There was no formal medical education in the American Colonies for more than 150 years. A like interval, traced back from the present, would land us in the presidency of James Madison; in other words, it was a long time to carry on without well-trained physicians. Only near the end of the Colonial period, moreover, did a few Americans go abroad for professional education. There are no statistics but it has been estimated that even a decade after the first native school was founded in 1765, 95% of American practitioners held no medical degrees whatever.1
Throughout the Colonial era, nevertheless, wellinformed persons realized that European governments provided by law for formal medical training and licensing. Why then were there no demands that English colonists be protected in a similar way? We usually ascribe this seeming neglect to a lack of population and wealth, or say that early Americans were