A Condensed Statement of the requirements of 
the principal University Medical Schools in 
Europe with regard to Candidates for the Degree 
of Doctor of Medicine, by Dr. J. S. Billings, 
Surgeon, U. S. Army. 
[Prepared at the request of Chas. J. M. G-winn, 
one of the Trustees of The Johns Hopkins 
University, for his personal information, but 
permitted by Dr. Billings to be printed in Jan- 
uary, 1893, for the use of the Trustees and 
Faculty of the University. ] 
Privately Printed. 
Baltimore, 
1893. 2 
The principal University Medical Schools in Europe are 
as follows: 
Great Britain : Oxford, 
Cambridge, 
London, 
Dublin, 
Edinburgh, 
Glasgow. 
France : Paris, 
Montpellier, 
Nancy. 
Germany 
and Austria 
Berlin, 
Leipzig, 
Heidelberg, 
Gottingen, 
Freiburg, 
Bonn, 
Vienna, 
Munich. 
Belgium : Liege. 
Sweden : Upsala, 
Lund. 
Italy : Rome, 
Naples, 
Bologna, 
Padua, 
Parma. 
Denmark : Copenhagen. 
Russia : Dorpat, 
Moscow, 
Warsaw, 
Odessa. 
Norway : Christiania. 
Hungary : Buda-Pesth. 
Those that probably afford the best means of modern 
advanced medical instruction are : 
Berlin, 
Paris, 
Vienna, 
Upsala. GREAT BRITAIN. 
Preliminary Examination Required.* 
1. No person is allowed to be registered as a medical 
student unless he shall have previously passed a preliminary 
examination in the subjects of general education as hereinafter 
provided. 
2. The Education Committee issues from time to time a 
list of examining bodies whose examinations fulfil the condi- 
tions of the Medical Council as regards general education. 
3. Testimonials of proficiency granted by educational 
bodies, according to the subjoined list, are accepted; the 
Council reserving the right to add to or to take from the list. 
4. A degree in Arts of any University of the United 
Kingdom, or of the Colonies, or of such other Universities 
as may be specially recognized from time to time by the 
Medical Council, is considered a sufficient testimonial of 
proficiency. 
5. The following are some of the Examining Bodies whose 
examinations fulfil the conditions of the Medical Council: 
Oxford, Cambridge, Durham, London, Edinburgh, etc. 
* British Medical Journal, Sept. 3, 1892, p. 497. 4 
Recommendations of the General Medical Coun- 
cil on Professional Education and Examination.* 
Professional Education. 
The course of the medical study after registration should 
occupy at least five years. The first four of the five years 
should be passed at a school or schools recognized by any of 
the licensing bodies mentioned in Schedule (a) of the Medical 
Act, provided that the first year may be passed at a Univer- 
sity or teaching institution recognized by any of the Licensing 
Bodies, where the subjects of Physics, Chemistry and Biology 
are taught. 
In every course of Professional Study and Examinations 
the following subjects must be contained : (1) Physics, includ- 
ing the Elementary Mechanics of Solids and Fluids, and the 
rudiments of Heat, Light and Electricity; (2) Chemistry, 
including the principles of the science and the details which 
bear on the study of Medicine; (3) Elementary Biology; 
(4) Anatomy; (5) Physiology; (6) Materia Medica and Phar- 
macy; (7) Pathology; (8) Therapeutics; (9) Medicine,includ- 
ing Medical Anatomy and Clinical Medicine; (10) Surgery, 
including Surgical Anatomy and Clinical Surgery; 
(11) Midwifery, including Diseases peculiar to Women and to 
Newborn Children; (12) Theory and Practice of Vaccina- 
tion; (13) Forensic Medicine; (14) Hygiene; (15) Mental 
Diseases. 
Preliminary Education Required.! 
For the Preliminary Examination for registration as a 
medical student the subjects are: 1. English language, 
including grammar and composition. 2. Latin, including 
* British Medical Journal, Sept. 3, 1892, p. 498. 
\ The Lancet, London, 1890, II, p. 485. 5 
grammar, translation from specified authors, and translation 
of easy passages not taken from such authors. 3. Mathemat- 
ics, (a) arithmetic, including vulgar and decimal fractions, 
(6) algebra, including simple equations, (c) geometry, includ- 
ing the First Book of Euclid, with easy questions on the 
subject-matter of the same. 4. Elementary mechanics of 
solids and fluids, comprising the elements of statics, dynamics 
and hydrostatics. (This subject may be postponed until the 
next examination.) 5. One of the following optional sub- 
jects : (a) Greek, (6) French, (c) German, (d) Italian, (e) any 
other modern language, (/) Logic, (g) Botany, (h) Zoology, 
(i) Elementary Chemistry. 
