will be forthcoming. New York University is much lass secure. Its maintenance at its present level is conditioned on adherence to a lower admission standard than is scientifically justifiable or educationally necessary. It cannot much longer resist the upward trend; for its scientific faculty—and thence the initial stimulus comes—is apt to chafe under the limitations which the lower standard imposes. Whether on the higher basis the school will be a permanent factor in the situation is thus largely a question of adequate support from the outside in the next few years. None of the other local schools have at this date a substantial foundation of any sort.
The ground being thus cleared, the clinical difficulty still presses. Institutional competition is reduced; but personal and professional competition remain. Why should non-schoolmen freely retire for the sake of schoolmen? The situation is curiously deadlocked. The school faculties are not now made up on educational lines,—they cannot be. If the number of schools were reduced to two or three, it would still be true that their clinical faculties would in the main be constituted of men very much like the more important men omitted from them. Such being the case, the hospitals and the doctors naturally refuse to yield to the universities; and until they do yield, the universities cannot freely reconstruct their clinical branches. The faculty men would themselves doubtless make common cause with the outsiders as against a university which asks a free hand in order to bring in a body of clinical teachers from the outside. The usual hospital staff will not vacate for the present type of clinical faculty, because the faculty lacks commanding scientific and pedagogical preeminence; nor will the present faculties surrender to the universities for the purpose of enabling the latter to fill the places with men of another type.
Under these circumstances, palliation may perhaps come through some coöperative effort. Tension and friction will at least decrease as the number of schools diminishes. Clinical teaching in the municipal hospitals, perhaps, could then be controlled under some form of federation. The vast resources of these great institutions might under combined management form a great postgraduate and special clinic; and the municipal authorities might conceivably relax, for the common benefit of a single organization and for the glory of a great enterprise, restrictions which they have found necessary in dealing with several institutions engaged simultaneously in training boys. Unquestionably such action would bring the present postgraduate schools into the university, where they ought to be.
With this arrangement consummated, however, the schools still lack teaching hospitals in which the undergraduate student can be vigorously disciplined while his freely chosen teachers are themselves engaged in intensive clinical research. The teaching hospital must be in close geographical proximity to, and in the most intimate intercommunication with, the scientific laboratories. In the case of Columbia, every physical and educational condition is already satisfied by Roosevelt Hospital: the scientific laboratories, the dispensary, the maternity hospital, are on one side of the street; the general hospital on the other. Together they would form an ideally
