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We have still to deal with schools of our third division. They are most numerous in the south, but they exist in almost all medical "centers,"—San Francisco, Chicago, —there plainly on the sufferance of the state board, for the law, if enforced, would stamp them out,—St. Louis and Baltimore. Outside the south they usually make some pretense of requiring the "equivalent" of a high school education; but no examiner of any kind is employed, and the deans are extremely reluctant to be pinned down. Southern schools of this division, after specifying an impressive series of acceptable credentials ranging once more from university degrees downward, announce their satisfaction with a "grammar school followed by two years of a high school,'" or in default thereof a general assurance of adequate "scholastic attainments" by a state, city, or county superintendent, or some other person connected with education or purporting to be such; but the lack of such credentials is not very serious, for the student is admitted without them, with leave to procure them later. Many of the schools accept students from the grammar schools. Credentials, if presented, are casually regarded and then usually returned; a few may be found, rolled up in a rubber band, in a dusty pigeonhole. There is no protection against fraud or forgery. At the College of Medicine and Surgery, Chicago, a thorough search for credentials or some record of them was made by the secretary and several members of the faculty, through desk drawers, safe, etc., but without avail. The school is nevertheless in "good standing "with the Illinois state board, and is "accredited" by the New York Education Department to the extent of three years' work. At the medical department of the University of Georgia I was told: "We go along way on faith." In visits to medical colleges certificates were found from non-existent schools as well as from non-existent places.^[1] Of course a few fairly competent students may be found sprinkled in these institutions. But for the most part, the student body gets in on the "equivalent." At the Atlanta School of Medicine, 73 per cent of last year's first-year class entered thus; at the Mississippi Medical College (Meridian, Mississippi), 80 per cent; at Birmingham Medical College, 62 percent. In point of quality, the classes are not competent to use such opportunities as are provided. In Atlanta the Grady Hospital is open for bedside clinics to groups of six students; on the average, two come. In Chattanooga it is "rare to get a medical student who knows even a little algebra; it is impossible to use with medical students the text-books in science used in freshman academic classes." At Charlotte I was told that "it is idle to talk of real laboratory work for

1. Accepted certificates are in this form:

   To ............................... Dean:

   Sir: I have examined Mr ................................ of ............................... and find his scholastic attainments equal to those requisite for a first-grade teacher's certificate in our public schools, with the equivalent of two years of high school study.

   Yours very truly,

   (Sign here) ..............................., Superintendent of Public Instruction.

   These are furnished to the student by the medical college; he needs only to have them signed. The college does not investigate the signature; no official mark or seal is asked. Even the medical department of Vanderbilt accepts preliminary certificates in this form.