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150 one doctor for every 563 persons. In view of local conditions, let us reckon one additional doctor for every additional 750 persons: 60 will be required. And, further, let us make up the death-roll man for man: 60 more would be needed—altogether 120. There are at the moment in this region only two available sites, Salt Lake City and Denver. At the former the University of Utah is situated; the latter could be occupied by the University of Colorado, located at Boulder, practically a suburb. The outlying portions of this vast territory will long continue to procure their doctors by immigration or by sending their sons to Minneapolis, Madison, Ann Arbor, Chicago, or St. Louis.

(7) The three states on the Pacific coast, California, Oregon, Washington, are somewhat self-contained. They increased last year by 53,454 persons, requiring 36 more physicians; 50 more would repair one-half the losses by death: a total of 86. Available sites, filling the essential requirements, are Berkeley and Seattle. The former, with the adjoining towns of Alameda and Oakland, controls a population of 250,000 or more; the medical department of the University of California concentrated there would enjoy ideal conditions. At present the clinical ends of two divided schools share San Francisco, and the outlook for medical education of high quality is rendered dubious by the division. With unique wisdom the University of Washington and the physicians of Seattle have thus far refrained from starting a medical school in that state. They have held, and rightly, that in the present highly overcrowded condition of the profession on the coast, there is no need for an additional ordinary school; and the resources of the university are not yet adequate to a really creditable establishment. The field will therefore be kept clear until the university is in position to occupy it to advantage.

(8) In Canada the existing ratio of physicians to population is 1:1030. The estimated increase of population last year was 239,516, requiring 160 new physicians; losses by death are estimated at 90. As the country is thinly settled and doctors much less abundant than in the United States, let us suppose these replaced man for man: 250 more doctors would be annually required. The task of supplying them could be for the moment safely left to the Universities of Toronto and Manitoba, to McGill and to Laval at Quebec. Halifax, Western (London), and Laval at Montreal have no present function. At some future time doubtless Dalhousie University at Halifax will need to create a medical department. The future of Queen's depends on its ability to develop halfway between Toronto and Montreal, despite comparative