assistants varying in number with the size of the classes and the extent to which the institution is minded to encourage original activity; a departmental helper attached to each department; preferably, too, a technician and a mechanic, who will, however, in the end more than save their cost.
The budget of a department thus organized in a medical school of, say, 250 students, favorably situated, would assign $3000 to $5000 a year to its head, $2000 to $2500 to a first assistant, $1000 to $2000 to additional assistants, $750 to a helper, and $2500 to $5000 to maintenance, including books, new apparatus, material, animals, etc. The total, ranging from $9250 to $15,250, still omits a proportionate share of the general overhead expense of administering the institution. A university department in one of the fundamental medical sciences, none too elaborately provided, cannot, then, on the average be effectively maintained for less than $10,000 to $15,000 per annum. At the moment, of course, the departments are not all equally expensive. Anatomy and pathology cost more than pharmacology and bacteriology. But the average is not thus seriously disturbed; for the former will extend above the line as much as the latter can be reduced below it. All of them, as they are developed, tend to cost more. Where the sum named has not yet been reached, the tendency towards it is unmistakable. It is, of course, true that fairly good instruction is at times furnished more cheaply. In the small two-year schools situated in small towns, the professors receive less, sometimes much less, than the sums stated; and the expense of maintenance does not at times exceed a few hundred dollars per annum. But these departments cannot continue on this makeshift basis: they are now manned by young men, who, finding themselves doomed to routine and sterility, begin fighting at once to get away. The teacher who is content under such circumstances will soon be out of date; and the instruction, however conscientious, will be decidedly limited in range. To live, these departments must be much more liberally supported; and in the small two-year schools where this has been the case—notably at Cornell and Wisconsin—the departmental budgets correspond pretty closely to our presen estimate. The organization of a department of, say, physiology on the minimum basis of efficiency, for 25 students or less, would require, after providing the initial plant, $3000 for the professor, $1000 for his assistant, $750 expense on the score of material for class use, $250 to keep some little research going, $300 for books and periodicals, $600 for a janitor,—a total of $5900 for the routine teaching of a few students under undesirable limitations. As it is clear that there is no justification just now for the existence of medical schools that are incapable of greatly bettering the type, it follows that schools unable or indisposed to spend the requisite sums lack a valid reason for being. We may then assume that the five departments of a properly organized medical school, capable of handling 125 students, in its first two years can hardly be properly sustained on a total budget of less than from $50,000 to $75,000 annually. If, now, the student pays $150 a year for tuition, there will be an annual deficit ranging from $31,250 to $56,250 a year. Not all the medical schools that are
