hu Z'mel 
 
 THE MEDICAL SCHOOL OF THE 
 UNIVERSITY OF MINNESOTA and 
 THE MAYO FOUNDATION FOR 
 THE PROMOTION OF MEDICAL 
 EDUCATION AND RESEARCH 
 
 I. The Formal Statement of the Committee, 
 as published in the Journal - Lancet, 
 March 15, 1915. By the Committee. 
 
 II. The Mayo Foundation from the Stand- 
 point of The Graduate School. 
 
 By Dean Guy Stanton Ford. 
 
 III. History of Negotiations. 
 
 IV. Precedents for Affiliation. 
 
 By the Committee. 
 
 Printed and distributed by 
 
 GEORGE E. VINCENT E. P. LYON J. E. MOORE 
 J. C. LITZENBERG R. O. BEARD 
 
 Committee upon The Relations of The Medical School 
 with The Mayo Foundation 
 
Digitized by the Internet Archive 
 in 2017 with funding from 
 
 University of Illinois Urbana-Champaign Alternates 
 
 https://archive.org/details/medicalschoolofuOOford 
 
THE MEDICAL SCHOOL OF THE UNIVERSITY OF MINNESOTA 
 AND THE MAYO FOUNDATION FOR THE PROMOTION 
 OF MEDICAL EDUCATION AND RESEARCH 
 
 FOREWORD 
 
 The medical profession of the State and the 
 alumni of the medical school everywhere will be 
 interested to know, from authoritative sources, 
 the nature and the terms of the proposals which 
 have been framed and submitted to the Board of 
 Regents for affiliation of the Mayo Foundation 
 with the Medical School of the University of 
 Minnesota. 
 
 The profession at large should be inter- 
 ested in an event big with possibilities for the 
 future of medical education in this State. 
 
 Not alone the theories, but the conditions of 
 medical education in Minnesota, bearing upon 
 this question, should be understood. The advan- 
 tages of affiliation should be appraised. The ob- 
 jections to it should be carefully weighed and its 
 net values determined. 
 
 With these objects in view, this statement is 
 offered. Carefully reviewed by representatives 
 of both parties to the proposed arrangement, it 
 issues with authority. 
 
 It presents (a) the plan of relations during 
 the proposed experimental period of affiliation ; 
 (b) the main outlines of the ultimate plan to 
 which temporary affiliation, if successful, may 
 lead. 
 
 MEDICAL EDUCATION IN MINNESOTA 
 
 In the unification of medical education Minne- 
 sota has accomplished much. In its control by 
 the State University, the standards of prepara- 
 tion for the practice of medicine are assured. By 
 its ready adoption of educational advances, 
 through a quarter of a century of progress ; by 
 the generous equipment of its scientific labora- 
 tories ; by the attainment of a teaching hospital 
 providing, in part, for its major clinics; by the 
 upbuilding of a large and efficient outpatient 
 service, the University Medical School has placed 
 itself in the forefront of teaching institutions. 
 
 The acquirement of rank, like the inheritance 
 of privilege, imposes the principle of noblesse 
 
 oblige. The State is committed to the nearest 
 and the speediest approach it may make to the 
 highest ideals of medical education. It has ac- 
 cepted the obligation of medical research in the 
 service of the people. 
 
 In all State institutions, development is con- 
 tingent upon adequate appropriation. In a young 
 commonwealth, of rapid growth and diversified 
 interests, the demand for the means of support 
 is imperative in every field of education. The 
 medical school has received its share, but that 
 share has been inadequate to the supply of its 
 multiplying needs. It has called to its aid the 
 public hospitals of the Twin Cities and with 
 helpful response. Yet with a taste of the teach- 
 ing values of hospital beds all its own, it finds 
 the quasi-control of other service unsatisfactory. 
 It now requires an additional pavilion of one hun- 
 dred and fifty beds, a home for the School for 
 Nurses and suitable quarters for its outpatient 
 dispensary. Finally, it needs room, on the new 
 campus, to house the one badly dislocated branch 
 of its service, — the department of pathology, bac- 
 teriology and public health. Doubtless it will 
 have to accept the fulfillment of these needs by 
 piecemeal and with as much grace of patience as 
 its faculty can muster. It does not possess today 
 the full requirements of effective undergraduate 
 training, to say nothing of the needs of graduate 
 teaching. Its perennial cry is : “More beds !” 
 
 At the present moment, a new problem, — a 
 new opportunity of service awaits it. 
 
 THE PROBLEM OF GRADUATE MEDICAL TEACHING 
 
 The need in America of the Graduate School 
 in Medicine is apparent. It is a need not yet 
 formulated as to type ; a need which finds in- 
 dividual expression and must be individually met. 
 Methods of meeting it are engaging the minds of 
 medical educators both east and west. 
 
 The practical closure of the field of graduate 
 study abroad has accentuated the desire for do- 
 mestic opportunity ; has stimulated teachers' and 
 
instructors to provide it. Men of medicine in 
 America have long felt that the pilgrimage of 
 medical graduates to European clinics is, in large 
 degree, a tradition. They have long held that 
 the mechanism and material of research may be 
 found within our own medical doors. The clini- 
 cal Mecca across seas has always been sought by 
 many men of merit, and by more men of means. 
 Too often the fruitful student has been barred of 
 his full fruition by stay-at-home demands for his 
 daily bread. With a modicum of relief from 
 financial pressure, with a nearby chance of study, 
 he is ready to grasp eagerly the offer of grad- 
 uate teaching. 
 
 The tendency to specialism in medicine creates 
 the objective of the great majority who go to 
 the clinics of Europe; but for one who seeks his 
 goal through patient years of preparation in the 
 schools, the many among specialists break into 
 full bloom during a summer’s junket to the Old 
 World. To medical educators of today, this 
 forcing method no longer appeals. The argu- 
 ment of fitness is gaining in the moral sense of 
 men, and in the fit training of specialists Uni- 
 versity schools recognize one of the great needs 
 of the hour and, therefore, one of the chief ends 
 of graduate medical teaching. 
 
 Willing students wait the opportunity ; but 
 other things, also, are needed for the develop- 
 ment of the Graduate School in Medicine. The 
 task calls for men ; for men of large vision as 
 graduate teachers, for men who can evolve 
 method and material other than that which serves 
 the purposes of undergraduate instruction ; men, 
 who, foregoing the ways and works of the poly- 
 clinic, — the historic vaudeville of so-called grad- 
 uate study, — can lead the graduate student up to 
 larger conceptions of advanced scientific medi- 
 cine ; men who can cultivate in others the desire 
 to lay broad and deep the foundations of really 
 specialized function in the practice of the pro- 
 fession, who can inspire in their fellows the pas- 
 sion for research and the habit of following in 
 the footsteps of scientific truth, wherever they 
 may lead. 
 
