Annual Oration ON THE FUTURE OF LONDON MEDICAL EDUCATION

1904 The Lancet  
MR. PRESIDENT AND GENTLEMEN,—Some years ago I met a distinguished foreigner on his first visit to London. He said : What a strange people you are in England. Yuor country has given birth to some of the greatest y o u r leaders of modern thought. Had we been fortunate < enough to call them compatriots their monuments would I have been conspicuous in our towns, the public places of 3 our capital would have borne their honoured names. I have traversed London," he pursued, "without once being
more » ... ut once being reminded that I was in the country of Darwin and of Spencer; the name even of Newton met my eye only at < the corner of a back street off Holborn." I did my best i to explain the apparent paradox. I traced in detail the < principles of English street nomenclature ; I urged the ] probability that the Newton of High Holborn was not the 1 author of the " Principia " but a local builder ; I pointed out that a London statue was the very last < form of memorial a philosopher would wish for; but 1 my companion went away only half satisfied and ldft 1 me, to speak frankly, as unconvinced as himself. One i cannot in candour deny that the contrast is somewhat odd between the commanding position in the history of ( science which England owes to the labours of a few of her i gifted sons and the attitude of comparative indifference which the mass of contemporary Englishmen display, I will i not say merely to the personal fame of their illustrious pioneers, but in general to the entire question of the advance of scientific knowledge within their bounds and to the development of the means of national education which that advance demands. Elsewhere in civilised Europe we are made conscious of a franker public recognition of the change that the last century made in the conditions of the modern world, of the extent to which the cultivation of exact knowledge has revolutionised the requirements of public and private business, and of the obligations and necessities which the new order of things has imposed on the community. Elsewhere than among ourselves it is not thought a strange thing that the resources of a State should be employed to extend the bounds of abstract knowledge ; elsewhere we see -the organisation of education no less an object of government than the ordering of the police or the control of the highway. Even in comparatively poor countries we find scientific knowledge and trained intellects regarded as sound public investments and the popular voice applauding a liberal application of public money to secure them. May we not say that the time has come when England should make up its mind whether the continental view of the require-r ments of the age is right or wrong ? 7 If it be right one cannot without concern view the extent to which this country has lagged behind. At present England speaks with uncertain voice and mind. She evinces no real conviction of the practical value of scientific knowledge or scientific training. Science is lauded to the skies in words and left to starve in fact. Research is commonly treated as though it were a matter of merely private ambition or concern. Commerce and industry are still in doubt whether any more scientific training is necessary for their employes than sufficed a century ago. In questions of public education, except as far as they may concern a point of religion, the generality of Englishmen hardly affect an interest. The prevailing note of indifference belongs to no particular class or section. The country squire who regards schools as an insidious means of undermining agriculture may be matched by the industrial magnate who frankly despises all technical knowledge gained outside the workshop. The Minister who with difficulty consents to make a public grant VA AOIO for research has himself to wrap its object in some specious guise of 6 ° ntility " lest the popular voice should condemn it as a dole to a privileged class. In the matter of public education half-heartedness has led us into a course as wasteful as it is illogical. For 30 years past, at a vast expenditure, we have been educating the entire population up to a preliminary stage and providing no means for those who show themselves capable ot it to proceed further. If a national system of education is to produce a national advantage worth the money it costs its aim must surely be largely a selective one. The ultimate object, from a statesman's point of view, of national education is to bring the best brains of the country, or, to speak more precisely, the best combinations of brains and energy, to the front ; to bring them into the positions in which they can be turned to the best account in the national struggle for supremacy. In England we have stopped at the first stage, the most costly and least remunerative. We have produced year by year a mass of educable material and made nothing further out of it. Whatever individual talent the elementary school may have revealed we have taken no care to insure its afterdevelopment. We have laid a costly foundation and built nothing upon it. Cin we wonder that so many Englishmen regard national education as a failure and speak of it as a device to convert useful workmen into unnecessary clerks ? 2 If it be not so in fact it is not the fault of the policy that has been followed. , To all this there is a significant exception. John Bull's carelessness about science and education stops with the shore. When he has to deal with his own chosen elementthe sea-he is altogether another man. In nautical matters no one values exact knowledge more ; no one, unless perhaps his recent pupil in the Far East, has more assiduously cultivated scientific methods or been more careful of the training of the men to whom he entrusts his destinies. We need not, therefore, commit the absurdity of supposing indifference to science to be any permanent feature of the English character. It is but a passing phase, the origin of which we may discern in patent historical causes. Great Britain entered on the Victorian era under peculiar advantages. Our previous rivals in Europe had been exhausted by long wars which had brought us no greater disaster than increased taxation. America was still almost a negligible quantity. Our early use of coal and the mechanical inventions to which it had given rise had aided in giving us a long start of our contemporaries in the modern world which those inventions were bringing into being. Other nations might claim superiority in the graces of life ; in commerce, in industry, in material civilisation generally, the United Kingdom for many years was easily ahead of them all. We fancied, perhaps, that this was to last for ever. 04her nations had painfully set about the task of organising their resources, systematising their knowledge, trying to make the most of the human material they possessed ; we had, we thought, no need to do the same; our natural energies and superior aptitude would always keep for us the supremacy we had gained. In matters of education England no less enjoyed during this period a pre-eminence it has been difficult for her to forget. The universities of the continent had long been in a state of decay, material as well as intellectual. The last relics of the great mother University of Paris, that had once ranked in authority with Pope and Emperor, had disappeared in the Revolution ; of her half hundred of colleges nearly all had vanished. The collegiate foundations of Oxford and Cambridge, on the contrary, had steadily grown in opulence and lost nothing of external splendour. In the middle of the last century Oxford and Cambridge, to say nothing of Eton and Winchester, were as far in advance of anything of the kind elsewhere as the commerce of the Thames or the industries of Lancashire. As was natural, Englishmen grew to regard their two ancient seats of learning as the typeuniversities of the world and the particular kind of education prevalent there as the ideal of what university education should be. Universities elsewhere have since multiplied and gathered resources ; economic causes have diminished the income of our once wealthy colleges ; but England is slow to realise the new situation. The appeals for help which Cambridge has been lately making to its wealthy alumni are passing almost unregarded and the great majority of Englishmen would still, I believe, be surprised to be told that, measured by contemporary European, to say nothing of American, standards, neither Oxtord nor Cambridge would be reckoned among first-class universities. X
doi:10.1016/s0140-6736(01)75212-9 fatcat:aoejx2zrcfbu7liqry3yfncmgy