaware, Maryland, and the District of Columbia. Their population grows at the rate of 300,000 annually, for whom 200 doctors can care; 230 more would fill one-half the vacancies arising through death: a total of 430 needed. Available universities are situated in New York city, Syracuse, Philadelphia, Pittsburgh, Baltimore. The situation is in every respect ideal; the universities located at New York, Philadelphia, and Baltimore are strong and prosperous; those of Syracuse and Pittsburgh, though less developed, give good promise. Without sacrifice of a single detail, these five university towns can not only support medical schools for the section, but also to no small extent relieve less favored spots. The schools of Albany, Buffalo, Brooklyn, Washington, would, on this plan, disappear,—certainly until academic institutions of proper caliber had been developed. Whether even in the event of their creation they should for some years endeavor to cultivate medicine is quite doubtful. Appreciation of what is involved in the undertaking might well give them pause. Meanwhile, within the university towns already named there would be much to do: better state laws are needed in order to exterminate the worst schools; merger or liquidation must bring together many of those that still survive. The section under consideration ought indeed to lead the Union; but the independent schools of New York and Pennsylvania are powerful enough to prove a stubborn obstacle to any progressive movement, however clearly in the public interest.