The purpose of this paper is to describe what medical practice is like in the United States and how the people are affected by it. It is important to realize that there are 48 separate states, each with its own laws. While the basic outline remains the same throughout the country, there are, nevertheless, important differences from state to state. Education After leaving high school, which is usually finished at the age of 17 or 18, the intending medical student takes a " premedical " college course for four years, leading to the degree of bachelor of science. It should be appreciated that the commencing age of school is 6 years, and also that children in both primary and high schools do not work as hard as in England. A student beginning his medical course is therefore in the same situation as an English student after finishing "pre-med," except that he will be several years older. The medical school course extends over four university years. The first two years are spent on basic sciencesanatomy, physiology, biochemistry, pharmacology, pathology. The last two years are spent on clinical work. The graduating degree is M.D., which corresponds to the English M.B., B.S. The standard of the schools is maintained by inspection by the Council on Medical Education of the American Medical Association, and all American schools are now considered grade A. All Canadian schools are accepted as on a par with American schools. The A.M.A. recognizes all English and Scottish degrees as being on a par with the American M.D., but the Conjoint diplomas are not considered so (Council on Medical Education and Hospitals, 1950). Licence to Practise.-Each state is a law unto itself and regulates professional licensure through its state education department. Each state has different requirements regarding foreign graduates, citizenship, whether an internship is required, and if so whether straight or rotating-for example, New York State admits graduates of grade A equivalent foreign schools and does not require internship; non-citizens are admitted to its licensing examinations. One-third of the states will not license foreign graduates. All states hold licensing examinations and grant varying degrees of reciprocity to licentiates of other states. Most of the states recognize the National Boards examination, the most notable exception being Florida. Full information about licensing requirements is given in the annual State Board Number of the Journal of the A4merican Medical Association (Turner and Tipner, 1955). Internship and Residency.-Hospitals are approved for internship and residency by the Council on Medical Education and Hospitals of the American Medical Association. Each year the Journal of the A.M.A. publishes a special Internship and Residency Number giving the latest information about which hospitals are approved (Leveroos et al., 1955). There are three types of intermship-straight, mixed, and rotating. The appointments run for one year. A straight internship covers only one service-for example, surgery-while a mixed interns...
