Return to Proprietary Apprentice Medical Education?

To the Editor.—  I report an alarming occurrence that colleagues inform me is not at all unusual. A medical student attending a proprietary medical school in Mexico requested that he spend his entire neurology clerkship passively observing my hospital rounds. There was no requirement for his working up patients, let alone critique of his neurological examination and diagnostic and therapeutic formulations. Nevertheless, he stated he would be given full credit by his medical school for neurology, merely on my stipulation that he did, in fact, spend a month with me. I assume that he would also be required to pass a formal written examination. It thus appears that we are going full circle, returning to the pre-Flexner days of proprietary apprenticeship medical education. Hence the danger that the advances in scientific medicine will be jeopardized by those who have a poor background in clinical medical science.It may be that