Mr. Straus to Mr.
Bayard.
Legation of
the United States,
Constantinople, January 10, 1889.
(Received January 28.)
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.,
[Inclosure 1 in No. 156.]
Mr. Straus to the
Sublime Porte.
Legation of the United States,
Constantinople, October 18,
1888.
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.
Ministry of Foreign Affairs,
Constantinople, December 25,
1888.
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.
Ministry of the Interior, Administration of Civil Medical
Affairs
Constantinople, November 23,
1888.
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:
