BEPORT ON VISIT TO COLOMBIA NOVEMBER, 1923 ALAN GREGG TABLE OF CONTENTS I. GENERAL ACCOUNT Page INTRODUCTION ccc cc ccccen seers nn recs scensenrssnancecs 1 EDUCATION « ccscccccncaccascsnccccranscccrsssseessscesece 10 GONETAl cocceccccvcccvvesereeverccvesesveceveseece 19 School Administrations sveccccccscccssssscseseseces 11 Primary Education. esascccccccccccccccccevccecossee Li Secondary Educationesecccccccevcccerscsccceseesece 12 Higher Educationesccccnccccesscsescccsssvescsasncce 16 RESUME OF MEDICAL EDUCATION. cccscccccesveccssncecvcves 19 IIT. QUESTIONNAIRE - SURVEY OF FACULTY OF ifNDICINE OF UNIVERSITY OF BOGOTAc ccvccascacesesccsersccevevececee 22 LOCHLLONe ccc cece cccercccccesevcccenevescccensecsee 22 WASTOLYs ccccsccacceseeesevesenessresseereesseesace 25 OP GONL Zab ons occccccsescsaccccascccaccscscssesscces 24 Financial Status. sccccccccccccscccscrssceeveocaes 27 BULLAIingSecccccccsvvecesnscscesavesvecsscssesseces él LABORATORY FACILITIES AND COURSES. ceccccccececeee. 35 Qa ANALOMYs ceccccccccscccevoscsccccsceresvesecee 35 be. Physiological & Pathological Chemistry.ceeese oT Ce Histology and Embryoloryececcccscsassssccace 42 d. Bacteriology & Parasitolopyesscoccsveccecece 44. Ge General Pathology. cecsvvcvecscevseevvesesscen 45 f. Pathological ANATOMY s correc cscccccsnssssece 47 Ge Gorneral Medicineseccccccccccsccccccvcvvccee 49 he General Surgeryecscccccscccccscsvevesveneves 49 i. Legal Medicine & Toxicolozyeccsesccccscscecce 49 je PhArViaCologye cccccccucccccsvccecccvvcseveses Sl Ke Phystologyecesveseccccescsecsccecsrtssacaces 51 Le HYZLOneeccevccscccccerccccuccsccvscccccreces 53 m, Topogranhical Anatomyscceccccccscecerccscecs 55 CLINICAL PACILITIBS..ccccccccsccccccccsccsesevcees§ 55 San Juan de Dios Hospitalsscssccccaccvccvens 55 Hospital de la Misericordiassscovccecvccvccee 60 Library Facilities. cccccccccecceccseceseccveseaces 61 List of Faculty by Subjectseccesscoscocscecsccsece 63 Admission Requiremonts.acesceccsccesscccsscssevers 64 Students Fecssc.scsccsesseccvcceverecersrseseseeee 66 COULSESceccvccveescescceventesecssvecessesccsenves 67 Number of Students ~ LO23sccaaccsescscceresvccvees 69 Origin of Students (to be supplied) Distribution of BYAduateSesccccvccccaccssecesscaces 69 III. APPENDICES 2c cccaccccscacscncsccceveveseveccveseseveceecese 70 WATERIATL TW LIBRARY es ccccccocevccerseeveeeeceseeeectesceces 72 PLANS s ceccvcesesssrerserecersecsssecceccssscssrers 73-80 Wiles on Edeeation ‘in Colombia - Interview. Chardon -lnambert wens Bl -bh INTRO CTION What are the clues to the South American mind and the general social picture? When the Spanish explorers began their penetration and con- guest of America in the early 16th century* they found the ideal country for pure exploitation. European adventurers - not settlers accompanied by tueir familics but armed marauders with traditional feudal fearlessness, heightened by religious zeal, conquered the New World for their king and their church - - 4 conquest amazimgly swift, but extra- ordinarily deceptive. The nature of the country and the charace teristics of the native Indians imposed upon the conquerers con= ditions which have affected radivally, and to this day, the degree and naiure of the Latin dominance over that part of the New World. ‘fhe country was, and is, too vast, travel too difficult, maintenance of communications too unprofitable -- before these physical disadvantages centralized authority has failed in South America generation after generation, Administrators were spread too widely over huge areas. ‘The old story repeated itself: cen= tral authorities attempted to cpmn the great @istances by attempt- ing to secure obedience from distant lieutenants through threats and penalties, ond their domination became either intolerable or ineffective. .That was known: as: “liberty” was only ® name for re-= lief from the angry cruelties and amazing stupidities ** of u de- feated centrul authority. * Quesada entered what is novw Colombia in 1536. ** stupiditics - @. ge - For a long period in the 18th century Spanish law forced ull goods for South America to pass through Panama; goods from Cadiz for Buenos Aires had to pass first across the Isthmus, thence to Callao, and then in long delayed caravan journeys over the Andes and the plains of the Argentine to Buenos Aires. The governing classes of one region were too far removed from those of another district to build up the traditions of loyalty or to practice friendly codperation. The social solidarity of the con- querers could not survive the new prosperity. Consequently the history of North @xd South America has been one of excessive in- dividualism, of feudal loyalty, but not cooperation among equals, and tne dominance of the "jefe" instead of theo? a leader. Sige nificantly the newspapers of today have taken over the word leader bodily from English for there is no Spanish vord which expresses such a function. Nor is geographical diffusion of the Latin race the only clue to the social picture in South and Central America. Conquest of the Indians was relatively easy. They