is designed to increase the supply of medical manpower and to improve the quality of medical manpower in the United States in the future. The bill was reported by the committee, after the usual hearings and careful consideration, unanimously. We think it represents a sound and reasonable approach to a tremendous problem for the whole country.

Now, as has been related to you by members of the Committee on Rules who have briefly discussed this proposal, there are four programs contained in the bill. First, we provide assistance for the construction of schools for the training of health professions manpower. This means doctors, dentists, osteopaths, professional public health personnel, optometrists, podiatrists, and pharmacists. This is an extension of the existing program which was approved by this House in 1963.

The second program contained in the bill provides for student loans for students at health professions schools. This is also an extension of the present program, with which, no doubt, the Members of this House are familiar.

Now, there are two additional programs, Madam Chairman, provided in the bill that are new, insofar as they relate to schools teaching persons in the health professions field. I call to your attention that we are authorizing a system of grants to the schools which may be used by them in granting scholarships to persons studying in the health field. This is not a new idea, even though it is a new program insofar as concerns

the health fields.

Mrs. BOLTON. Madam Chairman, will the gentleman yield for a question? Mr. HARRIS. I will be delighted to yield to the gentlewoman.

Mrs. BOLTON. It seems to me, and I notice this is entirely for the medical end of things, reading from your report. There is nothing said here about schools of nursing. I do not see how a doctor is going to function in a hospital unless he has plenty of nurses.

Mr. HARRIS. As the gentlewoman will no doubt recall, when this act was authorized at the outset in 1963, it provided among other things for construction assistance for collegiate schools of nursing. However, if the gentlewoman will recall also, we provided a special program for nurse training in 1964. Therefore, the nurses come under their own program and not under this one. As I remember so well, the gentlewoman contributed so much to that program, which is working out exceedingly well.

Mrs. BOLTON. May I say to the gentleman I hope when we get to discussing the nursing problem you will permit me to take some time to say something, because I do not think it is going so well. Mr. HARRIS. I will be very glad to have the gentlewoman have the time and express her views.

As I was about to say, this question of providing scholarships to persons studying in our institutions is not new at all. A similar program was authorized under the National Science Foundation Act which was passed by this Congress about 1950, after several years of consideration

and hearings. Another similar program was also provided in the National Defense Education Act of 1952, when fellowships up to $2,500 per year were granted to advanced students for degrees beyond the baccalaureate.

I would remind our friend and colleague from California [Mr. SMITH], а member of the Committee on Rules, who raised the question a few minutes ago, that what we are doing here is not a new idea at all. We are carrying a program forward which this Congress inaugurated some years ago, but we are extending it to a new field. It is a well known and recognized fact that it takes about 10 years to educate a doctor from the time he starts his school program until he completes his training and education and is then ready to serve the sick and ill of our country.

We are seeing today out of our experience that it is becoming more and more difficult for capable applicants entering the schools of medicine and the health field to finance their education. Primarily this is because of the cost and the length of time it takes to complete training, which is far beyond that of any other profession in this country. Consequently we have felt that we are not catching up, we are not meeting the demands and the needs of our people. Even though other programs of student aid are available through well-known, altruistic people, who have made money available out of their own savings, and even though great organizations such as the American Medical Association offer loan programs, and even though there are some business organizations that offer scholarships, still we are not meeting all of the needs.

There are many fine potential students, as one institution after another has told us, people who are interested, but who simply cannot meet the high cost and the time required, the 10 years that would be required, to provide necessities for themselves to live and to go ahead with their education in this field.

We have had brought to our attention the cases of many people who would be interested if they were given encouragement and assistance. In view of this situation we have decided to try to meet this problem.

Mr. SMITH of California. Madam Chairman, will the gentleman yield? to the gentleman from California. Mr. HARRIS. I am delighted to yield

Chairman, I concur in the gentleman's Mr. SMITH of California. Madam statement, but I want to be certain that I never make a misstatement when I am presenting a rule. Was I correct in stating that outright grants or scholarships will not have to be repaid, if they are granted under that provision?

Mr. HARRIS. The gentleman is cor

rect.

Mr. SMITH of California. We have

never done that before?

Mr. HARRIS. It is new for this pro

gram, but it is not new in the field of education.

Mr. SMITH of California. But it is new in this bill?

Mr. HARRIS. It is new for medical schools and in the health and profes

sional assistance program; the gentleman is correct.

Mr. SMITH of California. I think we are in agreement; I thank the gentleman, Madam Chairman.

