Mr. Bayard to Mr. Gresham.

No. 208.]

Sir: Referring to your Instruction No. 241, of the 19th of December, last, I have now the honor to inclose herewith a report drawn up by Mr. James R. Roosevelt, secretary of this embassy, on the subject of the enrollment of the United States on the list of countries recognized under the British medical act of 1866.

If this report should meet your approval, and be printed, it is believed [Page 281]that it will furnish a compendious and convenient reply to the many inquiries made at the Department as well as at this embassy.

If printed I should like to have a number of copies supplied for use here.

I have, etc.

T. F. Bayard.
[Inclosure in No. 208.]

Mr. Roosevelt to Mr. Bayard.

Sir: I have the honor, in accordance with your instructions, to submit to you the following report as to the possible enrollment of the United States on the list of countries recognized under the British medical act of 1886, for the purpose of allowing American graduates in medicine to be registered in Great Britain.

I have the honor to advise you that, as the result of several interviews held with Sir Charles Lennox Peel, clerk of Her Majesty’s privy council, and with Mr. Miller, secretary of the general medical council of Great Britain, the following facts have been ascertained:

The graduates of American medical colleges can, at present, practice without let or hindrance in the United Kingdom. They can not, however, sue for their fees in court, sign burial or death certificates, or hold local medical offices unless enrolled on the registry list of the medical council of Great Britain. As this privilege of enrollment has heretofore been denied to medical graduates of the United States and other foreign countries, they are, in consequence, when practising in England not in full standing, either with their brother practitioners or the public authorities.

It is stated, however, by the secretary of the general medical council that there never has been, on the part of the council, any objection whatever to the enrollment on its registry of the graduates of certain colleges of high scientific standing in the United States, should Her Majesty’s privy council see fit to grant the application of the U. S. Government to be recognized as a “foreign country,” to which the British medical act of 1886 be made to apply.

Section 17, part 2, of this act (49 and 50 Vict., June 26, 1886), copy of which I have the honor to inclose herewith, provides that—

Her Majesty may from time to time, by order in council, declare that this part of the act shall be deemed, on and after a day to be named in such order, to apply to any British possession or foreign country, which, in the opinion of Her Majesty affords to the registered medical practitioners of the United Kingdom such privileges of practicing in the said British possession or foreign country, as to Her Majesty may seem just.

To secure, therefore, the recognition of American practitioners and the placing of their names upon the registry, the following action on the on the part of the British authorities would be necessary:

1.
An order in council for the application of the medical act of 1886 to the United States, made at the request of the U. S. Government, through the ministry of foreign affairs, such request to be accompanied by satisfactory evidence, showing that the United States affords similar reciprocal privileges to the registered medical practitioners of the United Kingdom.
2.
Upon application of the act to the United States being so ordered in council, the recognition by the general medical council of certain American colleges of high scientific repute, whose graduates may thereupon, on proper application, be duly placed upon the medical registry and be admitted to practice. (See sec. 13 (1), 49 and 50 Vict., 1886, part 2.)

The power thus invested in the general medical council is subject to an appeal to Her Majesty’s privy council. (See sec. 13 (2), 49 and 50 Vict., 1886, part 2.)

In the conversations held with Sir Charles Lennox Peel, clerk of Her Majesty’s privy council, it was disclosed that the principal objections heretofore made to the application of the act of 1886 to the United States have been that no evidence has been offered showing that the United States, as a nation, affords reciprocal privileges to the registered practitioners of Great Britain. The wording of the act is:

That this part of this act shall be deemed, on and after a day named in such order, to apply to any British possession or foreign country.

If the proof of the existence of such reciprocal privileges were offered as regards any one or more States of the Union only it is extremely doubtful, therefore, whether such State or States could separately obtain the benefit of the application of the act. And, on the other hand, under the want of uniformity of laws in the several States regulating the practice of medicine, it would doubtless be difficult for the Federal Government to offer satisfactory evidence of the existence of reciprocity throughout the Union.

In this diversity in the laws of the different States and the apparent impracticability of the Federal Government’s giving the necessary assurance of a uniform reciprocity throughout the Union lies the whole difficulty.

Sir Charles Lennox Peel, however, has very kindly stated that should an application be made by this embassy to the privy council, through the foreigh office, either for the application of the act to the United States as a nation (showing, if possible, reciprocity in all the States of the Union), or if this should not be practicable, then seeking to make the act applicable to one or more States where reciprocity exists, the question would be most carefully considered by the privy council and a decision given by their legal advisers as to whether the wording of the act permits such application.

The evidence to be presented as to the existence of reciprocity would consist of the State laws authorizing the recognition and admission to practice of the graduates of foreign medical colleges.

It might be advisable, therefore, to have the question definitely settled in this manner, and thus put an end to the many inquiries on the subject received from individual members of the medical profession both at this embassy and at the Department of State.

I may add that, should a favorable decision be given by Her Majesty’s privy council, it would be of little service to the class of medical practitioners represented by the Department’s correspondent, Dr. Joseph Tempest, of Bradford, England. As he is not apparently the graduate of any medical college of scientific standing and repute in the United States, it is highly probable that his claim to be placed upon the registry would be disallowed.

I have, etc.,

James R. Roosevelt.
[Page 283]

Medical Act, 1886

* * * * * * *

Part II.—Colonial and foreign practitioners.

