MEDICAL EDUCATION AND MEDICAL COLLEGES IN THE UNITED STATES AND CANADA-1765-1885. THE most suggestive facts revealed by a study of the tables and data presented in the following pages are, First, that the number of medical colleges has not increased during the past year; and, Second, that the numbers of medical students and of medical graduates are decreasing. There are still 128 institutions for medical instruction in the United States and Canada, the same aggregate as at the date of the last Report. But there were 760 less students in attendance upon, and 273 less graduates from, the sessions of 1884-85 than upon and from the sessions of 1883-84. In the United States there were 953 less students, and 278 less graduates. In Canada there were 176 more students and 5 more graduates. Third, a more marked uniformity in the requirements of colleges. There are 2 more regular schools (101), the same number of homeopathic (13), one less eclectic (11), and one less physio-medical (1), which, with two miscellaneous or mixed schools, make the aggregate (128) as before. Graduates at the close of the sessions of 1884-85 have presented diplomas to the ILLINOIS STATE BOARD OF HEALTH -as the basis of applications for certificates entitling to practice in Illinois-from 42 regular, 7 homeopathic, 3 eclectic, and 2 physio-medical schools; being from 5 more regular, 1 more eclectic, and 1 more physiomedical than the previous year. Excluding 4 Canadian schools, the graduates of 11 out of 38 regular schools, and of 4 out of 12 other schools. were required to supplement their diplomas by passing examinations before the BOARD in those branches or subjects of the Schedule of Minimum Requirements which were omitted in the curricula or requirements of their respective colleges. In the previous year the graduates of 17 out of 31 regular, and of 4 out of 6 other schools were required to submit to such examination. It should be understood that diplomas issued at the close of the sessions of 1883-84, and subsequently, are accepted unconditionally -as sufficient warrant for the certificate of the BOARD, required by law from all colleges which give evidence, in their Announcements and elsewise, of an actual and bona-fide compliance with the Schedule herein published. The diplomas of colleges which do not give such evidence are required to be supplemented by an examination before the BOARD, on the branches or subjects of the Schedule omitted by the colleges in question. The figures above given show a marked improvement in the proportion of colleges now complying with these requirements. Whereas, during the first year after the Schedule took effect, more than one half of the regular and two-thirds of the other schools (whose graduates applied for certificates) had failed to comply in one or more respects, only a little more than one-fourth of the regulars and onethird of the others were derelict during the past year. The improvement is shown in detail in the tables embraced in the Summary of Institutions and Students, which-among other thingsshow that there are now 110 colleges which exact an educational requirement as a condition of matriculation; in the first Report there were only 45. Attendance on three or more lecture-courses before graduation is now required by 36 colleges, as against 22 heretofore; and provision is made for a three- or four-years' graded course by 45 others. Hygiene is now taught in 91 colleges, and medical jurisprudence in 97; as against 42 and 61, respectively, heretofore. The average duration of lecture-terms has increased from 23.5 weeks to a fraction over 25 weeks; 7 more colleges have lecture terms of five months or over, and 10 more have terms of six months or over, as compared with the sessions of 1882-83. WHILE this change in the standard and methods of medical education has been going on, it is worthy of note that the numbers of students and of graduates are diminishing-the latter in even a greater ratio than the former. The classes of the last sessions (1884-85) are less than those of any since the sessions of 1882-83. There were in attendance upon these latter sessions 13,088 students; in 1883-84 there were 12,762-a loss of over two and a-half per cent.; in 1884-85 there were 12,002-a loss of over eight per cent. since the Schedule of Minimum Requirements took effect. At the close of the sessions of 1881-82 there were 4,555 students graduated; in 1882-83 there were 4,215; in 1883-84, 4,101, and in 1884-85 only 3,831-or nearly 16 per cent. less than from the firstnamed sessions. There are