all the real and many imaginary needs. There are at this date something like 8000 public and over 1000 private high schools, so widely dispersed over the area under consideration that on the average few boys need go over five miles to school.[1] In the public high schools alone there are enrolled 300,000 boys.[2] What excuse exists for cutting under the high school? We can indeed do better than to accept as the basis of a medical education the high school "flat." In the colleges, universities, and technical schools of the north and west, exclusive of preparatory and professional departments, there were in 1908, 120,000[3] male students. The number swells with unprecedented rapidity; long before the country has digested the number of doctors now struggling for a livelihood, it will have doubled. Already in 1907, 903 of the doctors graduated in that year held academic degrees; that is to say, fully one-half of the number the country actually needed could conform to the standard that has been urged, or better. There is at this moment absolutely nothing in the educational situation outside the south that countenances the least departure from the scientific basis necessary to the successful pursuit of modern medicine.
For whose sake is it permitted? Not really for the remote mountain districts of the south, for example, whence the "yarb doctor," unschooled and unlicensed, can in no event be dislodged; nor yet for that twilight zone, on the hither edge of which so many low-grade doctors huddle that there is no decent living for those already there and no tempting prospect for anybody better: ostensibly, "for the poor boy." For his sake, the terms of entrance upon a medical career must be kept low and easy. We have no right, it is urged, to set up standards which will close the profession to "poor boys."
What are the merits of this contention? The medical profession is a social organ, created not for the purpose of gratifying the inclinations or preferences of certain individuals, but as a means of promoting health, physical vigor, happiness—and the economic independence and efficiency immediately connected with these factors. Whether most men support themselves or become charges on the community depends on their keeping well, or if ill, promptly getting well. Now, can anyone seriously contend that in the midst of abundant educational resources, a congenial or profitable career in medicine is to be made for an individual regardless of his capacity to satisfy the purpose for which the profession exists? It is right to sympathize with those who lack only opportunity; still better to assist them in surmounting obstacles; but not at the price of certain injury to the common weal. Commiseration for the hand-spinner was not suffered for one moment to defeat the general economic advantage procurable through machine-made cloth. Yet the hand-spinner had a sort of vested right: society had tacitly induced him to enter the trade; he had grown up in it on that assurance; and he was now good for nothing else. Your "poor boy"