The above is of course the minimum, and is represented 
more or less accurately by such examinations as that held by 
the Apothecaries Hall and by the Second Class College of 
Preceptors Examination. About half of the total number of 
students who register annually have passed an examination 
of this class. 
A large number of students, however, pass an Arts examin- 
ation of a somewhat higher class, of which the Matriculation 
Examination of the University of London, or the Senior 
Local Examinations of Oxford or Cambridge may be taken 
as types. The subjects for the London Matriculation are: 
1. Latin; translation from selected authors and of easy 
passages from other books, grammar, and easy sentences to 
be translated into Latin. 2. One other language: Greek, 
French, German, Sanskrit or Arabic—grammar, and transla- 
tion into English only. 3. English language, English his- 
tory, and the geography relating thereto. 4. Mathematics, 
arithmetic, algebra to quadratic equations, geometry, the 
subjects of the first four books of Euclid, with deductions. 
5. Mechanics, including hydrostatics (elementary). 6. 
Science: one of the following, (a) Chemistry of the non- 6 
metals, (6) Heat and Light, (c) Magnetism and Electricity, 
(<d) Botany. 
Examinations of a still higher order are now passed by an 
increasing number of students. In these we may class the 
B. A. degree of Oxford and Cambridge, and the Intermediate 
B. A. Examination in London. The subjects for the latter, 
which corresponds somewhat with several of the continental 
minimum examinations for medical students, are: 1. Latin: 
translation of selected and non-selected authors, grammar, and 
short passages to be translated into Latin; Roman history. 
2. Greek grammar, and translation from a selected author. 
3. English language, composition, literature and history. 
4. French or German: grammar, and translation into Eng- 
lish. 5. Mathematics: arithmetic, algebra to the theory of 
indices, and logarithms ; geometry, plane and solid, with the 
elements of coordinate geometry; trigonometry. 
OXFORD UNIVERSITY. 
The degrees in medicine and surgery are only open to 
graduates in Arts (Bachelor of Arts and Master of Arts). 
To become a Bachelor of Arts at Oxford the student must 
have attended twelve terms and have passed three examina- 
tions, namely, Responsions,* and the First and Second Public 
Examinations. The Responsions shall always include the 
following stated subjects: The Greek and Latin Languages, 
Arithmetic, and the Elements of Algebra and Geometry. 
The candidate shall offer one Greek and Latin Book, and 
shall be examined therein in such a manner as to test especi- 
ally his knowledge of the grammar of these two languages; 
* Responsions are the first examination which these students at 
Oxford have to pass who are candidates for the degree of A. B. 7 
he shall also be required to translate from English into 
Latin. Under special conditions the candidate is allowed 
to substitute for either Greek or Latin, but for one of the 
languages only, Sanskrit or Arabic. Every candidate who 
desires to be examined in an additional subject shall 
offer one of the following: 1. A portion of a Greek or 
Latin historical or philosophical author. 2. A portion of a 
French or German historical or philosophical author. 3. A 
portion of Bacon’s Novum Organum. 4. The Elements of 
Logic, Deductive and Inductive. But no candidate shall 
offer portions of the same author both as a stated subject and 
as an additional subject. 
The First Public Examination shall consist of an examina- 
tion in Holy Scripture; of an examination of candidates not 
seeking honors, and of an examination of candidates for 
honors in two schools, of which the subjects shall be, (1) 
Greek and Latin Literature, and (2) Mathematics. The 
examination in Holy Scripture shall consist of an examina- 
tion in (a) one of the Synoptic Gospels and the Gospel 
according to St. John; (6) either the subject-matter of the 
Acts of the Apostles or an equivalent portion of the Old 
Testament. Candidates who do not seek honors in Greek 
and Latin Literature shall be examined in (a) three books 
at least, being portions of Greek and Latin authors of the 
best age, one of such books at least being some portion of an 
historical and philosophical work; (6) either Logic or the 
Elements of Geometry and Algebra. Candidates for honors 
in Greek and Latin Literature shall be examined in Latin 
and Greek authors, especially poets and orators, and in one 
or more of the following subjects: (a) The History of Greek 
and Latin Literature, or of some periods thereof, with such 
portions of ancient writers on the Arts of Poetry and Style 
as shall be specified by the Board of the Faculty; (6) the 8 
Elements of Deductive Logic, together with some portion of 
an ancient writer on Logic, or on Language, or some other 
department of Logic. Such portion of an ancient writer on 
Logic, or on Language, and such other department of Logic 
as shall be specified by the Board of the Faculty; (c) the 
Elements of Comparative Philology as illustrating the Greek 
and Latin Languages. 
