In exclusion of pestilences like cholera and yellow fever. exercising such control the state needs every aid which medical experts in chemistry, bacteriology, and comparative pathology can place at its disposal. The medical profession itself hardly recognizes as yet how great promise there is in the further study of the connections between diseases in animals and in man-connections which smallpox, scarlatina in cows, tuberculosis in men and animals, and diphtheria already illustrate. Not even the state - that is, a single state or nation-can deal effectively with such a problem as the suppression of cholera or yellow fever. That is an international problem. The evils which the social and gregarious instincts of men create, by inducing the modern crowding into cities, must be socially remedied; and the most effective force which society can exert to this end is the influence of the highly trained medical officer. Every physician should be a medical philanthropist and missionary, zealous to disseminate knowledge of public hygiene." Present tendencies - Dr Bayard Holmes, secretary of the Association of American medical colleges, writes as follows touching present tendencies in medical education: About "Two stages of educational development are already manifest in the medical schools of the United States. half the schools have finished the first stage and are entering on the second, while the remainder are laboring tardily to complete the first. In the first stage of development, from the medieval lectures on the 'seven branches of medicine,' the course of study has been lengthened, some entrance requirements instituted and the number of distinct and separate studies greatly increased. Laboratory and recitation work have been introduced, written examinations have been made frequent, once a month or oftener, and a sort of graded medical school established. In this condition are most of the schools that maintain the standard established by the Association of American medical colleges. Some few schools, however, have already outgrown this system of educational lock-step and are organizing a cur riculum adapted to the needs of students of differing tastes or abilities. This curriculum is planned not to instruct but to educate; not from the standpoint of the teacher's convenience, but from that of the student's advantage. The first stage of educational development multiplied the teachers, scattered the energies of the student (in some cases requiring him to go before 10 different professors each week) and dissociated related topics. The second stage of development early introduces the student to the study of the live man, makes continuous clinical study on single cases by each of the students a means of unifying the whole curriculum, and requires thesis work of each student, necessitating on his part clinical, laboratory; experimental and library work on the same subject. This introduces intensity in the place of diffuseness; independence in the place of subordination and original investigation in the place of catechism. To assert that the elective method for any large part of the medical curriculum is already established in any considerable number of medical schools, would be misleading, but this is certainly the tendency of the day. The growth of medical libraries in the medical schools, the establishment of thoroughly equipped accessory laboratories, the publication of bulletins and theses and the numerous articles on medical pedagogy written by active medical teachers testify to the intense struggle for the liberation of the medical student and the medical teacher from the iron-clad course of study. When this second stage of development has been realized, the medical schools will do more than furnish quiz classes, preparatory to state board and hospital examinations; they will become fountains of original investigation pouring out every year both welltrained medical men, and large and important contributions to medical science, these contributions produced as a means to a rational education." Early legislation - The earliest law relating exclusively to physicians was passed by Virginia in 1639, but like the later act of 1736 it was designed mainly to regulate their fees. The act of 1736 made concessions to physicians who held university degrees. In only 2 of the 13 colonies were wellconsidered laws enacted to define the qualifications of physicians. The general assembly of New York in 1760 decreed that no person should practise as physician or surgeon in the city of New York till examined in physic and surgery and admitted by one of his majesty's council, the judges of the supreme court, the king's attorney-general and the mayor of the city of New York. Such candidates as were approved received certificates conferring the right to practise throughout the whole province, and a penalty of £5 was prescribed for all violations of this law. A similar act was passed by the general assembly of New Jersey in 1772. In 1840 laws had been enacted by the legislatures of nearly all the states to protect citizens from the imposition of quacks. Between 1840 and 1850, however, most of these laws were either repealed or not enforced as a result of the cry that restrictions against unlicensed practitioners were designed only to create a monopoly. Synopsis of present requirements - In the following political divisions medical diplomas do not now confer the right to practise medicine, an examination being required in all In some tables Texas is classed with the states in which diplomas confer no right to practise, but the Texas laws conflict. The following require for admission to the licensing examination : Alabama, requirements of State medical association Delaware, competent common school education, diploma from legally incorporated medical school District of Columbia, diploma of school authorized by law to confer M.D. degree Florida, diploma from recognized medical school Georgia, diploma from legally organized medical school Idaho, diploma from legally chartered medical school Illinois, less than one year of high school work, diploma from approved medical school Indian territory, Cherokee nation, diploma from reputable medical school Iowa, less than one year of high school work, diploma from recognized medical school Louisiana, fair primary education, diploma of recognized medical school Maryland, common school education, diploma from legally incorporated medical school Minnesota, four full courses of lectures at recognized medical school Montana, diploma from legally chartered medical school New Hampshire, full high school course or its equivalent, diploma from regularly organized medical school New Jersey, common school education, diploma from legally incorporated medical school New York, four years' high school course or its equivalent, diploma from registered medical school North Carolina, diploma from medical school in good standing (after Jan. 1, 1900) North Dakota, 3 six months' lecture courses Pennsylvania, common school education, diploma from legally chartered medical school South Carolina, diploma of recognized medical school Utah, diploma from chartered medical school in good standing Vermont, high school course or equivalent and diploma from a U. S. medical school Virginia, evidence of a preliminary education The following require the licensing examination only: Connecticut Hawaii Massachusetts Oregon Mississippi Washington West Virginia North Carolina (diploma after 1900) The following require approval of medical diploma by duly qualified boards: California Kentucky Nebraska Ohio South Dakota The following require either approval of medical diploma or examination by state or other duly qualified boards: The following requiring either approval of medical diploma or examination, admit to examination on : Arkansas, a good literary education Nevada, five years' practice in the state just prior to act or diploma from reputable school without the United States Oklahoma, full course of lectures Kansas requires only presentation of diploma or other certificate of qualification to unqualified local officer Alaska has no law. In Cuba, the Philippines' and Puerto Rico' the requirements are in process of transition. The following political divisions have mixed examining boards, that is the boards are composed of representatives of the several schools of medicine: 1 The assistant secretary to the military governor in the Philippines writes Sep. 4, 1899 that "the Spanish law as to admission to practise still governs. In general this requires a diploma from a reputable college, school or university of such profession, or in lieu thereof an examination." 9 General Davis established Sep. 30, 1899 in Puerto Rico an examining committee for licenses to practise medicine, dentistry, pharmacy, midwifery and professional nursing. Only those with satisfactory credentials are admitted to examination. |