 There is needed, too, a wealth alike of clinical 
 and laboratory material, — a wealth which the or- 
 dinary medical school, even of University parent- 
 age, does not possess ; which, often, indeed, it 
 does not enjoy to the full measure of its under- 
 graduate demands. Graduate teaching in experi- 
 mental medicine or surgery, or in the specialties 
 of practice, must be built upon a broad basis of 
 4afeuratory study in each relational field, while its 
 
 special clinical problems must be made continually 
 the subject of laboratory investigation. Large 
 must be the mass of available material from 
 which the adequate selection of norms and of 
 aberrants, for the uses of the specialist in study, 
 may be drawn. 
 
 The appreciation of these great essentials of 
 graduate medical teaching has made the approach 
 of teachers to its problems very slow. It should 
 no longer bar them where means and men and 
 material are to be found. 
 
 THE GRADUATE SCHOOL IN MEDICINE OF THE UNI- 
 VERSITY OF MINNESOTA 
 
 With the authority of the Board of Regents, 
 the Administrative Board of the Medical School 
 has launched, within the past year, the Graduate 
 School in Medicine. Realizing that the definition 
 of graduate work must be clear, that a distinct 
 line of demarcation must be*drawn between it and 
 the practitioners’ courses of the past, that the 
 conditions under which it is offered must accord 
 with academic traditions, the school has estab- 
 lished itself as a branch of the Graduate School 
 proper of the University of Minnesota. It is 
 under the joint direction of the Dean of the 
 Graduate School, the Dean of the Medical School, 
 and a committee of the medical faculty on grad- 
 uate teaching. 
 
 It offers a number of distinct opportunities, 
 viz. : 
 
 (a) The pursuit of special research problems, 
 under chosen supervision, for unstated periods 
 of time. 
 
 (b) Courses of graduate study in the general 
 field of medicine, from which selection of major 
 and minor subjects is made. These courses, 
 under direction of the committee, include rela- 
 tional studies along clinical lines and founda- 
 tional studies in laboratory branches. They in- 
 volve the preparation of a thesis. They are ar- 
 ranged in time periods of two and three years. 
 They lead, finally, to the degrees of Master of 
 Science and Doctor of Science, respectively. 
 
 (c) Teaching fellowships, awarded to the 
 selected graduate in medicine, who desires to 
 train himself in a given specialty. These fellow- 
 ships, in limited number, are offered in Surgery, 
 Internal Medicine, Obstetrics, Pediatrics, Eye, 
 Ear, Nose and Throat Diseases, and Nervous Dis- 
 eases. They cover a period of three years of 
 study and carry stipends of $500, $750, and 
 $1,000 for student support in the three succes- 
 sive years. Fellows devote themselves exclu- 
 sively to their chosen courses for eleven months 
 
per annum. They give one-fourth of their time 
 to teaching assistance, within their specialty. 
 One-fourth of the entire period is devoted to re- 
 lated laboratory studies. Major and minor sub- 
 jects are chosen and a thesis, upon some ap- 
 proved problem within the scope of the major, is 
 required. These courses lead to the degree of 
 Doctor of Science, qualified by the special sub- 
 ject pursued. 
 
 (d) Graduate scholarships, awarded for pe- 
 riods of two or three years, to the selected grad- 
 uate in medicine, who wishes, similarly, to pre- 
 pare for the practice of a given specialty. These 
 scholarships do not carry any stipend, but are 
 exempted from payment of tuition fees. They 
 require the devotion of only a minor measure of 
 time to assistant teaching and cover only nine 
 months in each year. The requirements of these 
 scholarships are otherwise identical with those 
 governing the teaching fellowships, excepting 
 that two years of successful study may lead to 
 the degree of Master of Science, while the three 
 year period leads to the Doctorate in Science. 
 
 Six teaching fellowships and five graduate 
 scholarships have been provided for the present 
 year. Several of these are already filled and the 
 number of applicants has been surprisingly great. 
 These positions will be increased as means of 
 support can be found. 
 
 The opportunity of graduate teaching appears 
 to be limited only by the capacity of clinics and 
 laboratories to. provide suitably for the needs of 
 students. Every effective means of increasing 
 this capacity is to be sought. Experience has 
 proved the unfitness of public hospitals for pur- 
 poses of graduate study. The graduate’s work 
 must be done where clinical and laboratory facil- 
 ities are definitely controlled and freely granted. 
 
 THE MAYO FOUNDATION FOR THE PROMOTION OF 
 MEDICAL EDUCATION AND RESEARCH 
 
 The large volume of clinical and laboratory 
 material gathered in the Mayo Clinic at Roch- 
 ester, Minnesota, suggested to its staff, some ten 
 years ago, the idea of placing it within reach of 
 graduate students in medicine. Large success in 
 any professional calling always awakens in men 
 the instinct of professional parentage. It has 
 awakened to a new and a notable departure in 
 this professional group. 
 
 For a time, the opportunity of graduate study 
 was informally extended to a few men who de- 
 sired to remain in residence at Rochester for that 
 purpose. Some five years ago, nine graduate fel- 
 
 lowships were created by the clinic, under annual 
 and progressively increasing support stipends for 
 each of a succession of three years. As the 
 laboratory and clinical facilities for research have 
 grown, this number of fellowships has been stead- 
 ily increased until, at the present time, thirty-six 
 graduate students have been appointed and are 
 actively pursuing their studies. Already ninety- 
 five men owe a graduate allegiance, as untitled 
 alumni, to the Mayo Clinic. 
 
 Its staff has long recognized the desirability of 
 placing this graduate work, with the large edu- 
 cational and scientific resources at its command, 
 under University control ; and very recently, im- 
 portant steps have been taken to organize these 
 opportunities and to effect this relationship. To 
 secure the most nearly ideal conditions for its 
 fulfillment, it has seemed desirable to create a 
 permanent mechanism which, while utilizing the 
 educational and scientific values the clinic affords, 
 can be held distinct from the Mayo Clinic as a 
 professional enterprise. 
 