The Second Public Examination consists of an examination 
for candidates who do not seek honors; of preliminary 
examinations, and of a final examination in Seven Honor 
Schools, of which the subjects shall be: 
1. Literae humaniares. 
2. Mathematics. 
3. Natural Science. 
4. Jurisprudence. 
5. Modern History. 
6. Theology. 
7. Oriental Studies. 
No one shall be admitted as a candidate in any Final 
Honor School until he shall have entered upon the eleventh 
term from his matriculation.* 
There are two degrees in medicine at Oxford,f B. M. and 
D. M., and two degrees in surgery, B. Ch. and M. Ch. The 
B. M. and B. Ch. degrees are granted to those members of 
the University who have passed the second examination. 
Graduates in Arts (B. A. or M. A.) are alone eligible for 
these two degrees. In order to obtain the degrees of B. M. 
and B. Ch. the following examinations must be passed: 
*For further details of requirements see “The Examination 
Statutes” (Statt. Univ. Oxon., Tit. VI), together with the Regula- 
tions of the Boards of Studies and Boards of Faculties, for the year 
1890-91. Oxford, 1890. 
fThe Lancet, Sept. 3, 1892, p. 530. 9 
1. Preliminary subjects : Mechanics and Physics, Chemistry, 
Animal Morphology, and Botany. 2. Professional, (a) 
First examination : Subjects—Organic Chemistry, unless 
the candidate has obtained a first or second class in Chemistry 
in the Natural Science School; Human Physiology, unless 
he has obtained a first or second class in Animal Physiology 
in the Natural Science School; Human Anatomy, and 
Materia Medica with Pharmacy. (b) Second examination: 
Subjects—Medicine, Surgery, Midwifery, Pathology, Forensic 
Medicine with Hygiene. The degree of D. M. is granted to 
Bachelors of Medicine of the University—(1) who took the 
degree of B. M. previously to the end of Trinity Term, 1886, 
provided they have spent three years in the practice of medi- 
cine after taking that degree, and have composed a disserta- 
tion on some medical subject approved by the Regius Pro- 
fessor of Medicine, before whom it must be read in public; 
(2) who took the degree of B. M. subsequently to the end of 
Trinity Term, 1886, provided they have entered their thirty- 
ninth term and have composed on some medical subject a 
dissertation which is approved by the professors in the 
Faculty of Medicine and examiners for the degree of B. M. 
whose subject is dealt with.* 
UNIVERSITY OF CAMBRIDGE. 
The student must enter at one of the colleges, or as a 
non-collegiate student, and keep nine terms by residence in 
the University. He must pass the previous examination in 
Classics and Mathematics, or obtain exemption through the 
* Generally after finishing the regular courses the graduates spend 
three or four years in the London hospitals, especially St. Bar- 
tholomews. 10 
Oxford and Cambridge Schools Examination Board. He 
may then devote himself to medical study in the University, 
attending the hospital and the medical lectures, dissecting, etc. 
For the degree of Bachelor of Medicine* (M. B.) five years 
of medical study are required. There are three examinations 
for M. B. 
1st. Chemistry and other branches of Physics, and Ele- 
mentary Biology. 
2d. Human Anatomy and Physiology and Pharmaceu- 
tical Chemistry. 
3d. a. Principles and Practice of Surgery (with opera- 
tive and clinical surgery) and Midwifery and Diseases of 
Women. 
6. Pathology, Principles and Practice of Medicine, Ele- 
ments of Hygiene and Medical Jurisprudence. 
The examinations are partly in writing, partly oral, and 
partly practical, in the hospital, in the dissecting room, and 
in the laboratories. 
As Operative and Clinical Surgery now form parts of the 
third M. B. examination, candidates who have passed both 
parts of that examination are admitted to the degree of 
Bachelor of Surgery (B. C.) without separate examination or 
without keeping an act. 
The degree of Doctor in Medicine may be taken three 
years after that of M. B., or four years after that of M. A. 
An act has to be kept, consisting of an original Thesis, 
sustained in the Public Schools with viva-voce examination, 
and an extempore essay has to be written on some subject 
relating to Physiology, Pathology, or the Practice of Medi- 
cine, or State Medicine. 
* The Lancet, London, Sept. 3, 1892, p. 530 11 
For the degree of Master in Surgery (M. C.) the candidate 
must have passed all the examinations for B. C. He is 
required to pass an examination in Surgical Anatomy and 
Surgical Operations, Pathology and the Principles and 
Practice of Surgery, and to write an extempore essay on a 
Surgical subject. Before he can be admitted to this exam- 
ination, two years at least must have elapsed from the time 
when he completed all required for the degree of B. C. 
