Carnegie Report Derides Tennessee Medical Schools (1910)

Attack Made on Tennessee

More Low-Grade Medical Schools than any State

Carnegie Foundation Formulates Accusation

Some Excuses Made for the Alleged Conditions, but the State Is Charged with Making the Worst use of the Means at Its Command

New York, June 6. — In the report of the Carnegie foundation on medical education in the United States, made public today, the following concerning Tennessee appears:

“The State of Tennessee protects at this date more low-grade medical schools than any other Southern State.  It would be unfair and futile to criticise [sic] this situation without full recognition of local conditions.  A standpoint that is entirely in order in dealing with Cincinnati, Chicago or St. Louis is here irrelevant.  The ideals held up must indeed be the same; but there attainment is much further in the future.  The amount of money available for medical education is small; the preliminary requirement must be relatively low.  Practically all that can be asked of Tennessee is that it should do the best possible under the circumstances.

“This it does not do.  The six white schools value their separate survival beyond all other considerations.  A single school could furnish all the doctors the State needs and do something to supply the needs of adjoining States as well.  Low as the entrance standard must be, it has been made lower in order to gather in students for six schools where one would suffice.  The medical schools solicit and accept students who have not yet made the best of the limited educational opportunities their homes provide; and to this extent, not only injure the public health, but depress and demoralize the general educational situation.

Some Shortcomings

“The same is true in reference to laboratories and clinics.  However small the sums applicable to building and equipping laboratories, conditions are needlessly aggravated when six plants are equipped instead of one.  Fees that ought now to be used in providing better teaching are still paying for expensive buildings in Memphis and Nashville.  The city hospitals of both places, small at best, are divided between two schools, though they do not furnish enough material for one.

“Those who deal with medical education in Tennessee are therefore making the worst, not the best, of their limited possibilities.  Their medical schools, treated on their merits, would speedily reduce to one; the utterly wretched establishments at Chattanooga and Knoxville would be wiped out; the more showy, but quite mercenary, concerns at Memphis would be liquidated.  The University of Tennessee, with an annual income that does not as yet suffice for the legitimate needs of its own plant at Knoxville, should abandon for the present the effort to develop at Nashville a school that it can neither control nor support.  The time may come when there will be a call for the State university to enter the field.  But that time is not now.  For the present it is dividing its own forces and hindering the most effective use of such resources as Nashville affords.  The whole field is strangely confused.  Lincoln Memorial University (which is an industrial school, not a university) at Cumberland Gap shelters a medical school at Knoxville; the University of Tennessee at Knoxville shelters an entirely superfluous school at Nashville.

Vanderbilt University

“If our analysis is correct, the institution to which the responsibility for medical education in Tennessee should just now be left is Vanderbilt University; for it is the only institution in position at this juncture to deal with the subject effectively. his does not mean that Vanderbilt has now any large sums of money available or that it should inaugurate impossible entrance standards.  It can do neither, for the general situation countenances neither.  The suggestion merely recognizes the facts that one school can do the work, that Vanderbilt occupies in Nashville the point of vantage; that, in the public interest, the field should be left to the institution best situated to handle it.

“On the other hand, any such arrangement imposes upon Vanderbilt a very distinct responsibility.  It would have to nurse its enrolment [sic]; having determined just how large a school local needs require, it must fix and enforce the strictest entrance requirement compatible therewith.  At the present time this standard would be less than four-year high school graduation; but whatever it be, if only it is real and definite, it will operate to grace up general conditions.  Improved teaching should compensate student defects.

Remedies Suggested

To this end, every effort should be made to secure endowment specifically applicable to the medical department; in the interval, fees must be employed not to wipe out old obligations, however incurred, but to improve the school.  The contract between Vanderbilt University and its medical department should be canceled.  The practitioner teachers must make good their ambition to advance medical education by being content with the indirect advantage accruing from school connections.  If the entire fee income is used to equip the laboratories, to employ full-time teachers in the fundamental branches, to fit out and organize a good dispensary, there will still remain defects and makeshifts enough; but the school will wear a different aspect than is resented by any institution in the State today.

“Let it be said ungrudgingly that these suggestions are offered in no spirit of unkindness.  The State University and Vanderbilt have had their hands full.  They have worked valiantly amidst conditions that might well appal [sic] the strongest hearts.  They deserve no blame for the past, provided only they unselfishly and vigorously co-operate in forgetting it.  In the last few years right courses of action in medical education have for the first time been defined.  A decade hence it will be fair to look back and ask whether the universities of the State have followed them.

“Of the three negro schools in the State, two are without merit.  The third — Meharry — is a more creditable institution.”

Source:  Nashville American, June 7, 1910, page 2

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