 At the suggestion, indeed, of representatives 
 of the University, the Mayo Foundation for the 
 Promotion of Medical Education and Research 
 has been created and incorporated. An endow- 
 ment fund has been provided by its founders. 
 This fund now amounts to over $1,500,000 and 
 is to be further increased in principal and by 
 accumulating interest from year to year. It has 
 been placed, temporarily, in the hands of an in- 
 dependent board of trustees. It should be noted 
 that this endowment fund is already removed 
 from the hands of the Founders and has been 
 conveyed under a trust agreement which specifies 
 the purposes for which it is to be used and the 
 ultimate disposition to be made of it. It cannot 
 be employed for the support of the clinic. It is 
 specifically devoted to medical education and re- 
 search. For the present, an annual budget is 
 provided for the support of the Mayo Founda- 
 tion. So long as the foundation remains inde- 
 pendent, this budget will be expended and the 
 educational and research work of the Foundation 
 will be conducted by a chosen Board of Scientific 
 Directors. The available clinical and laboratory 
 material of the clinic is placed at the disposal of 
 the Foundation for scientific uses. 
 
 The problem which is now pressing for solu- 
 tion in the minds of medical educators in Min- 
 nesota is this : Shall the unity of medical edu- 
 cation in the State be preserved and strengthened 
 by affiliation with this new field of teaching and 
 research? Shall the scientific opportunities of 
 
the Mayo Foundation be cultivated and standard- 
 ized under the control of the University? Shall 
 they be directed and applied to educational uses 
 from the University base? Or, shall two distinct 
 and independent centers of medical education and 
 research exist, instead, in the State of Minne- 
 sota? 
 
 For the Mayo Foundation, as a seat of grad- 
 uate teaching and research, has been established. 
 Affiliated with the medical school or not, it will 
 go on in the good work it has begun. Its values 
 in men and in material for educative purposes 
 will not be permitted to go to waste. 
 
 The Proposals for Affiliation Between the 
 
 Medical School of the University of Min- 
 nesota and the Mayo Foundation for the 
 
 Promotion of Medical Education and Re- 
 search 
 
 THE PROPOSED PLAN OF AFFILIATION FOR AN 
 EXPERIMENTAL PERIOD 
 
 Negotiations for affiliation between the Medi- 
 cal School of the University of Minnesota and 
 the Mayo Foundation for the Promotion of Medi- 
 cal Education and Research were initiated by 
 Dean E. P. Lyon, at a meeting of the Adminis- 
 trative Board of the Medical School on October 
 8, 1914. A committee, consisting of the Presi- 
 dent of the University, the Dean, and the Secre- 
 tary of the Medical School, and two other mem- 
 bers of the Administrative Board was appointed. 
 
 This committee has acted conjointly with a 
 committee of the Mayo Foundation and pro- 
 posals have been formulated for an experimental 
 period of affiliation between the two institutions. 
 The terms of these proposals are as follows : 
 
 a. The Scientific Directors of the Mayo Foun- 
 dation are to be nominated to and approved by 
 the Administrative Board of the Medical School 
 and, upon such approval, are to be appointed by 
 the Board of Regents of the University of Min- 
 nesota. 
 
 b. The members of the staff of the Mayo 
 Foundation are to be nominated by the Directors 
 and approved by the Administrative Board of 
 the Medical School. 
 
 c. The experimental period of affiliation pro- 
 posed may be terminated at any time upon one 
 year’s notice by either party and upon the ful- 
 fillment of existing obligations to the student 
 body. 
 
 d. The purposes of the affiliation are to be : 
 
 1. The joint conduct of graduate work. It is 
 stipulated that all graduate students, working in 
 
 either institution, are to be matriculated and reg- 
 istered at the University under the rules of the 
 ^Graduate School ; that all students’ fees are to be 
 paid to the University ; that no charges upon the 
 University are to be made for any work done in 
 or by the Mayo Foundation ; that details of 
 graduate work, in general, and of each individual 
 student’s work, in particular, are to be arranged 
 by joint committee; that credit for work at the 
 University or at the Mayo Foundation is to be 
 given by the University. It will be provided that 
 all students receiving University credit shall 
 spend a certain prescribed portion of time in 
 residence at the University. 
 
 2. The interchange of graduate scholars and 
 fellows ; the details of such interchanges and the 
 regulations governing them, in point of time to 
 be spent and of work to be done by these scholars 
 or fellows, at either the University or at the 
 Mayo Foundation, to be determined by joint com- 
 mittee. 
 
 3. The interchange of workers, in assistant- 
 ships, special lectureships, direction of laboratory 
 work, conduct of elective courses and pursuit of 
 research, in either field, as between the faculty 
 of the Medical School and the members of the 
 staff of the Mayo Foundation ; the details of such 
 interchange to be arranged by joint committee. 
 
 e. It is further provided : 
 
 1. That courses of graduate instruction in the 
 affiliated institutions and the teachers conducting 
 them, shall be approved by the committee of the 
 Medical School on Graduate Teaching and by the 
 Dean of the Graduate School, and that the con- 
 ferring of degrees, to which such work contrib- 
 utes, is to be recommended by the Graduate 
 School to the Board of Regents of the Univer- 
 sity of Minnesota ; and 
 
 2. That the Committee of the Medical School 
 on Graduate Teaching be authorized to act con- 
 jointly with a Committee of the Mayo Founda- 
 tion in arranging details of the above plan. 
 
 Such an experimental period of affiliation has 
 been approved by vote of the General Faculty. 
 The specific proposals, outlined above, have been 
 approved by the Administrative Board of the 
 Medical School and have been accepted by the 
 Mayo Foundation. They have been submitted to 
 the Board of Regents of the University of Min- 
 nesota for consideration and final action. 
 
 THE TENTATIVE PROPOSALS FOR PERMANENT 
 AFFILIATION 
 
 Emphasis should be put upon the fact that the 
 sole issue now under discussion is that of tern- 
 
porary affiliation and that the plan of permanent 
 relationship has not been finally approved. 
 These proposals are essentially tentative. 
 
 The endowment fund is to remain untouched, 
 is to be increased annually in principal and by 
 accrued interest, during the experimental period 
 of affiliation. Should this experimental period be 
 undertaken and prove successful, the Founders of 
 the Mayo Foundation have already provided that, 
 with the approval of the University, the present 
 Trustees in charge of the endowment fund shall 
 surrender it, for entire control, in investment and 
 expenditure, alike, under the purposes declared 
 in the gift, to the Board of Regents of the Uni- 
 versity of Minnesota. No restrictions are placed 
 upon the Regents, excepting that the educational 
 and research work is to be maintained at Roch- 
 ester in affiliation with and directed bv the Uni- 
 versity. 
 
