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Rh to four years, still varying, however, from six to nine months each in duration. Didactic teaching has been much mitigated. Almost without exception the schools furnish some clinical teaching; many of them provide a fair amount, though it is still only rarely used to the best teaching advantage; a few are quite adequately equipped in this respect. Relatively quicker and greater progress has been made on the laboratory side since, in 1878, Dr. Francis Delafield established the laboratory of the Alumni Association of the College of Physicians and Surgeons of New York; in the same autumn Dr. William H. Welch opened the pathological laboratory of the Bellevue Hospital Medical College, from which, six years later, he was called to organize the Johns Hopkins Medical School in Baltimore. It is at length everywhere conceded that the prospective student of medicine should prove his fitness for the undertaking. Not a few schools rest on a substantial admission basis; the others have not yet abandoned the impossible endeavor at one and the same time to pay their own way and to live up to standards whose reasonableness they cannot deny. Finally, the creation of state boards has compelled a greater degree of conscientiousness in teaching, though in many places, unfortunately, far too largely the conscientiousness of the drillmaster.

In consequence of the various changes thus briefly recounted, the number of medical schools has latterly declined. Within a twelvemonth a dozen have closed their doors. Many more are obviously gasping for breath. Practically without exception, the independent schools are scanning the horizon in search of an unoccupied university harbor. It has, in fact, become virtually impossible for a medical school to comply even in a perfunctory manner with statutory, not to say scientific, requirements and show a profit. The medical school that distributes a dividend to its professors or pays for buildings out of fees must cut far below the standards which its own catalogue probably alleges. Nothing has perhaps done more to complete the discredit of commercialism than the fact that it has ceased to pay. It is but a short step from an annual deficit to the conclusion that the whole thing is wrong anyway.

In the first place, however, the motive power towards better conditions came from genuine professional and scientific conviction. The credit for the actual initiative belongs fairly to the institutions that had the courage and the virtue to make the start. The first of these was the Chicago school, which is now the medical