UNIVERSITY OF LONDON. 
Bachelor of Medicine.—Every candidate for the degree of 
Bachelor of Medicine will be required—1. To have passed 
the Matriculation Examination in this University. 2. To 
have passed the Preliminary Scientific Examination. 3. To 
have been engaged in his professional studies during four 
years subsequently to passing the Preliminary Scientific Ex- 
amination at one or more of the medical institutions or 
schools recognized by this University, one year at least of 
the four to have been spent in one or more of the recognized 
institutions or schools in the United Kingdom. 4. To pass 
two examinations in Medicine. 
Intermediate Examination.—The Intermediate Examination 
in Medicine takes place twice a year. * * No candidate 
shall be admitted unless he have passed the Preliminary Scien- 
tific Examination at least two years previously and have 
produced certificates to the following effect: 1. Of having 
completed his nineteenth year. 2. Of having subsequently 
to having passed the Matriculation examination been a stu- 
dent during two years at one or more of the medical institutions 
or schools recognized by this University, and of having attended 12 
a course of lectures on each of three of the subjects in the 
following list: Descriptive and Surgical Anatomy, Histology 
and Physiology, Pathological Anatomy, Materia Medica and 
Pharmacy, General Pathology, General Therapeutics, For- 
ensic Medicine, Hygiene, Obstetric Medicine and Diseases 
peculiar to Women and Infants, Surgery, Medicine. 3. Of 
having subsequently to having passed the Preliminary 
Scientific Examination, dissected during two sessions. 4. Of 
having subsequently to having passed the Preliminary Scien- 
tific Examination, attended a course of Practical Chemistry, 
comprehending practical exercises in conducting the more 
important processes of general and pharmaceutical chemistry, 
in applying tests for discovering the adulteration of articles 
of Materia Medica, and the presence and nature of poisons 
and in the examination of mineral waters, animal secretions, 
urinary deposits, calculi, etc. 5. Of having attended to 
Practical Pharmacy and of having acquired a practical 
knowledge of the preparation of medicines. 
For the M. B. Examination, Degree of “Bachelor of 
Surgery,” “ Master in Surgery ” and Doctor of Medicine, see 
the Lancet, London, Sept. 3, 1892, pp. 531, 532. 
UNIVERSITY OF EDINBURGH. 
The applicant must bring a certificate of “Preliminary 
Examination,” or must be a Bachelor of Arts (B. A.) of a 
University. Certain schools and corporations are author- 
ized to give these certificates of “ Preliminary Examination.” 
This examination comprises: English, Latin, Arithmetic, 
Elements of Mathematics and Mechanics. Besides this the 
candidate must have certificates for any two of the following 
branches, which he may choose: Greek, French, German, 13 
Higher Mathematics, Natural Philosophy, Logic, Moral 
Philosophy. If the candidate desires to become a Doctor 
of Medicine (M. D.) he must further have certificates as to 
“ Greek ” and “ Logic or Moral Philosophy,” and also one 
of the following, according to his choice: French, German, 
Higher Mathematics, Natural Philosophy. 
Three medical degrees * are conferred by this University, 
namely Bachelor of Medicine (M. B.), Master in Surgery 
(C. M.), and Doctor of Medicine (M. D.) Only Bachelors of 
Medicine can receive the degree of Master in Surgery. No 
one is admitted to the degrees of Bachelor of Medicine and 
Master in Surgery who has not been engaged in medical and 
surgical study for four years. The candidate for the degrees 
of M. B. and C. M. must give evidences by certificates: 
a. That he has studied each of the following depart- 
ments of medical science, viz. Anatomy, Chemistry, 
Materia Medica, Institutes of Medicine or Physiology, 
Practice of Medicine, Surgery, Midwifery and the Diseases 
peculiar to Women and Children, and General Pathology, 
each during courses including not less than one hundred 
lectures; Practical Anatomy, a course of the same duration 
as those of not Jess than one hundred lectures : Practical’ 
Chemistry, three months; Practical Midwifery (that he 
has attended at least twelve cases of labor under the super- 
intendence of a registered medical practitioner, or that he 
has attended six such cases, and also has attended, for at 
least three months, the practice of a midwifery hospital in 
which practical instruction is regularly given); Clinical 
Medicine and Clinical Surgery; courses of the same dura- 
tion as those of not less than one hundred lectures, being 
given at least twice a week; Medical Jurisprudence, Botany 
* The Lancet, London, 1892, Sept. 3, p. 533. 14 
and Natural History (including Zoology) during courses 
including not less than fifty lectures. 