 It is provided that should the Mayo Clinic, 
 for which the University will be charged with 
 no responsibility whatever, fail of self-support or 
 deteriorate in the quality of its work, and no 
 longer supply, for the uses of the Foundation, 
 sufficient clinical and laboratory material, the 
 Board of Regents may, at its discretion, make 
 other arrangements for the continuance of the 
 Foundation. Suggestion of a subsequent renewal 
 of relations with a possibly resurrected clinic at 
 any time has been discussed, but is not regarded, 
 by either party, as an essential point. In all 
 other respects, the conditions of the experimental 
 period of affiliation are to become those of the 
 permanent relation, subject to modification by 
 joint agreement when the event is to be accom- 
 plished. 
 
 Summarized, the proposals mean : 
 
 a. The Mayo Foundation is an accomplished 
 fact. It exists for the prosecution of medical 
 research and the encouragement of graduate 
 study. 
 
 b. It is endowed with an ample fund to be 
 used for the specific purposes of the Founda- 
 tion and for nothing else. 
 
 c. That fund is irrecoverably in the hands of 
 a Board of Trustees instructed, if affiliation be- 
 comes permanent, to turn it over to the Board 
 of University Regents. It will belong to the 
 University. 
 
 d. The Foundation, its work, its workers and 
 its finances, will be definitely separate from the 
 clinic. 
 
 e. The Foundation is to be definitely con- 
 trolled as to expenditures, personnel of staff, 
 
 courses of instruction and credits by the Board of 
 Regents. 
 
 f. Graduate students, directed by the Univer- 
 sity, will do work both at the University and in 
 the Mayo Foundation at Rochester. 
 
 THE APPRAISAL OF VALUES 
 
 It is well that the advantages which offer to 
 the University Medical School in this affiliation 
 be carefully appraised. Such a gift to medical 
 education and research is so unusual and looms 
 so large in its possibilities that one marvels that 
 its benefits should need statement. Nevertheless, 
 a State institution is the one type of beneficiary 
 which has the duty of examining carefully the 
 conditions of a gift. The values not only of the 
 gift itself, but of the opportunities it opens up, 
 are cited. 
 
 It might seem enough to say that with the 
 ultimate control of this endowment for higher 
 medical education and research by the Board of 
 University Regents, the whole tale of benefits to 
 flow from it would be inclusively told. But this 
 event takes exception to the mathematical prin- 
 ciple that the greater includes the less, perhaps 
 because the seemingly less is really the larger. 
 
 The association of the Medical School with a 
 body of professional men who have successfully 
 applied economic principles to the practice of 
 medicine, who have approximated the ideals of 
 medical service, who have achieved distinctive 
 and effective methods of clinical investigation, 
 has clearly apparent worth. 
 
 The contribution to the service of the Medical 
 School of men of ability and distinction who will 
 give their time and energy to the work of the 
 Foundation under the direction of the Univer- 
 sity ; the devotion of an immense mass of scien- 
 tific material to the uses of education and re- 
 search, and both without a dollar of expense to 
 the State, either for buildings or maintenance, 
 have a significance that does not need emphasis. 
 
 The immediate development, with a minimum 
 of cost to the University, of a Graduate School in 
 Medicine which will stand absolutely alone in the 
 sphere of medical education in America, as com- 
 passed today, and will set the type of graduate 
 instruction for the country at large, is an oppor- 
 tunity not to be put by and one of which leading 
 medical educators throughout the country are 
 taking full account. 
 
 The substantial improvement and immediate 
 enlargement of the mechanism of efficient train- 
 ing of specialists in medicine, — a most important 
 
service to the State, — and again without increase 
 of budget, means more to the future of medical 
 education than can be foretold. 
 
 The stimulative influence of the work of each 
 affiliate upon the other, by means of the ready 
 exchange of teachers and workers, will be far 
 greater by virtue of the distinctive place and 
 character of each institution than were they com- 
 pletely merged and their individual identity lost. 
 
 The stimulus to medical research which must 
 come out of the friendly rivalry and the mutual 
 assistance of men in the two institutions ; the en- 
 larged vision of problems which should widen 
 with the increased means of solving them, should 
 mean the higher development alike of the teach- 
 ing faculty and the Foundation staff. 
 
 The encouragement that this affiliation would 
 afford to the development of other agencies of 
 medical education within the State, the sugges- 
 tion it conveys of extra-mural assistance to be 
 sought in the service of medical teaching, should 
 not be overlooked. 
 
 THE OBJECTIONS TO AFFILIATION 
 
 Doubtless there are objections to the proposed 
 affiliation which it is better not to define ; but, 
 indubitably, there are medical men and medical 
 educators, of lofty purpose, who are fearful of 
 so new and so broad a departure in the history 
 of the Medical School. 
 
 That affiliation of the Medical School with the 
 Mayo Foundation is an improper thing, because 
 the latter will derive its financial support and its 
 scientific material mainly from the Mayo Clinic 
 and because the clinic is a private enterprise and 
 conducted for profit, appears to be the crux of 
 opposing argument in the minds of many. 
 
 Could any contention that the Mayo Clinic is 
 ethically, professionally or scientifically unfit be 
 sustained, this argument might gain weight. 
 Since the ablest and most sincere opponents of 
 the plan hasten to lay a tribute of respect before 
 the men who have founded the Mayo Foundation, 
 the argument loses force. Granted the integrity 
 of the institution, the plea applies as properly to 
 every clinical teacher who, whether singly or in 
 association with his fellows, is, simultaneously 
 with his teaching function, engaged in the pri- 
 vate practice of his profession. 
 
 The proposition that the Mayo Foundation is 
 inseparable from the Mayo Clinic and that in af- 
 filiating with the first the University necessarily 
 goes into partnership with a private professional 
 business, is destroyed by many a precedent and 
 demands specific correction. 
 
 METHOD OF SEPARATING THE FOUNDATION FROM 
 THE CLINIC 
 
 A careful examination of the work now con- 
 ducted at Rochester shows that it is practicable 
 to separate the scientific and educational work 
 (which will belong to the Foundation) from the 
 business of treating the sick (which will belong 
 to the clinic). 
 
 The scientific and research work occupies 
 nearly three floors of the new building. To these 
 floors patients do not go. Half of the staff mem- 
 bers never see patients. Some are not even re- 
 motely concerned with the patients of the clinic. 
 They are full-time laboratory research workers. 
 Others divide their time between practical duties 
 connected with the clinic and investigation. 
 