were not exterminated (though their leaders frequently wore of course) nor pushed into segregation in specified reserves: they were enslaved outright or in thin disguise sand their Spanish masters, wherever European women could not come and live, began the long course of being ab- sorbed by the race they conquered. An extensive biological dilu- tion of the European race has taken place, a dilution the natural result of isolation and the difficultics of. travel. In consequence many regions have been populited by a mulatto and mestigo group which cannot be compared with the Latin side of their ancestry in ability and traditions. If the Spaniards had found a smaller urea in which to expand, adapted in point of climate und perhaps less seductively rich in gold and gems and slave labor, we should have seen the development of a New Spain more closely comparable to the mother country in social organization,and retaining more closely the imprint and character of the European social fabric. We should have seen a slower settlement of New Spain, but by a uniform race. A boat load of Europeans would have oolenizsc an Aoblee 3 Tete Sathet than area and propagated there social order and rather than spread over a vast area with an almost explosive violence only to lose or vastly to weaken their traditions of social solidarity after a generation of freebooting and miscegenation. Instead the vast distances separated the ambitious settlers, the tropical climate made them loath to bring their families,so that in one valley after another, in one district, even in one country after another the adventurers set up separately orders of tyrannous ‘domination over the natives. Nor was this a process characteristic only of the first 100 or 200 years. The whole of South America “ today with its 7,598,000 squar e niles (North America 6,559,000 square miles) has about the population of Japan. Settlements of virgin territory are still to be made in Colombia, whose thir- teen persons to the square mile is an average from which diffe- rent areas vary widely. In this racteal and geographical diffusion of the Latin people all traditions that have to do with social solidarity and community cooperation were, and are still, being greatly modified by this method of settlement and this extreme dilution of the original stock. Another factor which has diminished the sense of respon- sibility to the community and the tradition of public service,es- pecially in Colombia, is the character of the Catholic Church in this country. From the outset the Church has so jeslously guarded not only educational institutions but all movements connected with public charities that the idea of charities independent of the Ghurch for their supoort is still strange and phenomenal to the Colombian mind, Many a rich Colombian prefers approbation of the Church to the regard of his fellowmen or posterity, and if bene- factions sre to be made at all the church receives them. This in- fluence continues. Large grants are given by the government to the Catholic church for the maintenance of ordinary schools, schools for orphans, hospitals, asylums, et cetera, and such institutions extremely rarely receive aid that is not either from religious or government sources. At the same time that geographical and racial factors have tended to keep the Latin American people from learning to cooperate with/ocher and evolve a highly organized and close-knit social order, their individual tadepenience upen Europe has been in many weys greatly intensified, The independence of the South American must never be interpreted as an independence based upon self-reliance or self-sufficiency. It is rsither an independence of other South Americans. For 300 years the rule of the New “orld in politics, religion, industry and commerce was the almost ex- elusive monoply of the Europeans. Before 1817 in Spanish South America ,of 602 captains general and governors, 588 had been Spaniards. Things European have to this ny SnpBraatt @ conno= tation of being superior und authoritative. And this is even more true perhaps of intellectual matters than of fashions or manufactured articles, People cannot look to Surope for instruc- tion and authority in learning,in religion,and in commerce for 300 years without forming habits of deference und a submissive | den wet and admiring attitude which weil vanish upon a declaration of mere political autonomy. It is important to realize the absolute dependence of South America upon Europe. The Republic of Colombia has an area of 440,846 square miles in which is scattered very unevenly a population of 5,855,000. This averages thirteon to the square mile (France 194; United States 36). It is an area larger than the states of Texas and Montana together, an area three times the size of Germany , with less than 1/10 of Germany's population. Only 20% of the country is under cultivation, and in 1920 there were only 890 miles of railroads in the entire country. Three large systems of mountain ranges running north and south occupy with their foothills and slopes 2/3 