Mr. HARRIS. We feel that in this profession there is just as great a need, if there is any way that you can compare it, as there is in any other profession in our entire society.

Madam Chairman, the committee considered this at some length and finally arrived at this conclusion. We did not 3 years ago when this bill was first approved include scholarships, because we were not convinced that this was necessary. However, it is like some of the other programs now. After we have had a few years' experience we have come to the conclusion that it is necessary if we are going to meet the need.

Madam Chairman, the fourth program provided in the bill is a program for what is called basic and special improvement grants to schools in the health professions field to enable them to strengthen their programs of teaching students.

Madam Chairman, the testimony presented to the committee during the hearings, and summarized in the committee report to which I invite your attention, demonstrates the clear need for this new program.

Now, I shall ask permission to revise and extend my remarks, and take up each one of these four programs and explain them, construction assistance, the student loan program, scholarship grants, and these basic and special improvement grants which I have briefly summarized to you.

CONSTRUCTION ASSISTANCE

Madam Chairman, the original Health Professions Assistance Act of 1963 has worked extremely well to date. Many medical and dental schools have submitted applications for construction assistance, which will, upon the completion of the construction, provide facilities for the training of additional students. Relying on these increased facilities which will be provided with assistance under the original legislation, many schools have increased their enrollment. For example, in 1962 the total first year enrollment in medical schools was 9,200; in September of this year it is estimated that this enrollment will total 9,925. Similarly, dental schools have gone from 3,680 in 1962 to an estimated 3,850 this September.

Applications have been approved and funded for six new medical schools and one new dental school. It is anticipated that additional medical and dental schools will be created under the program we are presenting to you today.

It has been estimated to us that, by 1975, we will need to have a minimum of 12,700 students admitted to the first year class in medical schools throughout the United States in order to produce graduating classes numbering 11,500. If we can obtain this enrollment increase,

then it will be possible, according to the

best estimates furnished to us for the physician/patient ratio in the United States to remain at the current level of 149 doctors for every 100,000 Americans. Frankly, I am not sure whether this will

be enough since trends in the practice of medicine in recent years have been in the direction of increased specialization by doctors, with a declining proportion of general physicians. It is for this reason, among others, that we must be alert to establishment or continuation of programs under which general practitioners may practice medicine more efficiently and effectively.

The Department of Health, Education, and Welfare made projections for the committee of the additional first-year places which will be created under the construction assistance provisions contained in this bill. This information is set out in a table at the bottom of page 4 of our committee report, and if these projections work out in accordance with the estimates we should, within a few years, upon completion of the construction provided for in this bill, have increased the number of first-year students in medical schools to almost 12,000 and to dental schools to a little over 5,000. The legislation also provides assistance in the construction and rehabilitation of schools of osteopathy, schools of public health, schools of optometry, schools of podiatry, and schools of pharmacy.

The committee was furnished information during the hearings both in this Congress and in the two preceding Congresses indicating the need for increased personnel in these fields. Fundamentally, the problem which we face in these areas arises out of the fact that our population is expanding so rapidly that the facilities to train persons to meet the health needs of our expanding population are not able to expand sufficiently to meet the needs except through the establishment of programs of Federal assistance for these schools.

STUDENT LOAN PROGRAM

The original Health Professions Educational Assistance Act of 1963 established a program under which student loan funds may be established at schools of medicine, of medicine, dentistry, and osteopathy. Loans may be made to students in these three disciplines up to $2,000 a year, with provision for a delay in repayment of the loans for 3 years following completion of his education. By later legislation, this program was extended also to students of optometry. Of the 152 schools which are eligible, 147 have established student loan funds. Under the bill, the maximum amount of a loan which may be made to a student has been increased to $2,500, the same amount authorized under the National Defense Education Act. The estimates furnished the committee indicate that approximately $25 million a year in appropriations beginning in the fiscal year 1967 will be needed in order to meet the needs of students at these schools, and the bill authorizes appropriations in this amount. The committee has also authorized the extension of the student loan program to schools of podiatry and schools of pharmacy, if the Secretary of Health, Education, and Welfare determines that the needs in this area require the extension of this program to these schools.

SCHOLARSHIP GRANTS

Our committee has also authorized a program of grants to the schools in amounts ultimately amounting to $2,000 times one-tenth of the total number of students in the schools, which may be used by the schools to make scholarship grants to needy students in amounts up to $2,500 a year.

