(a) If we turn again to our three sub-divisions we find that a specialist or consultant cannot expect to earn her working expenses for a good many years.  She must have one room at least in a certain specialist quarter of the town, known as the consultants’ area, and there the rents are usually high, in London about L150 a year, in the provinces slightly less.

We have already stated that she requires some hospital post; for this she will receive no remuneration, but if the hospital where she works has a medical school attached to it, she may expect to get a certain number of patients through the recommendation of students whom she teaches at the hospital.  There is generally also some teaching at the hospitals, for which the students pay definite fees.  She may also augment her income by lectures and work of that description.  She will probably find it necessary to write papers on her special branch of work and on the cases which come under her observation, but for this she will very seldom be paid.  It is, therefore only possible for a girl with some monetary resources independent of her work, to take up successfully a special branch of medicine.

If she elect to become a surgeon, a hospital post is an absolute necessity, and her income will, as in the case of the medical specialist, be delayed.  Eventually, however, if she is successful, it is greater than that to be obtained on the medical side.  The fees are high, and therefore money can be made more speedily in this branch of the work.  People, however, hesitate as a rule to trust a very young surgeon, so she will at first get her work chiefly as assistant to her seniors and must be content to wait some years for the much bigger fees which she will get as principal.  Ultimately she should make L1,000 to L2,000 a year.

(b) If she elect to become a general practitioner, her outlay at first is probably as great as that of the specialist, if not greater, but the return is quicker, and a great deal depends upon the choice of a neighbourhood.  If she chooses an upper middle class district she also, like the specialist, must be content to wait, and in fact she is ill-advised to choose such a neighbourhood unless she can rely on some good social introductions.

If she choose a district partly middle and partly lower middle class her return will be infinitely quicker.  She may expect to cover her expenses in the course of two or three years.  The work is, however, incessant and rather harassing.  If she select a working-class neighbourhood and have a dispensary, her return will be still quicker, such places frequently paying their expenses in the first or second year.  The people are nice to deal with, and the work is interesting, but it is apt to be very distressing for two reasons—­(1) that owing to the poverty of the patients they can so seldom be attended under conditions in which they have a fair chance of recovery, and (2) there is apt to be an appreciable amount of dirt.