three causes combined to which this result may be attributed: First, "hard times" throughout the country generally since the great business prosperity of 1882-although the value of this as one of the causes is weakened by the fact that the attendance upon the Canadian schools has increased instead of diminished, there being 176 more students at the last sessions than at those of the previous year, a gain of 23 per cent. Second, a general and increasing desire on the part of the profession to elevate the standard of attainments necessary to enter its ranks. And, third, the enforcement of certain requirements in States which have enacted laws regulating the practice of medicine. Under such a law the ILLINOIS STATE BOARD OF HEALTH, in 1880, adopted the following SCHEDULE OF MINIMUM REQUIREMENTS. I. CONDITIONS OF ADMISSION TO LECTURE-COURSES.--1. Credible certificate of good moral standing. 2. Diploma of graduation from a good literary and scientific college, or high school-a first-grade teacher's certificate. Lacking this a thorough examination in the branches of a good English education, including mathematics, English composition, and elementary physics and natural philosophy. II. BRANCHES OF MEDICAL SCIENCE TO BE INCLUDED IN THE COURSE OF INSTRUCTION.-1. Anatomy. 2. Physiology. 3. Chemistry. 4. Materia Medica and Therapeutics. 5. Theory and Practice of Medicine. 6. Pathology. 7. Surgery. 7. Surgery. 8. Obstetrics and Gynecology. 9. Hygiene. 10. Medical Jurisprudence. III. LENGTH OF REGULAR GRADUATING COURSES.-1. The time occupied in the regular courses or sessions from which students are graduated shall not be less than five months, or twenty weeks, each. 2. Two full courses of lectures, not within one and the same year of time, shall be required for graduation with the degree of Doctor of Medicine. IV. ATTENDANCE AND EXAMINATION OR QUIZZES.-1. Regular attendance during the entire lecture courses shall be required, allowance being made only for absences occasioned by the student's sickness, such absences not to exceed twenty per centum of the course. 2. Regular examinations or quizzes to be made by each lecturer or professor daily, or at least twice each week. 3. Final examinations on all branches to be conducted, when practicable, by competent examiners other than the professors in each branch. V. DISSECTION, CLINICS AND HOSPITAL ATTENDANCE.-1. Each student shall have dissected during two courses. 2. Attendance during at least two terms of clinical and hospital instruction shall be required. VI. TIME OF PROFESSIONAL STUDIES.-This shall not be less than three full years before graduation, including the time spent with a preceptor, and attendance upon lectures or at clinics and hospital. VII. INSTRUCTION.-The college must show that it has a sufficient and competent corps of instructors, and the necessary facilities for teaching, dissections, clinics, etc. DIPLOMAS of colleges whose educational requirements and methods of instruction fall short of the above schedule are not recognized as entitling their possessors to certificates authorizing them to practice in the State of Illinois. (This does not apply to diplomas issued prior to the sessions of 1883-84, but only to those issued at the close of said sessions and subsequently.) The only way in which holders of such diplomas may legally enter upon. practice in this State is by passing a satisfactory examination before the BOARD on the branches or subjects of the Schedule omitted. This Schedule is, therefore, the test of the "good standing" of a medical college in Illinois. Only colleges which come up to this minimum standard are accounted as in "good standing." To determine the status of any given institution, it is only necessary to compare the summary of the institution set forth in the following pages with the above schedule. There are 233 different medical institutions, dating from the year 1765, summarized in this report. Of this number the diplomas or licenses of 136 have been presented to the ILLINOIS STATE BOARD OF HEALTH for verification and acceptance-131 for the first time prior to the sessions of 1883-84, and the remaining 5 for the first time since that date. There are now remaining in existence 123 institutions of medical education of all classes which are empowered to grant degrees-116 in the United States, and 12 in Canada. Among the extinct schools there are 56, out of 145 regular; 9, out of 22 homeopathic; 20, out of 31 eclectic; and 6, out of 9 physiomedical and miscellaneous. All the fraudulent institutions are now extinct. |