Under present programs, the bright college graduate who wants to go on to medical school is faced with a difficult dilemma unless he comes from wealthy parents. More than four-fifths of the graduate schools in the life sciences received nonfundable grants in 1962-63 and the average grant was $2,700. In contrast, less than one-third of the medical students received nonfundable grants of any kind and the average which they received was $760. Only 15 percent of the dental students received scholarships which average $425. Similarly, there are relatively few scholarships available to students at schools of optometry and they are in relatively small amounts averaging out to about $350 a year to the students who receive the scholarships.

This means then that a student from a poor family faces a difficult problem if he wants to become a doctor or a dentist. He stands a good chance of getting He stands a good chance of getting scholarship aid in amounts sufficient to meet almost all of his needs if he chooses to study for a Ph. D., but if he decides to go into the study of medicine his prospects of receiving scholarship aid are quite low and the assistance he will receive will be inadequate to meet his needs.

Establishing a scholarship program would, in our opinion, increase the quality of students at schools of medicine by increasing the number of students who will be able to afford to attend these schools. The program should increase the number of applicants to medical schools and enable the schools of medithe number of applicants to medical cine, dentistry, osteopathy, and optometry to compete for brighter students more adequately with other disciplines.

who are studying at the graduate level What we are doing for these students is providing for them the same level of who are studying at the graduate level Federal support available to them if they is providing for them the same level of pursue graduate work in other areas.

BASIC AND SPECIAL IMPROVEMENT GRANTS

Madam Chairman, the program of basic and special improvement grants which our committee has approved for this legislation is a new program, but it is one that is badly needed and one that I support very strongly. In recent years, costs have been rising in every area, and the costs have increased drastically. For example, faced by medical schools for teaching in 1956-57, medical schools spent a total in 1956-57, medical schools spent a total in the 1962-63 school year these expendiof approximately $240 million; whereas tures had increased to over $600 million. in the 1962-63 school year these expenditures had increased to over $600 million. The Federal Government is, of course, supporting large amounts of research at medical institutions. These amounts increased from 1956-57 to 1962-63 from about $90 million to almost $350 million. about $90 million to almost $350 million. During this same period the regular operating costs of the schools, where little erating costs of the schools, where little if any Federal assistance is provided,

have increased from $146 to $256 million. Students are paying increasingly burdensome amounts of tuition and fees, from $719 average in 1956-57 to $1,025 average in 1962-63. Notwithstanding these increases in tuition and fees, tuition and fee income now comprises a smaller percentage of the total operating budget, dropped during the period discussed above from 14.3 to 12.6 percent.

The average cost of instruction of students increased from $5,026 average per year in 1956-57 to $8,000 average in 1962-63. State appropriations have increased in amount but decreased as a percentage of total operating costs from $49 million in 1956-57-33.5 percent of total-to $69.5 million in 1962-63-or 27 percent of total. The same is true of endowment income which has increased from $13.7 million-10 percent of totalto $20.7 million-7.8 percent of total.

These patterns apply equally to schools of dentistry, osteopathy, and optometry.

It is for this reason that our committee was convinced on the basis of the evidence submitted during the hearings that the medical schools in the United States need additional financial assistance if they are to continue to serve their teaching functions. Our committee has, therefore, provided a system of grants to the schools which are to be used to aid the schools to contribute toward the maintenance of their accreditation or to provide for their accreditation or to contribute toward the maintenance of the specialized functions which the schools serves, such as teaching or research, or to provide for these specialized functions.

Basic improvement grants are to be paid to schools in accordance with a formula set out under the bill under which the first year the school will receive $12,500 plus $250 for each full-time student enrolled therein; for the second and subsequent years of the program the school will receive $25,000 plus $500 for each student. These grants would be made to the school, without regard to whether it is wealthy or poor. It is intended that in the case of the wealthy schools, these grants would be used to aid them in strengthening, enriching, and improving their programs. These schools would use these grants for such things as achieving balance in their curriculum areas and for experimenting in innovations in professional health education.

In the case of the less well-to-do schools, these grants are critically schools, these needed. In a report of a council of the American Medical Association, it was stated that the weaker schools lack the number of faculty members they need. It was stated that these schools are handicapped by their basic financial instability. The report expresses concern about the quality of the educational programs, and states that almost all of the 10 schools with the lowest expenditures during 1960-61 have been warned of possible withdrawal of their accreditation.

In the field of dental schools already 3 schools have been placed on provisional accreditation and others are in serious jeopardy. The schools of osteopathy have the same basic problems, as do the

this body that optometry as a profession needs and deserves the same support as the medical skills originally included. For this reason, optometrists and optometry have been included in the provisions of H.R. 3141 across the board.