or more of the country, and largely due to enpeyratee ficulties Colombia is a oltindey where travel is extremely diffi- cult and communication sldw and uncertain. There is not the slightest doubt that enormous inherent physical wealth exists in these isolated tropical valleys und temperate mountainsides. The world's platinum now comes from Colombia; the world's emeralds are found there; iron, limestone and fine coal are close to each other in the highland near Bogota. Even oil fields are being opened in the Magdalena Valley. ‘the great variety in altitude allows a wide range of agricultural products, Bananas, sugar cane and European grains are all eusy of cultivation; the best coffee in South America comes from Colombia, But transportation difficulties, a scant and ignorant population, the dangers of tropical life, an extreme isoletion, and more than all these an ignorant government together with a decidedly chauvinistic attitude on the part of the Colombian people, have prevented and will continue to prevent rapid.iniigration or the growth and development of highly organized native communities inColentis, In any question of gronting concessions to foreign capital to exploit their natural riches, the Colombians are governed in the last analysis by the fear that the concessionaires will obtain so much power that the sovereignty of the country will in reality pass into the hands of foreigners. Nor is this attitude confined to the field of commerce and industry. A similar fear of competition from the foreigner exists among the professional classes, and experience shows that difficulties have always been put in the way of the doctor or protestant teacher who attempts to settle in Colombia. The more rich and independent Colombians have traveled emough to know how dense is the ignorance among their own lower classes, how extreme their poverty and how powerless their economic resources in labor, and physical and mental cam cities,when compared with European or North American peoples. This realization serves only to intensify the Colombians’ intransigent conservatism at the same time that it heightens his sense of inferiority and his conviction of the superiority of the foreigner in everything. It is said that 33% of the population are white, 47% mesticos and mulattos, and 20% Indians and negroes (cen- sus 1912). My impression was that 107 more nearly represents the white and 33% the Indians and negroes. There is no middle class. The professional men are recruited from the pure white dominant group. It is essential to realize that this relatively small group of pure whites of Spanish origin are the land-own- ing, directing element in an extremely large and sparsely set- tled country; that their social traditions do not lead them to believe that success comes from continued, steady, patient work; that economically they are largely parasitic upon the negro, Indian and mestico working class; and that their past experience has led them to expect an easy but precarious living from the exploitation of the ignorant peasantry and the extremely fertil= country. The highland in which Sogota is located bears a peculiar relation to the rest of Colombia because of its altitude of 8000 feet, the great fertility of its soil, its perfect adaptation to Buropean settlement, its natural resources in coal, salt and lime= stone, its history and its exploitation by means of railroads con= necting with the Magdalena River, It is unlike the rest of Colombia in topography -~ a high level plain. Communication between wheils inhabitants is extremely easy; social life and cooperative under= takings are not hindered by difficulties of transport and commu- nication; and perhaps more imvortant than anything else, the climate is such es to favor the survival and even the continued renewal through imtig-ation of a purely Buropean stock. Politically too, the sabane has attracted the leaders from all over Colombia to the national capital, Bogota. Thus Sogota und its surrounding sabana represent the highest range of social development in the whole republic, and enterprises and ideals which are successful in Bogota cannot be attempted with any promise of success in other parts of the country, esp cially in the tropical lowlands. Tt is not vossible to present here a study of the his- tory and influence of the Catholic Church in Colombia. Suffice it to make only she following points: 1. Of all South American countries, Colombia is most tho- roughly under the control of the Roman Vatholic Church. The con= trast with Brazil in this particular is striking. 