b. That he has attended for at least two years the medi- 
cal and surgical practice of a general hospital which accom- 
modates not fewer than eighty patients and possesses a 
distinct staff of Physicians and Surgeons. 
c. That he has attended during a course of not less than 
fifty hours instruction, the class of Practical Materia 
Medica and Pharmacy in the University of Edinburgh, or 
a similar class conducted in a University or recognized 
School of Medicine, or a similar class conducted at the 
laboratory of a hospital or dispensary, or elsewhere, by a 
teacher recognized by the University Court; or that he has 
been engaged by apprenticeship for not less than two years 
with a registered medical practitioner or a member of the 
Pharmaceutical Society of Great Britain, or a member of 
the Pharmaceutical Society of Ireland, or a pharmaceutical 
chemist, or chemist and druggist registered under the pro- 
visions of the Act for Regulating the Qualifications of 
Pharmaceutical Chemists, 1852, the Pharmacy Act, 1868, 
or the Pharmacy Act (Ireland) 1875, in the bona fide 
compounding and dispensing of drugs, and the preparation 
of their officinal and other preparations under his superin- 
tendence. 
d. That he has attended for at least six months, by 
apprenticeship or otherwise, the out-door practice of a hos- 
pital or the practice of dispensary physician, a surgeon or a 
member of the London or Dublin Society of Apothecaries. 
e. That he has attended during courses of not less than 
fifty hours instruction, classes of Practical Physiology and 
Practical Pathology in the University of Edinburgh, or in a 
recognized University or School of Medicine, or upon 
classes thereof conducted by a teacher recognized by the 
University Court. 15 
Examinations are had both in writing and orally on Chem- 
istry, Botany and Natural History (Physics is now required 
by the regulation of the General Medical Council), on Anat- 
omy, Institutes of Medicine, Materia Medica (including 
Practical Pharmacy and Prescribing) and Pathology; on 
Surgery, Practice of Medicine, Midwifery and Medical Juris- 
prudence; clinically on Medicine and on Surgery in a hospital. 
The examinations on Anatomy, Chemistry, Institutes of 
Medicine, Botany, Natural History, Materia Medica and 
Pathology, are conducted as far as possible by demonstrations 
of objects placed before the candidates. 
The degree of Doctor of Medicine may be conferred on any 
candidate who has obtained the M. B. and C. M. of the Uni- 
versity, and who is of the age of twenty-four years, and produces 
a certificate of having been engaged subsequently to his having 
received the degrees of M. B. and C. M. for at least two years 
in attendance on a hospital, or in a military or naval medical 
service, or in a medical or surgical practice. 
On the whole the requirements of the Edinburgh Medical 
College as well as that of Oxford are the same as those ob- 
tained in German Gymnasia in preparation for the Univer- 
sity ; with this exception, that studies left to the choice of the 
English student are made compulsory in the German Gym- 
nasia. 
GERMANY. 
Ill Germany the applicant for admission to the Medical 
Faculty of a University must have a certificate that he has 
successfully passed the “ Abiturienten ” examination, that is, 
the final examination of the Gymnasial course. This exam- 16 
ination is considered as more formidable than the professional 
examinations which follow. The course extends over a period 
of nine years, although in exceptional cases the students are 
permitted, on account of special ability and application, to 
finish in seven years. The studies required are Latin, which 
is taken throughout the course, and of which a high standard 
is required, as the student must on his examination be able 
to defend a thesis in this language; the authors read are 
generally : Cajsar, Ovid, Sallust, Cicero, Livy and Horace; 
Greek during six years, and the authors : Xenophon, Homer’s 
Iliad and Odyssey, Anacreon, Sophocles and Aeschylus. 
The French language, the German language, Mathematics, 
including Arithmetic, Geometry, Algebra, Conic Sections. 
Trigonometry and Logarithms. The field of study in His- 
tory is exceptionally large, including modern and ancient, 
from the Egyptians to the present day, with the Geography 
relating thereto; Anatomy, Botany, Zoology, Elementary 
Mechanics, Drawing, Astronomy, Chemistry, Logic, and 
religious instruction according to creed. 
This examination may be best compared to that for the 
higher certificates conducted by the Oxford and Cambridge 
Schools Examination Board. A student of moderately good 
ability, who has gone through the Gymnasial course, will 
rarely pass the “ Abiturienten ” examination until he is 
eighteen or nineteen years of age. 
