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Date of visit: April, 1910.

has a double duty and a double opportunity in medical education. It must in the first place produce most of its own physicians and a considerable share of those who practise in neighboring states, which, like New Jersey, are without medical schools. Its eleven medical schools have so energetically done their part in this matter that New York itself and all the adjoining states are suffering from plethora. There is, therefore, no section of the Union which is at this moment readier for an upward step: population is comparatively well distributed, communication is easy, roads a good, educational facilities abundant, and doctors superabundant. In the city of New York the two-year college requirement can be met at Columbia, New York University, and without expense at the College of the City of New York. Students outside the metropolis are, up to a certain number, similarly cared for by Cornell University.

But New York may be fairly asked to do more than produce doctors, however excellent the type. its vast hospital and university resources should make it the Berlin or Vienna of the continent; a genuinely productive contributor to medical progress; the center to which, in the intervals of a busy life, physicians will repair to freshen their knowledge and to renew their professional youth; to which the young graduate from the interior—from the Schools of Pittsburgh, Ann Arbor, Madison, Iowa City—will look for the extension of his scientific and clinical experience.

Little has as yet been done to realize this opportunity. The postgraduate schools are of very limited scope; the great New York schools have been in the main clinically unproductive. Why?

The reason is a matter of history. The schools that are now called university departments grew up as proprietary institutions. They have never been adequately financed. They obtained, and still obtain, their clinical facilities at each other's expense: that is to say, what one gets, the other loses. In the Bellevue Hospital a modus vivendi was found by division, with an arrangement that enables two schools to watch and obstruct the third and a lay board to oversee all three; in the great