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Rh " students, and are required to maintain higher standing in order to qualify for the M.D. degree. But as these students enter on a general rule and as a matter of course, and are, under a slight handicap, eligible to the M.D. degree, they are not accurately described as special. A special student is properly one whom no rule fits, one whose admission presents certain individual features requiring consideration on their merit. Such is not the case with the students under discussion: they enter just as regularly as the degree men, and without that limitation as to number which makes of the "special student" device something of a privilege. Harvard can thus admit any student who is eligible to the schools with the two-year college requirement. The other institutions under discussion telescope the college and medical courses: the preliminary medical sciences constitute the bulk of two college years; the next two years are reckoned twice. They count simultaneously as third and fourth years of the college and as first and second years of the medical course. At their close the student gets the A. B. degree, but his medical education is already half over. Without exception, the schools belonging to this group are high-grade institutions. They differ considerably, however, in the degree of rigor with which their elevated entry requirements have been enforced from the start. At the University of Pennsylvania, for example, in a class of 114, admitted this year (1909–10) on a one-year college basis, 75 (66 per cent) are conditioned; at Ann Arbor, of 36 entering on the two-year college basis, only 8 are conditioned at all, and those mainly in organic chemistry; at Yale, which advanced in 1909–10 from the high school to the two-year college basis, in a class of 28, them was only one partial condition in biology, and, best of all, failed members of last years class on the old basis were refused re-admission. Experience elsewhere indicates that the percentage of conditions declines rapidly as students learn by forethought to adjust their work to their ultimate purpose, and as the colleges facilitate adjustment by providing the requisite opportunities: both of which processes will be accelerated, if the medical schools have the courage—and the financial strength—to close their doors to students who labor under anything more than a slight handicap. Here as elsewhere development follows hard upon actual responsibility.

Our second division constitutes the real problem; out of it additional high-grade medical schools to the number actually required must be developed. About fifty institutions, whose entrance standard approximates high school graduation, belong here. Great diversity exists in the quality of the student body of these institutions: the regents' certificates in New York, state board supervision in Michigan, the control of admission to their medical departments by the academic authorities of McGill