Since that time 2 years ago when H.R. 12 was so carefully considered by this House, we have had occasion to consider and approve other far-reaching measures dealing with the health professions and health facilities. The vital problems of the nursing profession were faced up to and assistance in the form of construction grants and student loans were provided. Mental health and mental retardation were tackled for the first time, with a new approach and a sound philosophy. All of these programs have deserved and received the support of this House. Much remains to be done in the broad field of health care for all of our citizens. The more we have considered the broad problems and possible solutions the more definite it has appeared that the key to every medical and health problem facing us today will hinge on the creation and the assurance of adequate manpower in those professions in the medical and allied fields. In order to train such manpower we must have first-class accommodations, such as school buildings and equipment. This bill would provide them. Once the places exist in which training can occur a new set of problems and considerations follow

on.

The competition among the various academic fields for highly qualified personnel presently works against such institutions as medical and dental schools. Various fields of research attract the people best suited to educate our doctors. Medical schools do need additional funds if they are to provide the kind of medical education which the rapidly advancing profession must require. High quality instruction and adequate curriculum are not things merely to be desired but to be obtained with certainty.

There was a time when a State government could provide a medical school adequate to the needs of its particular population. Those days are gone. Medical schools, particularly the bigger and the better ones, train doctors to serve areas far removed from the boundaries of a particular State. To meet this situation H.R. 3141 provides for grants to all medical schools which after the first year would provide $25,000 plus $500 per student enrolled. This should make it possible for schools to compete on more even terms for faculty members. If such assistance is to be granted with Federal funds it is my conviction that there should be some assurance that we will end up with more doctors. By this I mean that we should make certain that upon spending these millions of dollars to support the operations of professional schools, we will train more people than would have been trained if this specific assistance had not been given. For this reason I suggested and the committee adopted an amendment which requires that any school applying for grants under this section must agree to increase its enrollment by 22 percent or 5 students, whichever is greater. This

increase in enrollment must continue for a period of years. You may recall that I suggested a similar provision in the construction authority of H.R. 12. The schools which have made application unschools which have made application under the statute have found it possible to give such a guarantee. By adding this amendment to the grants section we can be sure of even further additions to enrollment over the years. If Federal support to medical school operation will definitely increase the number of people being educated and the resulting number of doctors and other health professionals, such assistance is well justified. My amendment has resulted in 63 new projects and will ultimately produce 2,279 new enrollees. I am hoping this legislation will produce approximately another 2,000 new enrollees.

In addition to these general support grants we have provided for a series of special grants to assist schools finding it difficult to maintain accreditation. We need more schools but we must also be sure that existing schools are first rate. Any other kind of medical education is useless. There is no doubt that some schools will have access to more support than others. In all likelihood the areas with the weaker schools will also be areas in greatest need of additional doctors. It is necessary in providing for any grant of this type to leave considerable room of this type to leave considerable room for the exercise of judgment by those charged with the administration of the charged with the administration of the act. We have laid down the general guidelines for the use of these special guidelines for the use of these special funds and fully expect that they will be used to bolster the weaker institutions.

Based upon experience to date and the projects supplied by those most knowledgeable in the field we should be able to conclude safely that institutions for the training of medical personnel will grow training of medical personnel will grow in number and in strength. There is another major requirement to the production of doctors, dentists, and the other professionals mentioned in the bill. That requirement is a student body capable of requirement is a student body capable of and motivated to the completion of a

course of study. We presently make available loans up to $2,000 in 1 year. This cannot take care of all of the expenses at a medical school. The average cost per year is about $3,500 and at many schools it might be considerably more. Many students, by the time they have reached medical school, have borrowed reached medical school, have borrowed large sums of money. They must have They must have this undergraduate training and they must prove themselves to be worth the time and the efforts of the graduate school. school. The student of limited means applying for admittance to medical applying for admittance to medical school, after struggling to obtain his school, after struggling to obtain his college education, faces formidable excollege education, faces formidable expense. Although he may be able to obtain the full $2,500 per year-the amount tain the full $2,500 per year-the amount provided in this bill-he will still be short. There must come a time when the student surveys his obligations and decides that he has had enough. Even the challenge and the possible rewards of the medical profession will cease to give him the necessary incentive. Particularly is this true when we consider other possible fields of endeavor into which he might channel his ambition. There are might channel his ambition. There are grants, traineeships, and fellowships open to graduate students.