11. On and after the prescribed day where a person shows to the satisfaction of the registrar of the general council that he holds some recognized colonial medical diploma or diplomas (as hereinafter defined) granted to him in a British possession to which this act applies, and that he is of good character, and that he is by law entitled to practise medicine, surgery, and midwifery in such British possession, he shall, on application to the said registrar, and on payment of such fee, not exceeding five pounds, as the general council may from time to time determine, be entitled, without examination in the United Kingdom, to be registered as a colonial practitioner in the medical register;

Provided that he proves to the satisfaction of the registrar any of the following circumstances:

(1)
That the said diploma or diplomas was or were granted to him at a time when he was not domiciled in the United Kingdom, or in the course of a period of not less than five years, during the whole of which he resided out of the United Kingdom; or
(2)
That he was practising medicine or surgery or a branch of medicine or surgery in the United Kingdom on the said prescribed day, and that he was continuously practised the same either in the United Kingdom or elsewhere for a period of not less than ten years immediately preceding the said prescribed day.

12. On and after the said prescribed day where a person shows to the satisfaction of the registrar of the general council that he holds some recognized foreign medical diploma or diplomas (as hereinafter defined) granted in a foreign country to which this act applies, and that he is of good character, and that he is by law entitled to practise medicine, surgery, and midwifery in such foreign country, he shall, on application to the said registrar, and on payment of such fee, not exceeding five pounds, as the general council may from time to time determine, be entitled, without examination in the United Kingdom, to be registered as a foreign practitioner in the medical register;

Provided that he proves to the satisfaction of the registrar any of the following circumstances:

(1)
That he is not a British subject; or
(2)
That, being a British subject, the said diploma or diplomas was or were granted to him at a time when he was not domiciled in the United Kingdom, or in the course of a period of not less than five years, during the whole of which he resided out of the United Kingdom; or
(3)
That, being a British subject, he was practising medicine or surgery, or a branch of medicine or surgery, in the said United Kingdom on the said prescribed day, and that he has continuously practised the same in the United Kingdom or elsewhere for a period of not less than ten years immediately preceding the said prescribed day.

13 (1) The medical diploma or diplomas granted in a British possession or foreign country to which this act applies, which is or are to be deemed such recognised colonial or foreign medical diploma or diplomas as is or are required for the purposes of this act, shall be such medical diploma or diplomas as may be recognised for the time being by the general council as furnishing a sufficient guarantee of the possession of the requisite knowledge and skill for the efficient practise of medicine, surgery, and midwifery.

(2) Where the general council have refused to recognise, as aforesaid, any colonial or foreign medical diploma, the privy council, on application being made to them, may, if they think fit, after considering such application, and after communication with the general council, order the general council to recognise the said diploma, and such order shall be duly obeyed.

(3) If a person is refused registration as a colonial or foreign practitioner on any other ground than that the medical diploma or diplomas held by such person is or are not such recognised medical diploma or diplomas as above defined, the registrar of the general council shall, if required, state in writing the reason for such refusal and the person so refused registration may appeal to the privy council, and the privy council, after communication with the general council may dismiss the appeal or may order the general council to enter the name of the appellant on the register.

(4) A person may, if so entitled under this act, be registered both as a colonial and a foreign practitioner.

14. The medical register shall contain a separate list of the names and addresses of the colonial practitioners, and also a separate list of the names and addresses of the foreign practitioners registered under this act; each list shall be made out alphabetically [Page 284]according to the surnames; and the provisions of the medical act, 1858, relating to persons registered under that act, and relating to the medical register and to offences in respect thereof, shall, so far as may be, apply in the case of colonial and foreign practitioners registered under this act and of the said lists of those practitioners, in the same way as such provisions apply in the case of persons registered under the said medical act, 1858, and of the register as kept under that act.

15. On and after the appointed day it shall be lawful for any registered medical practitioner who, being on the list of colonial or foreign practitioners, is on that day in possession of or thereafter obtains any recognised colonial or foreign medical diploma granted in a British possession or foreign country to which this act applies to cause a description of such diploma to be added to his name in the medical register.

16. On and after the appointed day it shall be lawful for any registered medical practitioner who, being on the medical register by virtue of English, Scotch, or Irish qualifications, is in possession of a foreign degree in medicine, to cause a description of such foreign medical degree to be added to his name as an additional title in the medical register, provided he shall satisfy the general council that he obtained such degree after proper examination and prior to the passing of this act.

17.(1) Her Majesty may from time to time by order in council declare that this part of this act shall be deemed on and after a day to be named in such order to apply to any British possession or foreign country which in the opinion of Her Majesty affords to the registered medical practitioners of the United Kingdom such privileges of practising in the said British possession or foreign country as to Her Majesty may seem just; and from and after the day named in such order in council such British possession or foreign country shall be deemed to be a British possession or foreign country to which this act applies within the meaning of this part thereof; but until such order in council has been made in respect of any British possession or foreign country, this part of this act shall not be deemed to apply to any such possession or country; and the expression “the prescribed day” as used in this part of this act means, as respects any British possession or foreign country, the day on and after which this part of this act is declared by order in council to apply to such British possession or foreign country.

(2) Her Majesty may from time to time by order in council revoke and renew any order made in pursuance of this section; and on the revocation of such order as respects any British possession or foreign country, such possession or foreign country shall cease to be a possession or country to which this part of this act applies, without prejudice nevertheless to the right of any persons whose names have been already entered on the register.

(18) Nothing in the medical act, 1858, shall prevent a person holding a medical diploma entitling him to practise medicine or surgery in a British possession to which this act applies, from holding an appointment as a medical officer in any vessel registered in that possession.