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Rh brief periods in order to catch up with the times. Once more the training offered is of a practical, not of a fundamental or intensive, kind. It is calculated to "teach the trick" —or, perhaps better, to exhibit an instructor in the act of doing it. For, as nothing is known of individuals in the stream of students who course through the schools, it is impossible to give them an active share in the work that goes on at the bedside or in the operating-room. Their part is mainly passive; they look on at expert diagnosticians or operators. The danger of permitting an unknown student, tarrying for a brief stay, to participate at close range is prohibitive. In surgery the so-called practical courses are not usually worked out in such fashion that cadaver work, animal work, and service as dresser might prepare for actual participation: the school lacks means and facilities; the students lack the time. In medicine the absence of sufficient material, the lack of proper hospital organization and equipment, the scrappiness of professional service, combine to prevent a systematic, thorough, and intimate discipline.

Of the thirteen postgraduate schools, the best of them reflect the conditions and purposes above described. The Postgraduate and Polyclinic of New York and the Polyclinic of Philadelphia command large dispensary services and considerable hospital clinics, partly in their own hospitals, partly in public and private hospitals in the city. No unkind criticism is intended when the teaching is characterized as too immediately practical to be scientifically stimulating: it has the air of handicraft, rather than science. Comparatively little is done in internal medicine: surgery and the specialties predominate. The courses, being practical and definite, are disconnected; the faculties are huge and unorganized. In the main, demonstrative instruction is offered to small bodies of physicians, who come and go uninterruptedly through the year. Only one of the three—the Philadelphia school—has a laboratory building, and in that no advanced work is in progress; the two New York schools have laboratory space or equipment adequate only to routine clinical examinations. The teaching is in the main more elementary than the upper class instruction of a good undergraduate school of medicine. It is, of course, also at times more special in character. With the exception of the New York Postgraduate, these schools are without endowment: they live on fees, donations, and hospital receipts.

Two departmental postgraduate schools are conducted by the government at Washington for those accepted for service in the army or navy medical corps. Eligible for these appointments are graduated physicians who have had a year of hospital experience or three years of practice. Excellent practical instruction is furnished by way of supplementing the usual undergraduate course. The needs of the services can