Mr. Straus to Mr. Bayard.

No. 156.]

Sir: Referring to your instruction No. 131, of September 12, 1888, I have the honor to transmit a copy of a note verbale addressed to the Sublime Porte by Mr. Kin when chargé, under date of October 18, requesting that the Imperial Medical College be directed duly to recognize the diplomas of physicians graduated at the Bellevue Hospital Medical College in the city of New York.

The occasion of this note was a refusal on the part of the Imperial Medical College to license a graduate of the Bellevue Hospital Medical College, who is a Turkish subject, without first submitting to a thorough examination as to his fitness and learning, which he declined to do.

The Porte has sent a reply, accompanied by a report of the council of the administration of civil medicine, a translated copy of which I inclose for the information of the Department.

The sense and substance of such report in brief is the following:

When the applicant to practice his profession in this Empire produces a diploma of a State institution, where the State guaranties, as it were, by a staats examen, as in Germany, the sufficiency of the studies pursued and the examination, then such applicant, upon making proof of the fact that the diploma has been conferred upon him and submitting to a mere formal colloquium or medical conversation, is granted a certificate permitting him to practice his profession in this Empire.

On the other hand, if the applicant produces a diploma that is not of the grade above specified, that is to say, if the diploma is not from a State or Government institution, as above specified, then the applicant, in order to have the right to practice his profession in the Empire, must undergo a thorough examination, as is prescribed, to entitle him to a diploma from the medical college here.

This subject it seems presented itself in 1878, when the Porte first attempted to enforce with some degree of system the general law regulating the practice of medicine (see Legislation Ottomane, Vol. III, page 105.)

The matter was referred by the consul-general to the Department, and in its instruction to the consul-general No. 50, of 29th April, 1878, it incloses a report from the Commissioner of Education, which says:

The United States Government formally recognizes the diplomas of no medical school of this country or any other as affording any evidence of medical capacity, but surgeons of the United States Army and Navy, Marine Hospital Service, etc., are subject to a rigid examination before appointment.

In the light of your instructions first above referred to I assume you have no further instructions to give in this matter.

I have, etc.,

O. S. Straus.
[Inclosure 1 in No. 156.]

Mr. Straus to the Sublime Porte.

The legation of the United States learns that the Imperial Medical College refuses to recognize the diplomas of physicians issued by the Bellevue Hospital Medical College of New York, and therefore requests the ministry of foreign affairs to inform the Imperial Medical College that the above-mentioned American college is one of excellent standing, and its diplomas should receive due recognition.

[Page 708]
[Inclosure 2 in No. 156.—Translation.]

The Sublime Porte to Mr. Straus.

In reply to the note verbale the legation of the United States kindly addressed on the 18th October last, the ministry of foreign affairs has the honor to transmit herewith copy of a report of the administrative council of civil medical affairs concerning the diplomas of physicians granted by the college of the Bellevue Hospital at New York.

[Inclosure 3 in No. 156.—Translation.]

Report of the administrative council of civil medical affairs.

The council has taken cognizance of the note verbale addressed to the imperial ministry of foreign affairs by the legation of the United States of America, and in which this legation requests that the administration of medical affairs duly recoguize the diplomas of physicians granted by a medical college of New. York called “College of the Bellevue Hospital.” In this connection the council has the honor to remind the ministry that accordiug to the Ottoman law any person who calls himself a physician or apothecary and who claims to have studied in a faculty of medicine or in a school of pharmacy abroad, and demands to practice medicine or pharmacy in Turkey must—

  • 1st. Prove his studies and his medical or pharmaceutical knowledge by showing a diploma.
  • 2d. He must pass an examination giving proof that the diploma he exhibits belongs to him. This prescription of the law is formal and does not admit of any exception.

The examinations to which are subjected physicians and apothecaries who have prosecuted their studies in Europe, are of two kinds, according to the category to which the certificate of studies belongs.

