Adoption of Standards of the Best Medical Schools of Western Europe by Those of the United States

ADOPTION OF STANDARDS OF THE BEST MEDICAL SCHOOLS OF WESTERN EUROPEBY THOSE OF THE UNITED STATES EUGENE L. OPIE* Science and education in this country in the early nineteenth century lost touch with modern science in Europe. Preoccupation with development ofour vast resources for a time partially paralyzed intellectual pursuits . The invention ofutilities based on new scientific knowledge was not neglected. Nevertheless, the need ofdoctors was as always keenly felt, but littletimeandeffortwere spared for their education. Inan earlier timeJohn Morgan, Benjamin Rush, William Shippen, who established the medical college ofthe University ofPennsylvania, and Samuel Bard, who promoted the establishment of the New York Hospital, had received their medical education at the University ofEdinburgh. Later, fewhere received European training, and medical education fell to a low level. Medical schools were called "proprietary" because they depended upon fees charged by self-appointed faculties. These schools multiplied enormously , and in the middle of the nineteenth century instruction was limited to two years of lectures, the same each year, and to six months per year so that the students might aid in the summer harvest. Better schools, especially those associated with universities and the better hospitals , introduced a graded course oftwo or more years. Dr. William Welch wrote: "One can decry the system of those days—the inadequate preliminary requirements, the short courses, the faulty arrangement ofcurriculum , the domination ofthe didactic lecture, the meager appliances for demonstrative and practical instruction—but the results were better than the system." Capable men were often apprentices oftheir teachers. There * Affiliate, The Rockefeller University, New York, New York 1002t. Publication cos» in part were kindly contributed to Perspectives by Merck 6c Co. and Washington University School of Medicine. 309 were good doctors in the "horseand buggy age" ofthis country, and some were eminent and trusted by the community in which they practiced. The condition of medical education during the nineteenth century is well illustrated by the medical schools established in Saint Louis. Their history follows. I WASHINGTON UNIVERSITY COLLEGE OF MEDICINE On Washington's birthday, February 22, 1853, the legislature ofMissouri granted a charter to an educational seminary which was named for the Rev. William G. Eliot, who planned to conduct it. No limitations were placed upon the educational activities ofthe seminary, but sectarian or partisan instruction was forbidden. After exactly one year, the corporation appointed by the charter changed the name to Washington Institute, as requested by Dr. Eliot. Three years later by change ofthe charter the institute became Washington University. The first college degrees were granted in 1862 and a law school, a school ofarchitecture and engineering, a school of fine arts, and a school of botany were in time added to the university. Then came the medical school and after it a dental college. AMALGAMATED MEDICAL SCHOOLS Two medical schools amalgamated to form the Medical Department of Washington University. Subsequent events were in part determined by the two former faculties who were influential members ofthe community in which they practiced. Many ofthe men who guided such schools strove earnestly to improve the standards and facilities oftheir schools and were not responsible for the low level ofprofessional medical education. The medical school later known as the Saint Louis Medical College began in 1842 with a faculty of five men as the medical department of Saint Louis University. At this time Saint Louis had a population of scarcely 20,000 scattered along the bank ofthe Mississippi. The number of faculty and students increased rapidly, and seven years later they occupied a conspicuous new building containing large lecture rooms, a well-stocked museum, ample anatomical rooms, and a small laboratory for the professor ofchemistry. It separated from Saint Louis University in 1855. A historian ofthe school wrote: "The personality ofthe teacher was of greater importance than the content of his teaching. . . . Instruction was concentrated in the lecture and force ofthe teaching lay in the impressive310 Eugene L. Opie · Washington University Perspectives in Biology and Medicine · Spring 1970 ness ofthe lectures." Two eminent surgeons, Charles Alexander Pope and JohnThompsonHodgen, were associated with the school. Itconferred the medical degree upon students who had twice attended the same lectures, given during six months ofeach year. A voluntary graded course ofthree years...