They also

offer a challenge and rewarding careers. If he wishes to pursue that line of endeavor known as the life sciences, and become expert in one of the many fields of research he can do so at very little expense to himself. Obviously this is making it increasingly difficult to keep many well-qualified students on the track toward a medical degree.

It is not the intention of this legislation to grant free medical education to all comers. I do believe that there are many instances in which assistance in the form of grants, whether they be called fellowships or scholarships, are justified. This bill would provide a fund for each medical school from which it could give scholarship support to a few students up to $2,500 per student in any given year. I think that we must rely upon the integrity of those who operate our medical schools to maintain their standards and to use scholarship funds for that purpose. Certainly the amounts anticipated in this bill will not cause an overwhelming rush of applicants to medical schools. It will still require dedication, determination, and perserverence, as well as outstanding intelligence to become a doctor.

Earlier we talked about manpower. This bill is meant to increase it. We need more health professionals in many different areas. Certainly we need more general practitioners. The answer does not lie in dissuading qualified persons from specializing. Neither of these groups should stand in the way of teaching. Each element of medical manpower is dependent upon the other and at the same time supports the others. It almost becomes the chicken and egg dilemma. This bill should provide encouragement in each of these directions and should add greatly to the prospects for firstrate medical care for every citizen.

For these reasons I support H.R. 3141 and recommend that the House pass it. The CHAIRMAN. The time of the

gentleman has expired.

Mr. SPRINGER. Madam Chairman, I

yield myself 5 additional minutes.

Mr. NELSEN. Madam Chairman, will the gentleman yield to me?

Mr. SPRINGER. I yield to the gentleman.

Mr. NELSEN. I would like to point out that the requirement in the bill that will insist on the expansion of the enrollees is the amendment that was offered, I believe, by the gentleman in the well. I want to point out that certainly this is a very constructive approach and a much needed amendment to this bill. I might point out further that in our hearings in our committee it was obvious that the need for doctors, especially in rural areas, is a crying need and one which we must try to meet.

I want to thank the gentleman for his statement and for reaching the objective he sought by his amendment. I believe it is a very worthwhile contribution to this legislation.

Mr. SPRINGER. Madam Chairman, I want to thank the distinguished gentleman for his words and say even though it was my amendment, I believe it was unanimously accepted in 1963 and again this year on both sides of the aisle.

Now, a lot of you are wondering here. This is a lot of money. Over this period of years from 1963 and through the period we authorize here it will run upwards of $800 million to $1 billion before we get through with this program, if we do not do any more to it. Can we expect that we are going to have a greater number of doctors per 1,000? I wish I could assure you that it is true, but the best estimate we can get, even with the increase we are expecting to get, even from the results of H.R. 12 in 1963 and H.R. 3141 in 1965, the best we can hope to do is stay approximately even on this score. That means approximately the same number of doctors per 1,000 population in this country that we have at the present time is what we will have by 1972. I believe for this reason this program was urgently needed in 1963 and I supported it then. For the same reason I am supporting it in 1965.

Mr. JONES of Missouri. Madam Chairman, will the gentleman yield for a question?

Mr. SPRINGER. I yield to the distinguished gentleman from Missouri.

Mr. JONES of Missouri. Do you think you are going to get any more students under a grant program than under a scholarship program or, to put it another way, would not a loan program do the job if you could not get enough students to fill all of the facilities you are going to have for training these people?

Mr. SPRINGER. That was a point we went into in some detail. There was some conflicting testimony on this. May I say that taking into consideration all of these factors, there will probably be enough applicants to fill all the positions regardless of whether or not we did this at all, but we were made very aware of the fact that there were a great many highly qualified students without funds who want to become doctors.

As to the second point, as to grants, I believe in the Education Act that they called them outright grants. In this bill we call them scholarships. I suppose we could have used the word "grant" but we did not.

Mr. JONES of Missouri. What is the difference?

Mr. SPRINGER. There is no difference. The effect of the scholarship and the grant are identical. On the loans we did feel there were many-and the American Medical Association testified to this 2 years ago there were many students in schools who ought to be giving more time to it rather than working at some other job. In other words, they ought to be working at this. It was the feeling that many of those students did not want to get a scholarship, but it was necessary to get a loan and they were perfectly willing to qualify for a loan and to pay it back.

Mr. JONES of Missouri. Was any consideration given to any obligation on the part of a graduate going into these rural areas, as was stated, where the need was great?