2. The Conservative party at present in power owes its pres= tige, not to say its existence to the support of the Church in small tovms and hamlets of the country and cannot be expected to offend the papal nuncio or the archbishoo in any matter important to them. 3, The church has considered schools, asylums, nospitsls and other philanthropic institutions to be one of its acknowledged fields und receives state moneys for the support of these institu-= tions under its own direction. It is extremely jeulous of its control of education in all forms, It has shown itself bitterly. * the upland plain opposed to American protestant schools; has blocked non-cstholic educational institutions of Colombian origin; and has prevented at all times any libéral tendencies to initiate educational re- form in Colombia. - 4, The Colombian government has entered into a formal con= cordat with the Papacy, the more important clauses of which are the following: Article 2 reads: "The Catholic Church shall preserve its full literty and independence of the civil power; it can exercise freely all its spiritual authority and eccle- siastical jurisdiction and conform its own government to its owm laws." Article 3 states: "The canonic legislation is independent of the civil law and forms no part of it; but it shall be solemnly respected by all the authorities of the Republic." Article 11 pledges the Church to cooperate with the Government in missions, education and charity. Articles 12 and 14 provide: that voublic education and instruction in schools, colleges and universities shall be organized and directed in conformity with the dogma and morals of the Catholic Church, “The government shall impedé the propagation of ideas contrary to Catholic dogma and to the respect and veneration due to the Church in the instruction given in literary and scientific as well ‘as other branches of education." 5, Power of the Church at present in Colombia is supreme, and no school or educt.cional movement could be successful against its opposition. In regard to the political and governmental system in Colombia the following points are imoortant: 1. The president through his power of nomination or dis- missal point-blank of any servant of the nation on the government pay-roll possesses dictatorial power as long as he remains chief 10 of the party in power und is not opposed by the church. 2. Difficult transportation, the extreme individualism and instability of the Colombian, and the extreme ignorance of at least 70% of the population meke a perfect medium for the: unreliable and unprineipled politicians whose irrespon- sibility and dishonesty are the curse of the Colombian people. 3. Public opinion as we know it in the United States does not exist in Colombia to curb the folly and injustice and faithlessness of the politicians. EDUCATION General -- Yifficulties of communication, the traditional in- dividualism of the soeial order ‘and the dense ignorance of the large proportion of the population impose great burdens upon education in Colombia. “Intelligence of the leaders is. above question, but the intense literary culture of a small group of the élite in Bogota is of scant significance in re- solving the problem. of national education unless indeed its effect is to plunge those in power into an even more intense pessimism. The chasm between the cultivated whites and the rest of the population is enormous. Statistics on education throughout Colombia are une reliable because political implications of truth-telling in official reports are grave. If an official.is paid to report yellow fever in his remote district, then from time to time he reports yellow fever unless instructed not to. The official ll Colombian Bluebock reports for 1922 in Colombia 25/4 illiteracy; reports of visitors and trsined students of education give it as 70-80%. School Administration -= In the United States government, Burcau of Education Bulletin No. 44, G, W. A, Luckey gives a valuable resume of education in Colombia. He says (1)"At the head of the education system cof Colombia, acting in vehalf of and amenable to the ational Government, is the Minister of Public Instruction, with large executive and appointive powers, He is one of the eight cabinet officers and exercises supervision and control over the public schools, high schools, colleges und special institutes, as the National School of Commerce, the National School of Fine Arts, and the National Acedemy of Music;" and (2) “fhere is also a nutio- nal council of educntion, At the head of each of the 14 state de- partments is tne director general of public instruction, and at the head of school affairs in the territories is a school inspector or supervisor. There are local, departmental, and national school inspectors, and municipal boards of education. The departments and municipalities, as well as private individuals, can maintain estab= lishments of primery and secondary education, but both public and private secondary schools must conform to regulations end apply to the Ministry of Public Instruction for the right to issue the dip- loma of bachiller (bachelor)? Primary Education a= Primary education is gratis, but it is not com- pulsory - not even on the statute books. It is largely a department 12 (provincial) affair, ' My Luckey states in bulletin #44 "There ure tyro course. ul study, one for rural schools and the other for urvan schools. In urban conditions there are sepa- rate schools for each sex, the course of study being divided into three parts called clcmentary, intermediate and