 The method of dividing the foundation from 
 the clinic will be worked out along these lines : 
 Any laboratory devoted entirely to research and 
 teaching will be supported by the Foundation. 
 Any apparatus, animals, chemical supplies, etc., 
 needed for these purposes will be furnished by 
 the Foundation. The salary of any chemist, 
 pathologist or other worker engaged wholly in 
 teaching and research will be paid by the Foun- 
 dation. Part of the salary of men giving part 
 of their time to this work may be borne by the 
 Foundation. Expenses of scientific publication, 
 etc., may be paid by the Foundation. Fellow- 
 ships may be supported by the Foundation. In 
 fact, the Foundation may do any of the things 
 for the furtherance of medical education and 
 research which would be proper for it to under- 
 take if it stood alone, and may do only such 
 things. 
 
 On the other hand, all expense connected with 
 the care and treatment of pay patients must be 
 borne by the clinic. A man engaged wholly in 
 this work could not be paid by, nor connected 
 with the Foundation. A laboratory used only 
 for clinical diagnosis would be supported by the 
 clinic, not by the Foundation. 
 
 Thus we get concepts of the Foundation and 
 the Clinic standing as separate and distinct in- 
 stitutions, each with a certain number of full- 
 time workers not engaged in the other at all, and 
 with a certain number of part-time workers di- 
 vided between the two institutions. The Foun- 
 dation would by lease or gift be entitled to quar- 
 ters in the clinic building and by proper arrange- 
 ment have the right to use the clinical material 
 for purposes of research and education to the 
 extent that the clinic may deem wise and to the 
 extent that the Foundation may desire. 
 
 The clinical, part-time teachers in the Univer- 
 
sity Medical School send specimens from their 
 private practice to the University laboratories. 
 They use their private case histories in writing 
 articles which go out in the name of the Uni- 
 versity. They make use of University patholo- 
 gists for making autopsies in private cases, and 
 the materials are worked up in the University. 
 All of these constitute analogies of the proper 
 separation of the Mayo Foundation from the 
 Mayo Clinic in the same way that the University 
 work of part-time teachers is separated from 
 their private practice. 
 
 OTHER FEARS 
 
 That affiliation with the Mayo Foundation 
 will serve to arrest the development of an ade- 
 quate clinical system at the University, is the ex- 
 pression of a fear which has taken possession of 
 some who frankly say that could this apprehen- 
 sion be removed they would find no other valid 
 objection to the plan. The difficulty is that, 
 while this fear is believed by the administrative 
 officers of the University and the Medical School 
 to be without foundation, to be a mere ghost 
 which these men have raised, no assurance to the 
 contrary can, with propriety, be given. The ad- 
 ministration cannot commit future Boards of Re- 
 gents or future legislatures to any program of 
 clinical development. 
 
 It may only be said that this fear is unshared 
 by the proponents of the plan, that it has never 
 been shared by any of them in either institution ; 
 and that, on the contrary, they hold that the nat- 
 ural stimulus to the growth of the Medical School 
 which the affiliation must be, will insure the 
 speedier completion of the absolutely essential 
 hospital laboratory of the clinical teacher. 
 
 That the Mayo Foundation would not be 
 adequately controlled by the University and 
 would be subject to the dictation of its Founders, 
 to the detriment of its stated purposes, is an argu- 
 ment most effectively answered by inviting the 
 
 reader to review the foregoing statement of the 
 terms of affiliation. A fund of one and a half 
 million dollars or more to go under permanent 
 affiliation and without reserve, save as to the lo- 
 cation of the work, into the hands of the Board 
 of University Regents ; a Board of Directors of 
 the Foundation approved by the Medical School 
 and appointed by the Board of Regents ; a Foun- 
 dation staff similarly approved by the Medical 
 School ; registration of students, courses of in- 
 struction and credits for study, controlled by the 
 University, are the safeguards which the plan 
 details. 
 
 That the State University should confine 
 its activities strictly to the University campus is 
 a time-honored and traditional view. It is not 
 the view of modern educators. To avail itself 
 of every fit agency of education and research 
 throughout the State, by which its effective force 
 may be increased, is as much the part of the mod- 
 ern State University as is the prosecution of 
 extension work on a campus as wide as the State 
 itself. 
 
 AFTERWORD 
 
 After all, the one real question involved in 
 the project for affiliation of the Mayo Founda- 
 tion with the Medical School is this : Will that 
 affiliation, in substantial measure, enable the State 
 to achieve more quickly, to approximate more 
 closely, to realize more fully the highest ideals of 
 medical education, to the attainment of which, 
 as the public parent of medical education in the 
 State, it is pledged? 
 
 George Edgar Vincent, 
 
 Elias P. Lyon, 
 
 James E. Moore, 
 
 Jennings C. Litzenberg, 
 
 Richard Olding Beard, Chairman, 
 Committee upon the Relations of The 
 Medical School with the Mayo Foun- 
 dation. 
 
THE MAYO FOUNDATION FROM THE STANDPOINT OF THE 
 
 GRADUATE SCHOOL 
 
 By Guy Stanton Ford, Ph. D. 
 
 Dean of the Graduate School 
 UNIVERSITY OF MINNESOTA 
 
 In discussing co-operation with the Mayo 
 Foundation from the standpoint of the Graduate 
 School, it is at least not difficult to keep in mind 
 the essential nature of the problem which the re- 
 gents, administrative officers, and faculties of the 
 University are considering. It is an experiment 
 in training some thirty or forty well prepared 
 young graduates of high grade medical schools 
 for careers as medical scientists, medical college 
 teachers, or specialists in active practice. The 
 net result, if the difficult work is well done, is, in 
 all three fields, a needed social service. The Uni- 
 versity has the right and the obligation to under- 
 take it and, in doing its part, to make use of every 
 opportunity and means for adequate training in 
 this relatively unoccupied field. It cannot too 
 often be emphasized that what is here contem- 
 plated has nothing to do with the old polyclinic 
 idea of a graduate school of medicine where a 
 group of busy city practitioners gave a hurried 
 six weeks’ course to practitioners who went home 
 with a certificate to frame and a debt to pay by 
 sending patients to the city specialists. The plan 
 in contemplation will require of a selected group 
 that they spend three years in advanced work, 
 meeting at the end the most rigid tests possible, 
 that of showing their calibre, as investigators, by 
 the preparation of a scientific contribution which 
 definitely increases our ability to cope with dis- 
 ease. Medical educators and university adminis- 
 trators who are assuming the responsibility of 
 making this exacting preparation possible could 
 have but one possible fear and that is, — not that 
 there might be too much material, too many 
 qualified instructors, too much financial support, 
 — but rather that in every point there may be too 
 little. In considering this essentially educational 
 problem all fears may be reserved for our limita- 
 tions and none for our opportunity to diminish 
 them by co-operation and control of the Mayo 
 Foundation. 
 