Mr. SPRINGER. May I say that we did. The gentleman from Mississippi [Mr. WILLIAMS]-and I wish he were here to discuss it with you-and I did a lot

is the reason why we did not do it. We did not think it would be workable.

I come from a rural area where there is a shortage of doctors and I wanted to come up with some kind of a plan, but we just could not get a workable plan. Mr. HARRIS. Madam Chairman, will the gentleman yield?

Mr. SPRINGER. I yield to my distinguished chairman.

Mr. HARRIS. On the point just mentioned, it will be remembered also that a bill was reported from the committee to provide this incentive that we discussed on the floor of the House, and because of the opposition to it the House did not approve the bill. It was defeated by a very small vote.

Mr. SPRINGER. That escaped my attention, but since the chairman has recalled it, I know that he is stating the fact.

Mr. JONES of Missouri. Mr. Chairman, has any consideration been given to the anticipated income of doctors as compared with graduates from other schools, other professions? The pay of a doctor, when he gets out into practice, is greater than the average, and would he not be in a better position to repay a loan than would many other people?

Mr. SPRINGER. I think the gentleman probably has a point there. This was a matter of discretion. We did feel that the number of years it takes to produce a doctor, a good one, was greater than to produce a graduate of another profession with a doctor's degree. I think that is true. Customarily, when a doctor graduates and goes through his internship and into specialization, it is a matter of 10 to 12 years. Another man may get a doctor's degree in 7 years.

Mr. JONES of Missouri. It has been my observation that the average doctor, after he gets out of school, in a very short time has an income of up to and more than $20,000 a year. Certainly he should feel some obligation to pay back the money he has borrowed. I, for one, am not going to vote to provide any grants when loans would accomplish the same objective.

Mr. SPRINGER. I recognize the value of what the gentleman has said. From the evidence before our committee we had the feeling, in the first place, that there were many students who were smart but simply had no funds and probably would never become doctors without this kind of assistance.

As to the loan situation, that is a little different. Generally the man has some money and he adds that loan in order to supplement his money. This is what Dr. Carter of our committee mentioned in the discussion of this bill. He

is an M.D. in the State of Kentucky. He, himself, had no scholarship, but he did have some money and did get some loans and he did repay them. The scholarship was for an entirely different purpose, to help those who had absolutely no money. There the only solution was this.

Mr. HALL. Madam Chairman, will the gentleman yield?

Mr. SPRINGER. Iyield to the gentleman from Missouri.

Mr. HALL. I appreciate the gentleman's yielding. I simply seek a point of clarification and perhaps a reference. I have read the hearings and the report and I am concerned about the gentleman's statement, who is in the well of the House, because I know he takes full seriously the public care of people in a quality fashion in the United States. I have reference to medical schools that are on the verge of collapse. I do not find any reference to that either in the hearings or in the report. Quite to the contrary, my information is that for the first time in many years we have no substandard medical schools that are expanding.

The number, as the gentleman points out, is growing. We are turning out more and more doctors. I just wonder if the gentleman can cite the record.

Mr. SPRINGER. I cannot give the gentleman the exact figures.

Mr. HALL. I do not know that I should want the gentleman to do that.

Mr. SPRINGER. I can tell you this in numbers; there are 10 medical schools in number, and 3 dental schools are on the provisional accreditation list.

Mr. HALL. This is accreditation by which body, if the gentleman knows?

Mr. SPRINGER. I will have to yield to my chairman on that, but I assume it was the American Medical Association.

Mr. HARRIS. Madam Chairman, if the gentleman will yield there is a reference to this at page 16 of the report. It is stated there as follows:

Testimony presented to the committee indicates that a small number of medical schools are so weak and poorly financed that it is doubtful that they can continue to provide acceptable education without more institutional support.

Mr. HALL. Madam Chairman, if the gentleman will yield further, would the distinguished chairman, without mentioning the names of the institutions, tell me the source of that testimony? That is all I am seeking.

Mr. HARRIS. It came from the Association of American Medical Schools itself and it is included in the report.

Also, it is included in the hearings and I shall be glad to look it up and refer the gentleman to it.

Mr. HALL. As I say, I have looked through the hearings and I am familiar with the situation and the competition, if I may use that word, between the Association of Medical Schools, the Association of Deans of Medical Colleges, the Hospital Association and the Council on Education of the American Medical Association which does actually accredit these schools.

I am of the opinion that perhaps in the spirit of the chase or for emphasis, we can well believe that perhaps none of our