The medical student at the University must devote eight 
semesters to medical study. The first four semesters are 
devoted exclusively to Physics, Chemistry, Zoology, Botany, 
Mineralogy, Anatomy and Physiology. At the end of these 
four semesters the student may pass the first examination, 
the tentamen physicum. With the fifth semester begin the 
purely medical studies, which must be continued without 
interruption for two years, and then the student may pass the 17 
State examination. The University examination can be 
passed either after or before the State examination. 
The State examination can be passed either before the chief 
examining committee in Berlin, or before special examining 
committees which are annually appointed for the different 
universities. 
The application for permission to pass the State examina- 
tion is to be accompanied by certificates that the applicant 
has completed a full course of study in the Gymnasium and 
in a University, that he has successfully passed the tentamen 
physicum, and that he has acted as practicant during the 
last two semesters, both in a medical and in a surgical clinic, 
and that he has attended at least four cases of midwifery in 
the obstetrical clinic. The examination extends over many 
days and is divided into five parts: 
1. Anatomy, physiology and pathological anatomy. 
2. Surgery and ophthalmology. 
3. Medical. 
4. Obstetrical and gynecological. 
5. Final examination. 
The examination in anatomy is divided into two parts. 
At the first the candidate draws by lot a question in osteology 
and another about the viscera, and he must immediately 
demonstrate the corresponding preparation which is handed 
to him. He is then given some nervous preparation which 
he must take away and dissect and demonstrate before the 
examiners at their second meeting. 
In the physiological examination the candidate must draw 
by lot two questions, one on histology, the other on physi- 
ology, and immediately discuss them (orally). He must 
prepare and demonstrate the histological specimen in the 
presence of the examiners so as to show his acquaintance 
with the microscope. 18 
In the pathological examination the candidate must make 
an autopsy of the whole or at least a part of the body and 
dictate the results. He must also demonstrate a pathological 
specimen. 
In the surgical examination each candidate must take 
charge of two patients for a week. In the presence of the 
examiner he must examine the patient and discuss the etiology, 
diagnosis, prognosis, and treatment. He must write out a 
history of the case and keep a record of it each day. The 
candidate must also attend the regular morning visits at least 
three times during this week and have questions about other 
cases put to him. At another time he is given a question 
about some operation and must give an account of the oper- 
ation and instruments employed, and then perform the 
operation upon the cadaver. He must answer in the same 
way another question on luxations. 
In the ophthalmic examination he must examine a patient 
with disease of the eye as above described in surgery. 
The medical examination is conducted in exactly the same 
way as was described in the surgical examination. In addi- 
tion, special attention is paid to the doses of medicine and to 
the writing of prescriptions. 
In the obstetrical examination he is shown a woman in 
labor and must make the diagnosis of the period of labor, 
the position of the child, and the prognosis, and must con- 
duct the labor. He must then write out a history of the 
birth. In addition, during seven days he must examine a 
number of obstetrical and gynecological cases and discuss 
them. He must also perform operations on the phantom. 
Finally he is subjected to a final oral examination to test 
his general medical knowledge. The cost of the examination 
is $51. The time between the different examinations should 
not exceed eight days. 19 
In order to pass the University examination it is not nec- 
essary to have passed the tentamen physicum. The appli- 
cation for permission to pass the University must be made to 
the dean of the medical faculty, and must be accompanied by 
certificates that the candidate has studied at least six, in some 
Universities eight semesters, a certificate of good character 
from the police, and a thesis on some medical subject, and 
$106. In some Universities the dean gives the candidate a 
preliminary examination to see if he is sufficiently well pre- 
pared, but in most Universities this is not the custom. If 
the thesis be satisfactory to the professors, then the candidate 
is allowed to come up for examination. The examination is 
an oral one, and is held in anatomy, physiology, general 
pathology and pathological anatomy, special pathology and 
therapeutics, surgery, midwifery and gynecology. After the 
examination the candidate hands in his dissertation. The 
examination is held before six regular professors, and each 
examiner examines for about a quarter of an hour. The 
dissertation is sometimes discussed in public, but more 
frequently not. 
There are two medical diplomas given in Germany, one by 
the State and the other by the University, and each has its 
separate examinations and requirements: the former being 
the more difficult of the two. The State recognizes only those 
doctors who have passed its examination. They alone have 
a license to practice and they alone can receive appointments 
to any medical office. Those doctors who have only passed 
the University examination can hold no appointment, and 
cannot insist on the payment of their fees from their patients. 
Any person who chooses, with or without a degree, can prac- 
tice medicine in Germany, but he does so at his peril, and if 
he makes any mistakes, he is punished both by fine and 
imprisonment. FRANCE. 