superior. The length of the course in both rural and urban schools is three years; but very few children, especially in rural com munities, continue in schovl for three years, and more than half of the children throughout the Republic do not attend school at all. Few, if any, of the graduates of the orimary schools enter the secondary schools for further e‘ucation. Of primary education three-fourths or more is publicly provided and less tnan one-fourth privately provided; in secondary edu- cation the proportivn is changed, only about one-third of the secondary schools being publicly provided and two-tiirds being maintained by private venture -- church or lay. Less than helf of the school buildings are mmicipally owned, the majority being rented for school purposes and poorly adapted to such needs. Subjects of study in rurel schools are resding, writing, arithmetic, religion, geography, good manners, sewing, and less arithmetic for girls; in urban schools, religion, reading, writ- ing, drawing, singing, ooject lessons, calisthenics, arithmetic, sewing for girls, geography, and history of Cotombia, elementary science, and notions of physics! Secondary education -= Quoting from Mr Luckey "Secondary education 13° is under the immediate direction and control of the National Government. It is given in governmental normal schools, of which there are usually two in each department, one for boys nd one for sirls; colegios, liceos, and institutos, The latter institutions have sprung up as special fitting schools for higher-end -profesé{énal “éducation, and-are- all. pay schools.for higher and professional education, and are all pay schools (open to both interns and externs) attended by ambitious students of the better classes, The usual type is the national colegio, which usually maintains both primary and secondary courses; the former of three or four years and the latter of five or six years, the entire course of nine years leading, on successful examination, to the bachelor's degree in letters or science. This is the usual form of secondary education and is quite distinct from and independent of the primary schools, The time element leading to the bachelor's degree is three years short of that required for graduation from our high schools, but . the pupils are, on beginning, probably a year older, ofa selective class, and the subject matter, in some lines, is more extended, though considerably less so in others," * * Of the 283 “colepios” in existence in 1921, only two, the National School of Commerce in Bogota, and the Colegio de San Luis Gonzaga in Zipaguira, are supported by the central government. The rest are either private schools or are sup= ported by the departments, although many of them receive sub- *from material of HvW 14 sidies from the government, amounting in 1921 to $48,840.50, and scholarships worth in the same year $44,633.70, Only 42 of these schools have the right to grant the divloma of “bachiller."” *Privete secondary schools must apply to the linister of Public Instruction for the right to grant the diploma of "“bachiller" waich is required for entrance to any institution of higher learning. This diploma, and ‘he examination on which it depends, should not be confused with the American degree of Bachelor of Art or Sciences, as seems often to be done judging from the way in which writers translate it. It is instead exactly similar to the “baccaleurcate” diploma snd the title, not degree, of “bachelier™ granted in France and other European countries to students who pass the final exami- nations of the secondary schools. Tt may be equivalent to more or less than American high school graduation, depending on the status of secondary and nigher education in any parti- cular country. *The right to issue the diploma of "bachiller" is granted to a private secondary school in Colombia on the fol- lowing conditions: 1. The petition must have the approval of the proper ec- clesiustical authority and that of the Director General in Pub- lic Instruction in the depurtments, and of the »wchool Inspector or Supervisor in the intendencies, *from material of HvW 15 2. The official course of study must be adopted. 3, The syllabus and regulations and the list of teachers must be submitted to the Ministry for approval and revision. 4. No person may be uppointed as a teacher who does not possess certain qualifications. 5. The school must be regularly established and suitably located, with a laboratory equipped for the demonstrative teach- ing of physics and chemistry. 