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Rh There are no library, no museum, and no teaching accessories. It is evident that the policy of paying practitioners has absorbed the resources of a school that exists for purely philanthropic objects.

Clinical facilities: These are hardly more than nominal. The school has access to a sixteen-bed hospital, containing at the time of the visit three patients. There is no dispensary at all. About thirty thousand dollars are, however, now available for building a hospital and improving laboratories.

Date of visit: February, 1909.

state of North Carolina makes a comparatively satisfactory showing in the matter of ratio between population and physicians; but this may, perhaps, in some measure be due to the fact that practitioners, unlicensed and unregistered, exist undisturbed in the remote districts. It is futile to maintain a low standard in order to prepare doctors for those parts; for the graduates, instead of scattering to them, huddle together in the small towns already amply supplied. It is admitted that all eligible locations are overcrowded. There is not the slightest danger that the necessary supply of doctors would be threatened if, for instance, the practice of medicine in the state were pitched on the plane of entrance to the state university; higher than that it probably ought not to be at this time.

The standard suggested—any real standard whatsoever, indeed—would quickly dispose of the thoroughly wretched Charlotte establishment. No clinical school would remain in the state. The two half-schools—at Wake Forest and at the state university—are capable of doing acceptable work within the limits of their present resources. Both of these schools now require college work for entrance. Is this step to be generally recommended at this time to southern universities with medical departments? Without attempting to arrive at a decision, it may be pointed out that there are two sides to the question. On the one hand, the college requirement is essential to the symmetrical development of the medical curriculum; on the other, a good medical course can be given at an actual high school level, provided that facilities and teaching are developed to a high point of efficiency. How will the university best serve the state,—by training a small number at the higher level, or by getting actual control of the state situation on a high school basis before pushing ahead to a basis just generally feasible in more highly developed sections of the country? The University of Michigan is only now requiring college work for entrance; it became a strong school of immense influence in its own community on a lower basis. Undoubtedly it is right now to go to the higher standard; perhaps it should have done so earlier. But its present efficiency and influence show—as McGill and Toronto show—that if a lower standard is felt to be a reason for better teaching and not an excuse for poor teaching, an institution unfavorably located for the initiation of