 Since September, 1914, the Graduate Commit- 
 tee of the Medical School, as the responsible unit 
 of the Graduate School, has been directing the 
 work of a group of a half-dozen such graduate 
 students as I have described above. The prob- 
 lems involved have never been adequately worked 
 out in any university. It is all path-breaking 
 
 work. Only the four essentials of all adequate 
 graduate work were clear — only well prepared 
 students should be encouraged, only well trained 
 instructors should be in charge, adequate clinical 
 facilities and material were essential and the re- 
 sults of bringing these three factors together 
 should be tested by the established standards of 
 scientific research. In none of these things 
 should undergraduate standards prevail. Where 
 a half-dozen cases or operations might give the 
 undergraduate student the accepted treatment, a 
 hundred might be too few to enable the graduate 
 student to strike out in new paths. 
 
 This was the situation when, after following 
 in a general way the discussions of the medical 
 faculty concerning co-operation with the Mayo 
 Foundation for graduate medical research and 
 education, I made a personal investigation of the 
 matter from the standpoint of the Graduate 
 School. If the reader will recall the first three 
 essentials of graduate work mentioned above, 
 qualified students, qualified instructors, adequate 
 material and support, he will have in mind the 
 approximate standards any Graduate School ad- 
 ministrator would apply. 
 
 My investigation was made in the second week 
 of January and I found a condition existing 
 which satisfied me upon all three points. There 
 was in existence a well endowed teaching foun- 
 dation whose funds were already sufficient to 
 carry its part of a teaching staff and laboratory 
 equipment, and in addition give good paying fel- 
 lowships to a group of graduate students. Of 
 the wealth of material and equipment for such 
 students I should need to make no mention, if 
 it were not for the fact that I am not speaking 
 of the first floor of the Mayo Building primarily,, 
 nor of the operating rooms at St. Mary’s Hos- 
 pital. I found what I was looking for in the lab- 
 oratories, museum and library of the upper floors, 
 and in the countless case records in the basement 
 of the Mayo Building. The richness of this ma- 
 terial, not seen by the casual visitor, furnishes 
 opportunities for graduate medical work in cer- 
 tain lines such as can be found nowhere else on 
 this continent, nor probably in the world. I 
 found a research and teaching staff, available 
 and at work, sufficient to do its full part in an- 
 
independent teaching foundation, and most cer- 
 tainly its part in a co-operative plan such as that 
 under consideration. Some of these were doing 
 nothing but research. The only difference ob- 
 served between those who were engaged part 
 time in clinical practice and our own part time 
 staff was that the private practice in Rochester 
 was conducted under the acid test of observers 
 from all over the world, and in Minneapolis our 
 staff does its teaching in one-half of the day and 
 devotes the other half in its own offices to pri- 
 vate practice. Of the active staff at Rochester 
 about eighteen were graduates or former mem- 
 bers of the University Faculty. This applies also 
 to four of the five educational directors. I found 
 finally that a body of about thirty graduate stu- 
 dents of international character was engaged on 
 a three-year course and that their preparation 
 was such that I should have no hesitancy in ad- 
 mitting them, with one exception, to the Grad- 
 uate School at the University of Minnesota for 
 the work we began last fall. As this whole 
 matter of approving students, staff, and educa- 
 tional budget is to be in the hands of the Uni- 
 versity authorities we should have only ourselves 
 to blame if standards and conditions are not 
 maintained. In other words, there existed an en- 
 dowed, well equipped, well-manned research and 
 teaching institution needing only the things we 
 
 could best supply to make the combination of the 
 Mayo Foundation and the Medical School of the 
 University a unique and at present unparalleled 
 Graduate School of Medicine. 
 
 There seemed to me, as the result of this visit, 
 three possibilities. The Mayo Foundation 
 might be left to live its own independent exis- 
 tence, it might seek affiliation with some other 
 university outside the State, or, lastly, it might 
 become what its generous founders desire, a 
 present ally and, ultimately, a great and benefi- 
 cent part of the University of that State where 
 those founders were born and have spent their 
 lives. 
 
 If there be any principle at the basis of our 
 University as at present organized which pre- 
 vents it from doing its great educational work 
 for the State and the nation and the world by 
 taking advantage of this and similar opportu- 
 nities when they shall arise in agriculture, arts, 
 engineering or medicine, then let us rebuild on 
 principles that will enable us to fit our function. 
 
 It seems fairly easy to understand, I hope, why 
 anyone interested in the development of grad- 
 uate work would rather face the present fears of 
 the few than have the next generation point out 
 his folly in not having favored at least, an ex- 
 perimental period of co-operation with the Mayo 
 Foundation. 
 
 HISTORY OF NEGOTIATIONS BETWEEN THE MEDICAL 
 SCHOOL AND THE MAYO FOUNDATION 
 
 The question of establishing relations, for edu- 
 cational and scientific work, between the Minne- 
 sota Medical School and the Mayo Clinic, at 
 Rochester, has been discussed, informally, for a 
 long time. 
 
 Upon October 8th, 1914, the Dean of the Medi- 
 cal School proposed to the Administrative Board 
 of the Medical School that this question of affilia- 
 tion be considered. The Dean was instructed to 
 appoint a committee to confer in the matter with 
 the Advisory Committee of the Medical Alumni 
 Association and with the Doctors Mayo. 
 
 A few days later such committee, consisting 
 of the President of the University, the Dean and 
 the Secretary of the Medical School, and the 
 chiefs of two departments, was appointed. 
 
 On November 14th, 1914, a tentative confer- 
 ence of the committee with the Advisory Com- 
 mittee of the Medical Alumni Association was 
 had. 
 
 At a regular meeting of the General Faculty 
 
 of the Medical School on November 19th, 1914, 
 the question of affiliation was informally dis- 
 cussed. The Faculty voted to request the Admin- 
 istrative Board of the Medical School to give 
 the Faculty an opportunity for the discussion of 
 any proposed plan before final action should be 
 taken. 
 
 Upon NQvember 29th, 1914, an initial confer- 
 ence between the committee of the Medical 
 School and a committee representing the Mayo 
 Clinic was held at Rochester. At this meeting, 
 the proposal of the creation of the Mayo Foun- 
 dation for the Promotion of Medical Education 
 and Research was made. The following day this 
 proposal was accepted by the Doctors Mayo. 
 
