Teaching Tomorrow's Medicine Today: The Mount Sinai School of Medicine, 1963-2003 (review)

Medical schools rarely stand alone. Thus this history of Mount Sinai School of Medicine (MSSM) in New York City turns out to be a multi-institutional history of universities, institutes, special centers and—above all—Mount Sinai Hospital, out of which MSSM emerged.

"The History of the School" (chap. 1) tells of determination, energy, and just plain hard work by a large number of far-sighted individuals, which resulted in a brand-new medical school—the aim eventually to create an entire medical center is made explicit (p. 7)—coming to life in a city hardly lacking opportunities for medical education. The rest of part 1 puts flesh on the skeleton, reviewing curriculum development (chap. 2) and—in a chapter written by Terry Ann Krulwich, "The Graduate School of Biological Sciences" (chap. 3)—discussing the actions that assured that undergraduate medical education would not be the school's sole mandate. Early plans to educate medical scientists as well as to train physicians show fruition in part 2, which comprises separate chapters or sections on various departments, centers, and institutes.

However impressive the emergence of MSSM is, what dramatically sets Mount Sinai apart from other medical schools is the way it grew out of a well-established hospital. This resembles the English pattern, where more than one medical school has been born under the sheltering wing of its parent hospital (see, e.g., E. A. Heaman, St Mary's: The History of a London Teaching Hospital [2003]). To be sure, in the course of explaining just how MSSM came into being, the authors acknowledge that the Association of American Medical Colleges was unenthusiastic, noting "that no hospital had founded a medical school on its own since the Flexner Report on medical education in 1910 and that this was not a precedent they wished to encourage" (pp. 6–7). Disappointingly, the authors do not spend much time exploring this matter or setting the establishment of MSSM in the context of American medical-school origins. The relative lack of that larger context notwithstanding, the detailed accounts of this particular school's growth bring it and its many successes alive.

While creating a new school is bound to be the result of many individuals' initiatives, the book's veritable catalog of names tends to have a blurring effect (see, e.g., pp. 46–49), especially on readers otherwise unfamiliar with Mount Sinai. The same is true where the shifts in names of departments and institutes (not least to recognize philanthropic contributions) are reported. Although such changes signal growth and openness to new realities, readers whose knowledge of MSSM is slender may become confused (see, e.g., pp. 162–64, 173, 222).

Part 2 presents a striking amount of eminent work in the sciences by numerous outstanding faculty members. Yet complicated projects briefly described are not easy for the nonspecialist to grasp, and the brevity of the descriptions could lead to charges that important work is being given short shrift. Furthermore, this approach means that the footnotes to the first five chapters of part 2 amount to little more than a bibliography of miscellaneous articles by MSSM faculty. Space devoted instead to elucidating such issues as those concerning the initial stimulus for the school (p. 17) might have resulted in a more important book.

This volume was clearly intended to celebrate people and their collective and individual accomplishments, rather than to evaluate where a particular institution fits in the overall picture of American medical education. To this end, the plethora of illustrations, repeated tributes to key figures, and four appendixes—more lists of names!—are assets. An unusual feature, comments by current and former students, concludes part 3 (chap. 12, "Student Voices: In Their Own Words"). Scott Friedman ('79) nicely sums up the book's rationale: "It seems to me like we are entering a new...