THE FRENCH LYCEE AND THE FRENCH 
MEDICAL FACULTIES. 
The courses and studies prescribed by the government* 
for the Lycee in 1892 were as follows : 
A. Division Elementaire, 
1. Classe preparatoire, 
2. “ huitieme, 
3. “ septieme, 
French, modern languages (English or 
German), history, geography, sciences, 
drawing. 
B. Division de Grammaire. 
4. Classe de sixieme, 
French and Latin, modern languages, 
zoology, arithmetic, ancient and orien- 
tal history, geography, drawing. 
5. Classe de cinquieme, 
French, Latin, Greek, modern lang- 
uages, geology (1st semester), botany 
(2d semester), arithmetic, Greek his- 
tory, geography of France, drawing. 
6. Classe de quatrieme, 
French, Latin, Greek, modern lang- 
uages, geometry, Roman history, gen- 
eral geography and geography of 
America, drawing. 
C. Division superieure. 
7. Classe de troisieme, 
French, Latin, Greek, modern lang- 
uages, mathematics, history of the 
Middle Ages, geography of Africa, 
Asia and Australia. 
8. Classe de seconde, 
French, Latin, Greek, modern lang- 
uages, mathematics, history of Middle 
and Modern Ages, geography of 
• Europe, drawing (optional). 
*A detailed statement giving further particulars, such as number 
of hours devoted to each study, authors read, etc., will be found 
in “ Plan d’Etudes et Programmes de l’Enseignement Secondaire 
classique,” Paris, 1892. 21 
9. Classe de Rhetorique, 
French, Latin, Greek, modern lang- 
uages, mathematics, modern history, 
geography(France),drawing (optional). 
10. Classe de Philosophie, 
Instruction in philosophy, physics and 
chemistry, elements of natural his- 
tory, contemporaneous history, draw- 
' ing (optional). 
In this schedule the “modern languages” referred to mean 
English or German. In mathematics the requirements ap- 
pear to be less than in the English and German Universities, 
being confined to arithmetic, algebra and geometry. 
There are two classes of medical men in France, the 
“Dodeur en Medecine” and the “Offider de Sante.” The 
applicant for the former must complete his studies at one of 
the six faculties of France, viz. Paris, Montpellier, Nancy, 
Lille, Lyons, and Bordeaux. To be admitted to one of these 
he must have the “ Diplome de Bachelier es lettres ” and the 
“ Diplome de Bachelier es sciences restreint.” The exam- 
inations for the Bachelier es lettres comprise the subjects 
taught in the three highest classes of Lycees, corresponding 
to the fourth, fifth and sixth, or perhaps more nearly to the 
lower and upper fifth and the sixth forms of an English 
school. A piece of Latin prose and an essay in German or 
English are required. Candidates are examined also in a 
number of authors,—Greek, Latin, or either English or 
German, History, Geography and French Literature; also 
Arithmetic, Algebra, Geometry, Elementary Logic and 
Mental and Moral Philosophy, and Elementary Chemistry, 
Physics and Natural History. These examinations are con- 
sidered about equivalent to the intermediate B. A. of the 
University of London, or to the pass B. A. at Oxford or 
Cambridge. The degree of “Bachelier es sciences restreint” 
in addition demands considerable knowledge of Chemistry, 
Astronomy, Zoology, Botany and Geology. 22 
The academical course is four years, and the studies are 
generally divided as follows : 
1st year—Physics, Chemistry, Anatomy and Dissection, 
Natural History, Physiology and Histology. 
2d year—Anatomy and Dissection, Histology, General 
Pathology, Surgical Pathology and Clinic, Physiology, 
Medical Pathology. 
3d year—Dissection, Surgical Pathology and Clinic, 
Medical Pathology and Clinic, Operations and Apparatus, 
Gynecology. 
4th year—Dissection, Surgical Pathology and Surgery, 
Medical Jurisprudence, Pathological Anatomy, Materia 
Medica and Therapeutics, Hygiene and Gynecology. 
