The report rejected a scheme for joint examination by the existing bodies, assisted by outside examiners appointed by a central authority, on the ground of difficulty and expense, as well as one for a separate State examination.  It also provided for compensation from the fees to be paid by the candidates to existing bodies whose revenues might suffer from the new scheme.

To this majority report, six of the eleven Commissioners appended separate reports, suggesting other methods for carrying out the desired end.  Among the latter was Huxley, who gave his reasons for dissenting from the principle assumed by his colleagues, though he had signed the main report as embodying the best means of carrying out a reform, that principle being granted.]

“The State examination” [he thought,] “was ideally best, but for many reasons impossible.” [But the] “conjoint scheme” [recommended in the report appeared to punish the efficient medical authorities for the abuses of the inefficient.  Moreover, if the examiners of the Divisional Board did not affiliate themselves to any medical authority, the compensation to be provided would be very heavy; if they did,] “either they will affiliate without further examination, which will give them the pretence of a further qualification, without any corresponding reality, or they will affiliate in examination, in which case the new examination deprecated by the general voice of the profession will be added, and any real difference between the plan proposed and the ‘State examination’ scheme will vanish.”

[The compensation proposed too, would chiefly fall to the discredited bodies, who had neglected their duties.]

The scheme [he writes in his report], which I ventured to suggest is of extreme simplicity; and while I cannot but think that it would prove thoroughly efficient, it interferes with no fair vested interest in such a manner as to give a claim for compensation, and it inflicts no burden either in the way of taxation or extra examination on the medical profession.

This proposal is, that if any examining body satisfies the Medical Council (or other State authority), that it requires full and efficient instruction and examination in the three branches of medicine, surgery, and midwifery; and if it admits a certain number of coadjutor examiners appointed by the State authority, the certificate of that authority shall give admission to the Medical Register.

I submit that while the adopting this proposal would secure a practically uniform minimum standard of examination, it would leave free play to the individuality of the various existing or future universities and medical corporations; that the revenues of such bodies derived from medical examinations would thenceforth increase or diminish in the ratio of their deserts; that a really efficient inspection of the examinations would be secured, and that no one could come upon the register without a complete qualification.