If the certificate of studies is a diploma of doctor of medicine and surgery, or of master in pharmacy emanating from a faculty or a university placed under the immediate and effective supervision of the government of the country in which this faculty or university is located, and of which the government guaranties the examination to which the candidate is submitted, then a mere colloquium or medical conversation is required. If, on the contrary, the school which has granted the certificate of studies or the diploma is a school which the government of the country where it is located does not guaranty, or if it is not a university or afaculty but a secondary school, then the examination the candidate is submitted to, is not a colloquium, but a rigorous examination for a doctorate; and if he passes satisfactorily he receives, not a permit to practice, but a doctor’s diploma or an apothecary’s diploma. By this method control of the title on capacity of physicians and apothecaries is effected over such who have prosecuted their studies abroad and who seek to practice their profession in Turkey. Let us come now to the special case. The honorable legation of the United States of America declares that the medical college of the Bellevue Hospital of New York is enjoying a good reputation and therefore the Ottoman mediical administration should accept the diploma of that college.

The medical adminstration has no desire to contest the rank the Bellevue Hospital College enjoys in America, and it does not refuse to accept the certificates of medical studies granted by that college. But that college is not under the control of the Government of the United States, and is not held responsible therefore except for its existence; its reputation it does not guaranty in any other way. Consequently the diplomas granted by that institution and by a number of other institutions not under the guaranty of the Government in the United States of America, can not be placed exactly on the same footing as the diplomas granted by the universities and faculties conducted under and guarantied by the governments of the different countries. Thus the medical administrations formerly classified with the latter, and this also as a special concession, only such diplomas as were granted by institutions of North America bearing the title of university. However, as it now appears from the information received, corroborated by the declaration of the legation of the United States, that the Government of that Republic does not come forward as a guarantor for any of the medical schools to be found on its territory, whether they are universities or colleges, that the United States Government never receives in its service physicians coming from those schools, whatever the title may be, [Page 709] unless they are submitted to a rigorous examination of admission, and lastly, from the report of the minister of the Sublime Porte at Washington, which has been communicated to us by the imperial ministry of foreign affairs on the 22d of October, 1304, under No. 319, from which it appears that the requirements and regulations regarding the granting of diplomas of physicians in North America are so various, that it differs so much in the several States, that the ministry of foreign affairs of the United States has been unable to furnish him exact and sufficient information on the question, and in order to get the various regulations of the different States forming the Federative Union of North America it needs a long time. Hence, as we said, by reason of this formal declaration and of this official information, the administration of the medical affairs of Turkey finds itself under the necessity not to make an exception any longer, not even as to the diplomas of the American universities, but to accept as certificates of studies in medicine all the diplomas from the American schools, be they universities or colleges, on a footing of a perfect equality, and it assimilates them with the diplomas of the European schools which are not controlled or guarantied by the governments, by subjecting the persons who have studied in such schools to the rigorous examination of doctorship; examinations such as those to which the United States Government itself subjects its own physicians.

We do riot think that the United States legation will have any objections to make against a measure in force in its own country. If the honorable legation replies to this that the United States Government subjects to such an examination only the physicians and apothecaries it takes in its service, we will answer that our Government makes no distinction between the physicians serving the population and those; serving the State, and that any physician in possession of a permit to practice freely his profession among the population can enter the medical or pharmaceutical service of the State, without his being submitted to any new test.

In Turkey, as in nearly all the countries of Europe, the practice of medicine is not a free profession like that of a merchant or an artisan; it is subjected to the immediate supervision of the authorities and under specific regulations provided by the law of every country.

The Ottoman government can not place the lives of its people in the hands of the first comer without ascertaining the real capacities of those who claim to attend the sick. Finally, or rather summing up our answer:

The Ottoman medical administration has provided two classes of proofs for physicians who, having studied in a foreign medical school, wish to practice in Turkey; that is to say, a proof by colloquium for physicians showing a diploma from a university or faculty controlled and guarantied by the government of the country within which these institutions are located, and the proof by the doctorship’s examination for those who how a diploma from a secondary school of medicine, or from a university, faculty, or a school not guarantied by the government of their respective countries; the diplomas of the universities, schools, and colleges of the United States of North America, will all be accepted upon a footing of equality; but as none of these schools are supervised or guarantied by the Government of the Union, the persons who present these diplomas shall be subjected to the same examinations as those who have studied in the schools of other countries which are not guarantied by the governments, viz: they shall be subjected to the rigorous examinations for the doctorship.

For the Council.

The Secretary-General: