Page:Carnegie Flexner Report.djvu/98

80 to use. Once the necessary resources have been bestowed upon them, the remaining task will be merely the absorption or the suppression of the various types of medical school yet to be discussed. It is surely significant that with but a single exception, these schools are also, like those of the first division, bona fide university departments.

So much for the best type of medical school on the high school basis. We consider next (2) the schools that on the same basis are shrewdly and more or less outspokenly commercial. A few of them — those at Chicago, Philadelphia, and Baltimore—have accumulated extensive and, in one or two departments, elaborate plants. They are on a routine level and, within the limits marked out by state board examinations, pedagogically effective. They drill their students energetically in the elements of such of the sciences as they touch at all, but the atmosphere is at best that of a successful factory. There is no free scientific spirit. The teaching of chemistry at the Medico-Chirurgical College of Philadelphia is an extreme case in point. The course is subdivided into fixed lessons, each of them so much raw material, for which the student receives a voucher, to be returned in proper shape before he can get the voucher for the succeeding task. The vouchers returned constitute an automatic record of attendance and form the basis of an oral quiz by an instructor. "The whole system is an imitation of the business system in vogue in the better organized business offices." Mechanically admirable, no doubt; but what convincing evidence the system itself affords of the unfitness of the students for the study of modern medicine!

Two schools of this group- the Long Island College Hospital (Brooklyn) and the Albany Medical School—are closely affiliated with laboratories which provide good teaching in certain branches: the Hoagland Laboratory at Brooklyn relieves the school of histology, pathology, and bacteriology; the Bender Laboratory at Albany carries the laboratory work in the same subjects. It will be noted that physiology and pharmacology are not properly provided by either; neither are they by the school. One might suppose that the school, relieved at one point, would become more effective at another. Not at all. Both schools pay in dividends to prosperous practitioners the sums that should be used in completing their fundamental instruction.

Scientifically, then, these schools may be called inert. They rarely cultivate any research at all; their faculties are generally composed of active practitioners whose training has rarely been modern. By way of exception Louisville has four full-time professors in the fundamental branches, the Medico-Chirurgical three, Creighton one. But very rarely has the full-time teacher opportunity to work ahead. His time and energies are bespoken by heavy routine, unlightened by a competent or organized force of assistants and helpers. In general, school positions are valued as professional