 Conferences between representatives of the 
 two committees have been had, from time to time, 
 as negotiations have proceeded. 
 
 On December 3rd, 1914, the committee of the 
 Medical School presented its report to the Ad- 
 ministrative Board of the School. Certain 
 
amendments of the plans submitted were pro- 
 posed. The committee was instructed to con- 
 tinue negotiations, to submit these amendments 
 to the Doctors Mayo, and to prepare a further 
 report. The amendments were so submitted and, 
 in the main, accepted. 
 
 On December 16th, 1914, the Administrative 
 Board of the Medical School met and received 
 a revised report, which was fully discussed. The 
 general principle of the affiliation was approved 
 by vote. The committee was instructed to sub- 
 mit the proposals for discussion to the advisory 
 committee of the Alumni Association and to the 
 General Faculty. 
 
 On January 19th, 1915, a second conference 
 with the Advisory Committee of the Medical 
 Alumni Association was held. 
 
 Following this conference, the officials of the 
 School received from the Alumni Committee the 
 following resolution : 
 
 “Doubting the wisdom of the general prin- 
 ciple of affiliation between the University and 
 any private institution, we, the Advisory Com- 
 mittee of the Alumni Association of the Medical 
 School, approve of a temporary arrangement be- 
 tween the University of Minnesota and the Mayo 
 Foundation to accomplish the following purposes 
 only : 
 
 a. The interchange of opportunity for grad- 
 uate study. 
 
 b. Opportunity for interchange of members 
 of the teaching staffs.” 
 
 On January 21st, 1915, a meeting of the Gen- 
 eral Faculty was called. Copies of proposals 
 were placed in the hands of the members. A 
 full discussion followed. It was voted to adjourn 
 consideration and to postpone vote for two weeks. 
 
 A second meeting was held February 5th, 1915, 
 and the proposals were again discussed at length. 
 By a vote of 39 to 26, the following resolution 
 was adopted : 
 
 “Resolved, That this Faculty recommends to 
 the Administrative Board the establishment of 
 affiliation in graduate teaching and in exchange 
 of workers with the Mayo Foundation, for a 
 trial period, terminable on one year’s notice by 
 either party and upon the fulfillment of exist- 
 ing obligations to students, under educational 
 conditions approved by the University.” 
 
 On February 8th, 1915, the Administrative 
 Board of the Medical School met. The pro- 
 posed experimental period of affiliation with 
 the Mayo Foundation was approved by a vote 
 of nine to one. The committee was instructed 
 to prepare resolutions, covering this action ; to 
 submit copies to members of the Board for com- 
 
 ment and to present the same to the Board of 
 Regents. 
 
 Upon February 18th* 1915, resolutions pre- 
 pared, in accordance with the foregoing instruc- 
 tions, were transmitted to the President for pres- 
 entation to the Board. 
 
 On March 4th, 1915, the above resolutions 
 were reported to the regular meeting of the 
 Administrative Board and two minor changes 
 were suggested. As so revised, the resolutions 
 were finally approved, the secretary was in- 
 structed to record them, to furnish a copy to each 
 member of the Board, and to re-submit final revi- 
 sion to the President. 
 
 On March 6th, 1915, such revised resolutions 
 were transmitted to the President. They read 
 as follows : 
 
 RESOLUTIONS 
 
 Whereas : An institution known as the Mayo 
 Foundation for the Promotion of Medical Educa- 
 tion and Research has been incorporated, in 
 which educational and scientific work in medicine 
 is being and will be done ; and 
 
 Whereas : Certain proposals for an experi- 
 mental period of affiliation between the Medical 
 School and the Mayo Foundation have been 
 formulated and considered; and 
 
 Whereas: It is understood (a) that the Mayo 
 Foundation is to be supported during the pro- 
 posed experimental period of affiliation by an 
 annual budget to be provided by the Founders ; 
 (b) that this budget is to be expended by a 
 Board of Directors, which will also be charged 
 with the supervision of the educational and scien- 
 tific work of the Foundation; (c) that this Board 
 of Scientific Directors is to consist of six physi- 
 cians or medical scientists, five of whom are to 
 be nominated by the Founders and one by the 
 Medical School, all of whom are to be submitted 
 for approval to the Administrative Board of the 
 Medical School and, upon such approval, are 
 to be submitted for confirmation to the Board of 
 Regents of the University of Minnesota ; and 
 (d) that the teaching and scientific work of the 
 Foundation is to be conducted by a staff, the 
 members of which are to be nominated by the 
 Board of Directors of the Foundation and are 
 to be submitted for approval to the Adminis- 
 trative Board of the Medical School. 
 
 Resolved, That such an affiliation for such an 
 experimental period be recommended to the 
 Board of Regents of the University of Minne- 
 sota, with the understanding that this period of 
 affiliation may be terminated at any time upon 
 notice of one year by either party to the affilia- 
 
tion and upon the completion of existing obliga- 
 tions to students. 
 
 Resolved, That (a) a reciprocal relationship 
 for the conduct of graduate work be under- 
 taken, with the understanding that credit for 
 work in either place is to be given by the Univer- 
 sity ; that registration of graduate students is 
 to be made at the University ; that students’ fees 
 are to be paid to the University ; that no charges 
 are to be made upon the University for work 
 done in or by the Mayo Foundation ; that the 
 details of such reciprocal relation and of the 
 work to be undertaken by graduate students, in 
 general and for each individual student matricu- 
 lated at either place, are to be arranged by joint 
 committee. 
 
 (b) That an interchange of graduate scholars 
 and fellows as between the University and the 
 Mayo Foundation be had ; that the details of such 
 interchanges and the regulations to govern them, 
 in point of time and of work to be done by 
 graduate scholars or fellows in either place, are 
 to be worked out by joint committee. 
 
 (c) That an arrangement of opportunities for 
 interchange of workers, in the way of assistant- 
 ships, special lectureships, direction of laboratory 
 work, conduct of elective courses and the pur- 
 suit of research, in either field, by the Faculty 
 or Foundation members, is to be made and that 
 the details of such interchanges of workers are 
 to be arranged by joint committee. 
 
 (d) That courses of graduate instruction con- 
 ducted in the affiliated institutions and the teach- 
 ers conducting the same, be under the approval 
 of the Committee on Graduate Teaching and 
 of the Dean of the Graduate School; and that 
 the conferring of degrees, to which such work 
 contributes, is to be recommended by the Grad- 
 uate School to the Board of Regents. 
 