6. It must offer the academic course in science as well as in philosophy and letters. *Decree No. 1122 of August 5, 1922,. issued new regula= tions governing the granting of this diploma, and the following "course of study must be given by official or private schools having the right to grant the diploma of "pachiller." lst 2nd 3rd 4th Sth 6th Yr. Yr. Yr. Yr. Yr.e Yr. Religion =----- cert - - ? ~ - ~ Apologetics -- 7°77 5-7 - - - - - 3 Spanish: Grammar & Composition - = 5 5 - - - - Spelling ---- 77 rec 5 - - ~ - ~ Rhetoric & Hist. of Lit. - - - 5 - - - English ---- 7-7-7747 - - - 5 5 - French = 2----°%7 7777 - 5 5 -- = - Latin -*- 2+ - 7 tert - - - 5 5 - Geography: General - --- 7 7 7 7 7 5 - - - - - Of Colombia ----*- 7° - 3 - - - - Cosmography ---7- "7-7-7 - - - - - 3 History: Of Colombia ------° - 3 - - - - Ancient --*7- 77-7 - - - 3 - - Modern sfc crt rc 7 tt - - - 3 - - Civics se 277-77 27778 -- - - - ~ 2 Mathematics: Analytical & Com. Arith. - 5 5 - - - - Accounting = --- ce 7 - - 5 - - - Algebra -----e 7 7 77 - - - 5 - - Plane & Solid Geometry -- - - 6 - ~ - *from material Evy 16 (Continued) lst 2nd $rd 48h 5th 6th Forward 20 2@1 #20 21 10 8 Physics - - -- 2+ +--+ -+-- - - - ~ 5 = Chemistry - = ------ - ~ - - - - § Natural History: Zoology, - physiology, hygiene, botany, geolory - - - - = ~ - - - 5 ~ Philosophy: bLogie == -- +--+ -- - - ~ 5 - - Cosmology, psychology == = ~ - - 5 = theodicy, ethics, philo. of luw--+----- += - ~ - - - 5 Experimental psychology -- - - - - - ar Total 20 21 20 26 25 2% Higher Education -- Again quoting from Mr Luckey. "There are two federal institutions of college rank, the National Unie versity of Bogota, with schools of law, medicine, dentistry, and engineering; und the National Schouls of Mines of Medellin, There are also a number of state or departmental universiticos, as follows: The University of Bolivar, at Cartagena, the Uni- versity of Antioquia, und the recently founded (1919) Women's University, at biedellin; the University of Nurino, at Pasto; the University of Cauca, at Popayan; and the University of lag- dalena, xt Santa Warta. In Bogota, the capital, sre ulso nutio- nal schools of agriculture, fine arts, and the conservatory of music. Entrance to the above universitics is on examination after graduation from the colegios or secondary schools." The government budget for 1923 follows. But little weight can be attached to the figures,for instruction in most cases is supplemented by small funds from the Catholic Chureh, 17 and expenses aea seldom tally with the budget. * Government Budget - 1923 Pesos Percentage PUBLIC INSTRUCTION - - ~ - ~ 1,251,506.48 5.0 Government - -- =~ - - = ~ 8,354,658.40 33.7 Foreign Affairs ----- - ' 535,658.41 2.2 Finance ----- 7-76 2,132 ,581.86 8.6 War - 2+ se - - = = (ee = = 2,819,233.28 11.4 Agriculture & Commerce - - - 1,438,538.00 5.8 Public Works - --- - = =~ ~ 2,845,687.07 9.5 Treasury --- 77-727 - .§,898,941.50 23.8 Total 24,776,605.00 100.0 The great lack felt by the kinister of Education is in the system of education and in the impossibdi lity of securing,at present salaries, or indeedin any way,en adequate teaching force. During the time of my visit the catholic clergy openly criticized the governnent's plan for educational reform*to ‘ameliorate the situation and frequent reference was made to the concordat which exists between the Republic of Colombia and the Vatican, en= trusting to the Church final authority in matters of primary and secondry education. The Church directs the primary and secondary schools, receiving from the government’ subventions for tiie purposein the latter schools, but the quality of these schools varies very widely -- from poor to scandalous. . Inasmuch es the Conservative zovernnent owes its tenure of power to the support of the church in rural Colombia, it is not extremely likely that any radioal modification in education will be forthcoming in Colombia within a generation. ¥material of HvW 18 7 18 In November 1923 talk was current in Bogoté of a foreign commission to be contracted by the government to study the Colombian educational system and renort to the President, The Vatican had. from the outset indicated that the commission was to be composed exclusively of catholics. I heve since learned that the Vatican has further stipulated that these catholics are not. even to come from a non-catholic country, and Belgium has been decided upon instead of the United States as originally planned. 19 7 ay RESUME OF MEDICAL “pUCATION Bi? Seriously isolated and difficult of access but in a region exceptionally healthful and stimlating considering its tropical latitude of 4h N., there is situated in Bogota the only promising medical school in Colombia. It is the most generously supported single school in an ill- supported educational system of a backward South American government. Its policy, its personnel, its administration are directly dependent upon the president of the nation, but he is bound in these matters to observe the indications of the Catholic Church -- and history shows the Church to have been not inactive in medical school affairs. General secondary education in Colombia is so poor that students entering the medical school show wide divergences, and yet an almost uniformly inadequate, preparation in the natural sciences. In the medical school the tradition and spirit of the instruction emphasizes the lecture and the examination. The professors are all, except the professor of anatomy who receives $120 a month, practitioners of medicine and their salaries of $45 to $60 a month explain why they cannot afford