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solidated school buildings. There are States in which relatively few consolidated schools have been established, but these few are large schools, adequately supported and equipped, and with professionally prepared and well-paid staffs. On the other hand, a large number of small one and two teacher schools, in which terms are short, teachers neither well qualified nor well paid, and equipment meager, are reported as consolidations. The data as to number of schools are believed to be of interest, but it is not the purpose of the statement to set up numbers as the sole measure of progress in consolidation.

Recent studies concerning the location of consolidated schools as between open country and villages indicate that more schools are situated in villages than in the open country, although there is no evidence to show that either is the more favorable except from the point of view of local considerations.

Increase in numbers of consolidated schools has not been so great during the present biennium as during the preceding one. Progress, however, has probably been more substantial. The size of the schools organized, the general improvement in facilities, the fact that larger units mean better support, and the increased tendency to place consolidated schools or systems under trained professional management have all tended toward improving the quality of school consolidations formed.

Obstacles to overcome.—Recent reports from a number of persons who are promoting school consolidation indicate that natural obstacles, such as contour and topography, hitherto considered as the most serious obstacles in the way of the extension of consolidation, are of less importance than they seemed in the early history of the movement. There is a fairly general agreement among these workers that the attitude of the people concerned toward education and toward modern ideas; the type of organization under which the schools are administered; and the ability of communities to secure from local, State, and county funds the money required to properly finance efficient schools are the real governing factors. In some sections, the traditional conservatism of farm people renders them unfavorable to radical changes and probable increases in the expense of maintaining schools. Certain farm organizations oppose the extension of the consolidation movement. In other sections the people are converted to the idea but are unable to finance larger and better schools until a new and better system of school support is developed for State, county, and district. In those States in which the administrative unit is the district or township, the crossing of established boundary lines creates difficulties. In several of these States laws requiring a favorable majority vote in each of the contributing units before a consolidation can be effected make it pos27301°—27 6

sible for a small group to obstruct the desires of the majority in the larger group of which it is a part.

Transportation:—Development in transportation has paralleled that of the consolidation movement, in general, during the biennial period. The tendency toward larger units has indeed made it necessary to give even more attention to the transportation phase of consolidated school management. Children are transported longer distances. Vehicles are made larger in order to accommodate more children, and they are of a better type. Manufacturing companies producing transportation vehicles are studying seating arrangements, placement and operation of doors, and other means whereby greater safety may be assured. The general increase in motor transportation in cities as well as for suburban and interurban purposes has accelerated progress in this.

The improvement in roads fostered by National, State, and local governments has added to the ease of transportation. Because of the increased mileage in hard-surfaced roads, wagons and small auto trucks are rapidly being superseded by large motor trucks. More children can be transported over longer distances; the time on the road between home and school is shorter; and consolidations covering a far larger extent of territory are feasible.

The greatest advance, however, has come through the systematic administration and operation of school transportation vehicles. Careful management as to cost, upkeep, efficiency, and the like have reduced expenses and added to the sense of responsibility felt by school officials and bus operators.

It has become generally recognized that transportation is a most important factor in the success of consolidated schools, and that safety is largely a matter of administrative management. Responsibility, which formerly centered in school boards and drivers employed by them either on a contract or salary basis, has now been centralized in the administrative officer, the principal or the superintendent, with considerable gain in efficiency and economy.

Complete data concerning the number of children transported and the amount of money spent on transportation concerned with schools are not available. An estimate based on reports from 32 States regarding the number of children transported and from 46 States concerning amounts spent for transportation apparently justify the estimate that in 1924 more than a million children were transported regularly at an expense of approximately $30,000,000.

TENDENCIES IN SECONDARY EDUCATION FOR RURAL CHILDREN

For the first time the rural high school has been studied on a national scale in the Bureau of Education during the biennial period 1922-1924. For the first time, through summaries of studies now completed, the essential characteristics of the rural high school can be shown, the extent to which farm children are participating in

secondary education pointed out, and an analysis made of selected

factors in their effect upon participation of farm children in secondary education. Conclusions gleaned from studies referred to are set forth at some length in the Rural High School, by Dr. Emery N. Ferriss, of Cornell University (U. S. Bureau of Education, Bulletin, 1925, No. 10); and in High School Education of the Farm Population in Selected States, by E. E. Windes, Associate Specialist in Rural Education (U. S. Bureau of Education, Bulletin, 1925, No. 6).

CHAPTER IV

MEDICAL EDUCATION, 1922-1924

By N. P. Colweix, M. D.,

Secretary of, the Council on Medical Education and Hospitals of the American Medical

Association, Chicago, III.

Contents.—I. A quarter century's progress in medical education—Inadequate governmental control over medical education—Action l>y a voluntary agency—Legal power v. publicity—Greatly enlarged teaching plants—Hospitals as related to medical education—Hospital interneships—The hospital an important educational factor. II. Newer problems in medical education—Higher cost of medical education—Scholarships and loan funds—The medical curriculum—Graduate medical education--Limitation of enrollments—Specialization in medicine—Changes in general practice—Conclusion.

I. A QUARTER CENTURY'S PROGRESS IN MEDICAL EDUCATION

A review of the previous reports on medical education, together with the statements presented herewith, will show that since 1900 a vigorous campaign has been successfully carried on for the improvement of medical education in this country. A better understanding of the conditions now existing can be obtained through a brief review of the development of medical schools since 1800. As shown in Chart 1, since 1800 the number of medical schools increased more rapidly than the population. From 4 medical schools in 1800 for 5,000,000 people, in 1860 the number had increased to GG for 31,000,000. During the 5 years covered by the Civil War, 20 medical schools ceased to exist or were suspended, thereby reducing the number to 46. Following the Civil War, however, the medical schools multiplied very rapidly, so that by 1900 there were 160 for 75,000,000 people.

With the rapid increase in the numbers of medical schools there was a correspondingly rapid increase in the number of medical students and in the numbers who were graduated each year. Figures in regard to students and graduates are available only since 1880. For the 100 medical colleges existing in 1880 there were 11,826 students, an average of 118 per college, and 3,241 graduates, an average of 32 for each college. In 1904, however, when the maximum number of students and graduates had been reached, there were 160 medical colleges which enrolled 28,142 students and graduated 5,747. The population in 1904 was approximately 82,000,000 people.

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