Page:Carnegie Flexner Report.djvu/48

30 and Toronto, insure as capable and homogeneous an enrolment as is obtainable at or about the high school level. A few others, not so well protected, are within measurable distance of the same category,—the medical department of Tulane University and Jefferson Medical College (Philadelphia), for example. In general, however, the schools of this division are difficult to classify; for they freely admit students on bases that are not only hopelessly unequal to each other, but are even incapable of reduction to a common denominator. On their actual standards the catalogue statements throw little light: there the requirements are cast in the form of a descending scale, running from the top, down. Equally acceptable in their sight are a bachelor's degree from a college or a university, a diploma from an "accredited" high school, an examination in a few specified and several of a wide range of optional studies, and a certificate from the principal of a high school, normal school, or academy, from a "reputable instructor," from a state or city superintendent of education, or from a state board of medical examiners, that stamps the applicant as possessing the "equivalent" of a high school education. Now it is dear that the alternatives at the top are mainly decorative. The real standard is perilously close to the "equivalent" that creeps in modestly at the bottom. There is, of course, no active prejudice anywhere against Ph.D.'s and A.M.'s and A.B.'s and B. Sc.'s; they are apt to be rather conspicuously exploited, when they drift in. But they do not set the pace; they do not determine or even vitally affect the character of the school. In these instances the medical curriculum either contains the pre-medical subjects in an elementary form, or, what may be worse, tries to go ahead entirely without them. The real standard is not influenced by the presence of degree men, and the wonder is that any of them sacrifice the advantage of a superior education by resorting to these institutions. The minimum is, then, the real standard; all else is permissive; for to the needs of those admitted at the bottom the quantity and quality of the instruction must in fairness conform.

To get at the real admission standard, then, of these medical schools, one must make straight for the "equivalent." On the methods of ascertaining and enforcing that, the issue hangs. Now the "equivalent" may be defined as a device that concedes the necessity of a standard which it forthwith proceeds to evade. The professed high school basis is variously sacrificed to this so-called equivalent. The medical schools under discussion agree to accept at face value only graduation diplomas from "approved" or "accredited" high schools. These terms have a definite meaning: they indicate schools which, upon proper investigation, have been recognized by the state universities of their respective states, or by some other competent educational organisation,—in New England, by the College Entrance Certificate Board; in the middle west, by the North Central Association. High schools and academies not acceptable at full value to state universities or to the bodies just named