The “Ojficiers de Sante.”—(This grade has either very lately 
been abolished or is about to be abolished.) These corre- 
spond to the “quondam” Wundarzte of the first class of 
Prussia, or the “magistri chirurgise” of Austria. They are 
educated in the “ Ecoles preparatoires,” of which there are 
twenty-one in France. The requirements for admission to 
these schools are very little; as educational proof they 
require “ un certificat de grammaire, ou un certificat delivre 
par un proviseur de Lycee, attestant qu’ils ont fair leur 
quatrieme.” They must be seventeen years of age before 
they can be admitted. At these Ecoles preparatoires the 
following studies are required : Chemistry, Natural History, 
Anatomy, Physiology, Medical and Surgical Pathology, and 
Clinic, Operative Surgery, Gynecology and Pharmacology, 
and a three years course is prescribed. After graduation 
they are assigned to certain departments in France to which 
their practice is limited. They can practice everything, but 
cannot perform the major operations without the supervision 
of a Docteur en Medecine. Several of the twenty-one Ecoles 23 
preparatoires are annexes to the three Medical Faculties of 
France, and, on certain conditions, the student may be 
admitted from them to the Medical Faculty; but, as a rule, 
the “ Officiers de Sante ” complete their education at the 
Ecoles preparatoires. 
SWEDEN. 
The applicant for admission to the Medical Faculty of a 
University (Upsala or Lund, or the Medical Academy at 
Stockholm) must have the “ Maturitats ” certificate from a 
Gymnasium. 
As a rule the time spent as a student at the Medical Faculty 
is ten years. After two and a half or three years he goes 
through the “ examen medico-philosophicum.” Three years 
later he passes the examination as candidate of medicine, 
which includes : Anatomy, physiology, physiological chem- 
istry, general pathology and pathological anatomy, pharma- 
cology. Four years later the “Examen pro licentia 
practicandi ”: practical medicine, practical surgery, ophthal- 
mology, obstetrics, forensic medicine. The studies are free, 
and no time for studies are prescribed, but a certificate is 
required that the applicant has attended clinic for six months 
in Lund or Upsala. All students must go to Stockholm, 
where they must acquire certificates of having attended : eight 
months the medical and surgical clinic; four months obstet- 
rical clinic, and two months psychiatric clinic. Only the Pro- 
fessors at Lund, Upsala or Stockholm can be examiners. A 
“tentamen” precedes each public examination, and only those 
students who have proved themselves capable in the “ tenta- 
men” are admitted to the final public examinations, which 
are therefore passed by all that are admitted to this. 24 
The standing of the medical profession in Sweden is very 
high. Owing to the length of the studies, the severe exam- 
inations, and the close relations between professor and student, 
the poorer material is well weeded out before the final exam- 
inations are attempted.* 
ITALY. 
The applicant desiring to commence the study of medicine 
at any of the twenty-one Universities of Italy must show 
that he has passed through an eight years course of study at 
school,—that is to say, five years in a “ Ginnasio ” and three 
years in a “Liceo.” Both Greek and Latin must be studied, 
bnt in the final examination for the“Licenza liceale,” which 
corresponds somewhat to the French “ Bachelier es lettres,” 
Greek is not compulsory. French is taught in the Ginnasio 
but not in the Liceo, and so does not enter into the final 
examination. A good knowledge of Latin is required, in- 
cluding several authors and both prose and verse composition. 
A considerable amount of history, geography and Italian 
literature is required. In mathematics, algebra is required 
to logarithms and quadratic equations, Euclid to the sixth 
book (including the fifth), plane trigonometry and conic 
sections; also mechanics. In science, elementary physics, 
chemistry and natural history are necessary. 
At the medical faculty of the University the course is six 
years; but there are no rules as to length or sequence of 
studies. The sole control are the many public examinations. 
For each examination there is a Commission consisting of 
* Billroth (Th.). Ueber das Lehren und Lernen der Medicinischen 
Wissenschaften, etc. Wien, 1876. 25 
the Professor of the special board in which the candidate is 
to be examined and two co-examiners appointed by the 
faculty. After each examination the candidate receives a 
certificate. There is no rule as regards the serial order of 
the subjects for examinations, although “usage” has made 
the following rule generally accepted : 
1st year—Zoology, Botany, Inorganic Chemistry. 
2d year—Physics, Organic Chemistry, Comparative 
Anatomy. 
3d year—Anatomy, Physiology. 
4th year—General Pathology and Pathological Anatomy. 
5th year—Special Pathology and Surgery and Clinic; 
Topographical Anatomy, Operative Surgery. 
6th year—Medical and Surgical Clinic, Hygiene and 
Medical Jurisprudence, Ophthalmology, Obstetrics. 
After all examinations have been successfully passed the 
candidate receives the “ Yenia practicandi,” or the right to 
practice. Should he aspire to the “ Diploma Laurea di 
Dottore in medicina e chirurgia,” he has to pass a special 
examination before seven professors, and write a Thesis on 
a subject drawn by lottery.* 
* Billroth (Th.). Ueber das Lehren und Lernen der Medicinischen 
Wissenschaften, etc. Wien, 1876.