Page:Introductory Address on the General Medical Council, its Powers and its Work.djvu/28

 its licentiates. In its own interest the Board has to recognize that it is hurtful, not helpful, to have the reputation of being over-lenient; and I may add, as a matter of statistical fact, that even in older days, before the full operation of this law was observed, the easiest examination was not the one which attracted the most students. In so far, however, as the primary tendency of competing examinations might be regarded as downwards rather than upwards, the State has established a check. It has affirmed the principles (1) that a certain minimum of stringency shall be required; (2) that the minimum shall always be such as to secure efficiency in the practice of the essential branches of medicine, surgery, and midwifery; and lastly (3), that to admit of the gradual rise of the minimum with advancing needs and advancing knowledge, the practical definition of it from time to time shall be left to the General Medical Council with the concurrence of the Privy Council.

It is here that the Constitution of the Council tells in favour of these self-acting—or, as I called them just now, economic—forces which tend to raise the standard of both teaching and examination. Every Board has its member on the Council. The Council informs itself by inquiry and inspection of the actual requirements of each in respect of training and of testing. If it appears, let us say, that England is at a given moment too lax in any particular, and that students are in consequence tempted to pass to England from Scotland and Ireland, the members from these sterner regions are at once on the alert. They are not usually deterred from speaking their minds by any overmastering awe of the majesty of English Universities or Corporations. They have a common interest in urging that the alleged laxity shall be remedied. The English Boards, even if they were united in a solid conspiracy of Saxondom, have only 12 votes out of 34. If the case against them is made out to the satisfaction of the members elected by the Government and the practitioners respectively, the English combination is powerless to prevent the carrying