giving the time to teach, Instructors receive $10-$30 a month and only undergraduates are available at such pay. The professor bends his energies and limits his responsibility to lectures and examinations. Demonstrations by assistants are next in import- ance, then individual instruction and last of all practical work by the ‘student himself. The instructors are all inadequately prepsred and their unreliability necessitates a prodigious amount of examinations conducted by the professors. Over 2400 individual examinations are held annually. Though the new building is not yet complete nor likely to be for 5-10 years it could be adequate if among the faculty there existed clear notions of what sound medical education is, and some familiarity with modern methods of teaching. Both preclinical and clinical courses are characterized 20 by totally inadequate emphasis upon the value of laboratory work no done by the student under competent supervision. The clinical facilities are not taken advantage of, largely through ignorance of methods successful elsewhere, and this defect will be more glaring when the new hospital buildings come into use during the year 1924. The dependence of the school upon the government is indicated by the relation of the income from students! fees, $16,000,to moneys received from the government, $58,000. It is apparent also that to administer a 6 year medical school for 400 students on a budget of $80,000 indicates ignor- ance on the part of the Government of the importance and cost of medical education. This attitude of the Gavt, together with the ignorance of effect- ive teaching methods on the part of the faculty are at the root of the difficulties of medical education in Colombia. One other serious obstacle can not be overlooked; the Colombian professors are jealous of their reputations and their dignity, and foreign professors, I was assured without inguiry, would not be tolerated in the chairs at present occupied by Colombians ,( though new chairs with temporary foreign professors would be welcome), wens. Ti pebid” Aoclopancad of a soll trawued weir teclieg force. T4,. The medical school needs to free itself from the domination of the Church as regards policy and the naming of personnel. 48, Through endowments, raised at least in part locally for chairs in the school, a beginning needs to be made to establish the school as an institution in part free from the ups and downs of government finance. Such endowments would stimulate more adequate support from the Govt. for other items, especially if they secured recognition and approval, from outside the nation. \%.: When the present teaching hospital goes into its new quarters there ls a real need for improvement in reorganizing the clinics on modern lines. Furthermore it is possible that a pathologist attached to the hospital 21 with opportunities to teach but no title that would offend the professors could be found. 5. A “Young Turk” party of graduates who have had experience abroad would in ten years do the most to improve the teaching, the relations and the influence of the medical school in Bogota. | Although the climate of Bogota is favorable to hard work and although ‘the improvement of medical education at some point between Mexico and Brazil would be of value especially in solving the problem of train= ing public health personnel, no recommendation is made for assistance to _the Faculty of Medicine st Bogotd for the following reasons: 1. By its geographic location it will always be relatively diffie cult of access and hence in its interests and in its influence jimited. 2. The characteristic original settlers’ indifference to community welfare und disinclination for teamwork at the expense of the indivi- dual has been intensified by exploitation of an inferior and defence- Less Indian stock. Classes of society (merchants, clergy, rural landowners, peasantry) are so widely divergent in most of their in- terests that the words "the common good" seem almost a mockery. Not only widely divergent but closely balanced against each other, and this deadlock of divergent if not opvosing interests is exceedingly slow to change. This divergence of interests and disinclination for teamwork paralyze every educational activity with which I came in contact even in Bogoté. 3, The Colombian has a strong sense of his own inferiority -- and it fuses with his fear in a deep distrust of the foreigner, especially the American. No valuable non-sectarian movement or institution was geen in Bogota which is not being maintained by Colombians who have received their inspiration from England, United States or France. Such an institution as McKenzie College in Sao Paulo is at present impossible in Colombia. 4, The stand-pat relation of the Catholic Church to education, and the total inadequacy of Colombian secondary education as 4& basis on which to build an adequate medical training make the scope of any attempt to improve the school at Bogoté extremely wide and full of opposition against which no foreign agency could be expected to succeed,