 (e) That the Committee on Graduate Teaching 
 
 of the Medical School, including the dean of the 
 Graduate School, be authorized to act conjointly 
 with a Committee of the Mayo Foundation in 
 arranging the details of the matters referred to 
 above. 
 
 THE CONDUCT OF NEGOTIATIONS 
 
 The bodies officially concerned in the conduct 
 of these negotiations are : 
 
 a. The Administrative Board of the Medical 
 School, consisting of the President of the Uni- 
 versity, the Dean, the Secretary of the Medical 
 School, the heads of all departments, and one 
 member elected by the General Faculty; charged 
 with the legislative and administrative affairs of 
 the School, subject to the Board of Regents. 
 
 b. The Committee of the Administrative 
 Board entrusted with actual negotiations. 
 
 c. The General Faculty of the Medical School, 
 composed of all teachers of professorial rank and 
 of instructors. Its function is purely advisory. 
 
 d. The Board of Regents of the University of 
 Minnesota, its governing body. 
 
 e. The Advisory Committee of the Medical 
 Alumni Association, in this instance an unofficial 
 consulting body, composed of graduates of the 
 Medical School. 
 
 f. The Mayo Clinic, consisting of the Doctors 
 William J. and Charles H. Mayo, of Drs. Judd, 
 Balfour, and Plummer, and the staff of physi- 
 cians associated with them. The activities of 
 the clinic, for many years, have been : ( 1 ) , in 
 the conduct of medical and surgical practice; 
 (2), in the investigation of disease; (3), in the 
 graduate teaching of medicine and surgery. 
 
 g. The Mayo Foundation for the Promotion of 
 Medical Education and Research, created in Nov- 
 vember, 1914, and since incorporated, endowed 
 by a trust fund of $1,500,000, to which is trans- 
 ferred the activities of the clinic designated 
 under (2) and (3). 
 
 PRECEDENTS FOR AFFILIATION 
 
 The University of Minnesota, through the 
 Agricultural Department, is already affiliated with 
 the farming interests of the State. It carries on 
 experiments with private farms, orchards and 
 herds. 
 
 The mining students are obliged to spend a 
 certain amount of time in privately owned mines 
 on the range. The Michigan School of Mines is 
 located at Houghton, entirely for the practical 
 benefit to be gained from the local mines. Other 
 
 mining schools have similar co-operative arrange- 
 ments. 
 
 Our forestry students do work in various parts 
 of the State. The University of Washington 
 Forestry Department does practical work in the 
 mills and logging camps of the State. New York 
 State maintains a Forestry Department in con- 
 nection with Syracuse University, a private insti- 
 tution. 
 
 The Medical School of the University of M in- 
 
nesota, through its Department of Pathology and 
 Bacteriology, does work for physicians in private 
 practice, performs autopsies and makes laboratory 
 tests. The Department of Pharmacology makes 
 special examinations for physicians and others. 
 
 Until recently the Medical School was affiliated 
 with various private hospitals. Under the new 
 elective curriculum and plan of graduate instruc- 
 tion there seems no good reason why such af- 
 filiations should not be renewed. Each proposi- 
 tion should be considered on its merits. 
 
 The University of Illinois and other state uni- 
 versities do a large part of their medical teaching 
 in affiliated private hospitals. 
 
 Our Graduate School permits its students to do 
 work for credit anywhere in the world where 
 facilities for research exist. This is a general 
 rule of graduate schools. 
 
 A committee, composed of leading clinical 
 teachers of the United States and Canada, was 
 appointed by the American Medical Association, 
 about a year ago, to consider plans for the reor- 
 ganization of clinical teaching in medical schools. 
 The report of the committee, submitted by the 
 president of the American Medical Association, 
 Dr. Victor C. Vaughan, of the University of 
 Michigan, has just been published. The follow- 
 ing is a quotation from this report : “As many 
 extramural hospitals as possible should be 
 brought into affiliation with the medical schools 
 to provide for the development of graduate work 
 which now needs careful consideration.” 
 
 The University of Cincinnati, a municipal in- 
 stitution supported by taxation, is affiliated with 
 many manufactories and building firms. The stu- 
 dents of its Engineering School get all their shop 
 practice in these private commercial concerns. 
 
 On the other hand, the Missouri Botanical Gar- 
 den, owned by the City of St. Louis, is affiliated 
 with Washington University, a private institution. 
 
 The State of Pennsylvania appropriates money 
 for various private hospitals in which medical 
 teaching is done. 
 
 The Massachusetts Institute of Technology, the 
 “Land Grant College of Mechanic Arts of the 
 State,” receives state aid and affiliates in Public 
 Health teaching with Harvard University, a non- 
 public corporation. 
 
 President Pritchett states : “The device of a 
 subsidiary board in control of a special department 
 of university work is by no means unusual. The 
 Hooper Institute of Medical Research of the 
 University of California is governed by a board 
 of seven men appointed by the Regents of the 
 University.” 
 
 Several State Universities are affiliated with the 
 Marine Biological Laboratory located at Woods 
 Hole, Mass. They pay for the support of re- 
 search tables and send their graduate students 
 there. 
 
 The Marine Biological Station at San Diego, 
 formerly independent, and affiliated with the Uni- 
 versity of California, has recently been taken over 
 by that University. It is run, however, by a 
 “Local Board.” This is almost a perfect prec- 
 edent for the proposed temporary affiliation with 
 the Mayo Foundation, to be followed, if desired, 
 by permanent union. 
 
 Animal Husbandry students at the University 
 of Ohio spend their first year in residence, their 
 second on stock farms, their third again in resi- 
 dence, and their last year on other farms. The 
 catalog says, “Some of the leading stockmen of 
 Ohio and other States have agreed to co-operate 
 in arranging this course.” 
 
 The Wisconsin catalog says, “The College of 
 Agriculture has inaugurated a movement for the 
 establishment of a system of accredited farms.’’ 
 Candidates for the M. S. degree may gain one 
 semester’s credit by work on such farms. 
 
 Purdue University, the Engineering College of 
 the State of Indiana, works in close co-operation 
 with the electric and steam railways of the State. 
 Students carry on tests and do other work under 
 service conditions on these privately owned rail- 
 ways. The school is especially proud of its courses 
 in locomotive engineering on this account. 
 
 Finally may be mentioned the extensive plan of 
 affiliation in seventh year or interne work under- 
 taken by our Minnesota Medical School. The 
 hospital in which a student takes his interneship 
 must be satisfactory to the school, i. e., must give 
 him satisfactory facilities and instruction. This 
 year of work is required for graduation. The 
 school is making this type of affiliation all the 
 time.