men. The course is five years, and students probably can gain as valuable an education during this time as in four years wholly devoted to engineering studies. Night schools, extension courses, correspondence schools and the like are all useful, but the plan of working half the time at the university and half the time in practise seems to be superior to any other. There is no reason why the system should not be extended in other directions, as to teachers in the public schools of a city. The University of Cincinnati is certainly to be congratulated on having inaugurated a movement which demonstrates the peculiar usefulness of a municipal university.
THE ACTIVITIES OF THE CARNEGIE FOUNDATION FOR THE ADVANCEMENT OF TEACHING
The Carnegie Foundation has published a bulletin on medical education in Europe, prepared by Mr. Abraham Flexner, with an introduction by Dr. Henry S. Pritchett, president of the foundation, which, like its predecessor on medical education in the United States and Canada, issued two years ago, is a document of considerable interest. It appears that in the German Empire, in Austria and in France there is about one physician to each two thousand of the population, in Great Britain about one to 1,100, while in this country there is one physician for 568 persons. The distribution is naturally such that the supply of physicians is relatively much greater in the cities than in the country districts. This is a difficulty which, as Dr. Pritchett indicates, can probably be overcome only by some sort of state support. It is emphasized by the fact that the abler physicians are likely to be drawn to the cities, while it is in the country, where hospital facilities and specialists are lacking, that physicians are needed who are able to meet every emergency.
Mr. Flexner and Dr. Pritchett hold that the supply of physicians in this country is excessive and demoralizing, and place the blame on the large number and low standards of our medical schools. It is not, however, certain that in view of our greater wealth the supply is relatively larger than in Europe; nor is it certain that conditions would be greatly improved by suppressing the weaker schools. If it were possible to select in the right numbers the men best fitted to become physicians and to give them the best possible education, this would clearly be the most desirable state of affairs; but such ideal conditions do not obtain anywhere in our complicated civilization. Medical education is already so prolonged and expensive that if requirements are further increased the career will be open only to the rich; it seems necessary to train more physicians than are needed in order that the best may be selected, and it does not follow that those who are unable to support themselves as physicians are the worse for having had a medical education. It would be well if more children were born to fit parents and fewer to those who are unfit, and the apostles of eugenics are performing a useful service in preaching from this text. But the Carnegie Foundation places itself in the position of the practical eugenicist who would put unfit parents out of the way. This is a delicate and difficult undertaking, which (me is scarcely prepared to entrust to Dr. Pritchett and Mr. Flexner.
The proprietary schools without proper laboratory and clinical facilities are probably being eliminated about as rapidly as is desirable. The American Medical Association publishes annually a list of those which are inadequate, and the Carnegie Foundation has given wide publicity to the deficiencies of these institutions. Such information is desirable, but it may be that the Carnegie Foundation is not the best agency to exploit it. Thus the foundation refused to give pensions to the professors of the University of Illinois at Urbana on the ground that its medical school in
