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This brief evaluation of the status of Cooper Medical College in 1901-1902 includes various evidence to support the view that the school's program, faculty and facilities were above the average of American medical schools of the day. It is also clear from the data on annual number of graduates cited in the above table that the College was successful in the competition with the Medical Department of the University of California for students, a practical indicator of relative standing.

The President's Financial Report for 1902 to the Board of Directors of the College showed that the medical school and Lane Hospital were both financially self-supporting and unencumbered. Together they comprised a thriving medical center. [33]

These favorable conditions, to which should be added the abiding loyalty of the Cooper Faculty, were a tribute to Levi Cooper Lane. His tireless efforts, selfless generosity, and far-sighted ideals of education and service to humanity were the source of a creative energy that fulfilled the aspirations of Elias Cooper and profoundly influenced the early course of medical education in the West.

In counterpoint to currently favorable conditions at Cooper Medical College, we have called attention to nationwide forces then increasingly at work to reform American medical schools. This movement was certain in due course to have a major effect on the College.

In respect to this reform movement, we have referred to the revival of interest at the American Medical Association in the restructuring of the medical schools; the creation of the Council on Medical Education as an agency for that purpose; and finally to the Council's agreement to cooperate with Abraham Flexner in his definitive study of American medical education under the auspices of the Carnegie Foundation.

We have already commented amply on the excessive number and sad state of American medical schools, and will now only briefly mention an important consequence of this condition, namely, the gross overproduction of ill-trained American doctors. In the early 1900's, the 160 American medical schools numbered as many as in Great Britain, France, Germany and Austria combined. Germany had one doctor for every 2000 souls, and one for every 1000 in the large cities. In this country there was an average of one doctor for every 570 persons; and frequently for every 400 or less in large cities. Many small towns with less than 200 inhabitants had two or three physicians. In general terms, the United States had about four times as many doctors per capita as Germany. Proprietors of low-grade medical schools were wont to advance the specious argument that their standards were low to enable economically disadvantaged students to attend medical school and serve their communities. Obviously, low standards and poor training were no longer needed in order to supply physicians, much less poor ones, to America. [34] [35]

This review of the status of medical education at Cooper Medical College and in the nation at large, will serve as background for our consideration of an impending crisis in the life of the Cooper school when : "The old order changeth, yielding place to new." [36]


Second Thoughts

When Dr. Lane established Cooper Medical College in 1882 he deeded all its lands and premises to the Corporation of Cooper Medical College. We recall that in 1893 he encumbered the deed by affixing to it a pledge from the Board of Cooper Medical College and the Faculty that "the College shall never be affiliated with, or become the department of any other educational institution, but shall remain an independent school in which Medicine and its Kindred Sciences shall be taught."

By 1901, Dr. Lane began to recognize that the ultimate destiny of medical education in the United States, as in Europe, was to be under the control of universities. He also realized that the expenses of his College would increase enormously as it became necessary to appoint more salaried professors; that the practice income of Faculty and tuition of students could no longer be expected to pay the full cost of medical education; and, finally, that eventual union with a University was necessary to the survival of Cooper Medical College. [37] [38]

On at least one occasion, and possibly more, Dr. Lane discussed with President Jordan the feasibility of a merger with Stanford. Although Stanford's financial condition had begun to improve, President Jordan was cautious in his assessment of the University's ability to fund a medical school. On 30 October 1901 he wrote: "As to the possibilities of organic union, should this be considered desirable by the Cooper Medical College, I may say that we would strongly favor it if it were practicable. Our main difficulty is this: We are not now ready to incur the expense of a salaried faculty; we do not think it wise to begin without one." [39] [40]

In view of the advantages to Cooper College in a union with Stanford University now foreseen by Dr. Lane, he decided to rescind his restriction on such a transaction. In order to do so it was necessary for him to regain possession of the College property that he and Mrs. Lane had previously deeded to the Corporation, and then reconvey it to the Corporation devoid of the encumbrance he had placed upon it. To this end Dr. Lane, who was seriously ill and failing rapidly at the time, initiated a series of meetings of the Board of Directors of the College from the 15th through the 18th of January 1902.

In the course of these meetings, the Corporation and Dr. and Mrs. Lane took the necessary legal steps to convey the Cooper properties to the Lanes and on 17 January 1902 they deeded the property back to the Corporation free and clear of the aforementioned restriction. In consequence, from this date forward, the Directors of the Corporation were at liberty to negotiate with Stanford regarding a relationship that might include organic union with the University. Dr. Lane's decision, at the eleventh hour of life, to remove all barriers to such negotiation was an evidence of his vision and a measure of his greatness as the century's leading benefactor of medical education in the West. [41]


The AMA Council's "Ideal Standard" of 1905

In 1905 the newly established Council on Medical Education adopted the following statement regarding an "ideal standard" for American medical colleges based on the programs of the better schools in England, Germany and France: [42]

  1. One of the chief functions of the American Medical Association should be the elevation of medical education in this country and it should be its avowed purpose to secure throughout this country, within a reasonable time, as high a standard as that of any country in the world.

  2. The elevation from present conditions to the highest standard desired must be gradually brought about in justice to all concerned and we would not at this time recommend too sweeping changes.

  3. The ideal standard to be aimed at from our present view-point should consist of:

    1. Preliminary education sufficient to enable the candidate to enter our recognized universities, the passing upon such qualifications by the state authorities. (Note: This is equivalent to accepting a high school diploma as the minimum standard for admission to medical school.)

    2. A five year medical course, the first year of which should be devoted to physics, chemistry and biology, and such arrangements should be made that this year could be taken either in a school of liberal arts or in the medical school. Of the four years in pure medical work, the first two should be spent in laboratories of anatomy, physiology, pathology, pharmacology, etc., and the last two in close contact with patients in dispensaries and hospitals in the study of medicine, surgery, obstetrics and the specialties.

    3. A sixth year as an interne in a hospital or dispensary should then complete the medical course.

It is believed that it will require about two years to secure the general adoption of these requirements by state boards and medical schools; and we, therefore, recommend that the effort be made to make these requirements effective by 1 January 1908.

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