Light on the Hill, Volume II
Miller, Russell
1986
THE MEDICAL SCHOOL. The Tufts School of Medicine was very much a going concern when Nils Wessell became president of the institution in 1953. In its sixty years as a part of Tufts it had achieved a reputation in New England for training general practitioners (family doctors) rather than teachers or investigators, unlike the other two medical schools in Boston, Harvard and Boston University. Because of the limits imposed by physical facilities, the total student body of the Tufts medical school remained relatively stable, averaging 445 for the years from 1952 to 1957. When Joseph M. Hayman replaced Dwight O'Hara as dean in 1953 he immediately found all available space fully utilized in the cluster of buildings on Harrison Avenue comprising the New England Medical Center (NEMC) in downtown Boston. There was no room either to establish a new department or to expand existing departments "unless something was moved out." | |
Much-needed housing for medical and dental students and interns was provided as a result of the benefactions of Hannah and Harry Posner of Medford. In 1951 they pledged $1 million toward construction of a dormitory to be named in their honor. It was the second largest gift which the institution had ever received, the largest having been the Austin B. Fletcher bequest in 1923. The Tufts trustees, in planning for such a building in 1950, had originally intended to finance the structure with a government loan but that was now no longer necessary. Before actual receipt of the Posner gift, Tufts borrowed $1 million to start construction. The building was to be located on land purchased by the university adjacent to the medical and dental schools. | |
There was considerable delay in acquiring the site from its private owners and the new dormitory was not occupied until 1954. Construction costs had risen in the meantime, so that the Posners increased their gift by $86,000 in 1953. Room rental had to be set so high that Posner Hall was not fully occupied at first, and operated | |
335 | for a short time at an annual loss of about $15,000. A women's dormitory, Hemenway House on Nashua Street in Boston, was purchased by the university in 1953. Piece by piece other property was added to the medical-dental complex by purchase, lease, or new construction. Several floors of the eight-story loft-type Arnold Building adjacent to the school were leased in 1959 and converted for multi-purpose use. All but $70,000 of the $1.3 million needed to remodel the building came from outside sources. The A. Warren Stearns Medical Research Laboratories building, named in honor of a previous dean of the medical school, was constructed in 1962 at an estimated cost of $2.3 million. The adjacent Arnold Building was purchased outright in 1967, and the South Cove, Traders, and Cyker Buildings had also been made available by then, after the medical school complained of an "incredible shortage" of space. Acting President Leonard Mead had reported in 1966 that "teaching, research, study and administration are performed in nooks, crannies, attics, and hallways." Because of continued emphasis on quality rather than quantity, and a highly selective admissions policy, the attrition rate was exceptionally low. Of the 112 entering students in 1949, 98 earned their degrees in 1953. The medical school was also very proud of the fact that the number of failures on the two-part National Medical Board examination was much below the general average. In 1956 only 3 percent of Tufts medical school students failed Part I, as compared |
336 | to a national figure of 10 percent, and for several consecutive years there were no failures of fourth-year students on Part II of the examination. |
The long-standing "New England Policy" of giving preference to applicants from the Northeastern states was continued, although there was growing pressure to liberalize it. All but 14 of the entering class of 118 in 1953 were from that area. In the following year, the largest number of first-year students (22 out of 112) were from the Tufts undergraduate student body. As a consequence of following this policy, there were more practicing medical school graduates from Tufts than elsewhere in four of the six New England states in 1958. The New England Policy was encouraged by the announcement that same year that each cooperating state (including Massachusetts) would pay, through the New England Board of Higher Education, a special annual subsidy of $2,500 for every student enrolled in excess of those in attendance in October 1956. Hence, Tufts was, according to Dean Hayman, forced for financial reasons to accept inferior students. Largely through the dean's efforts to "nationalize" the medical school student body and to modify the New England Policy, the number of completed applications exceeded 1,000 in 1958, out of which a first-year class of 175 was selected, 115 of whom attended. However, students from New England continued to comprise the majority of the medical school population in spite of the fact that the Tufts-Carnegie Self-Study in 1958 considered such a policy "parochial." President Wessell felt strongly that the only defensible admissions policy was "to accept the best qualified candidates regardless of geographic origins." The matter of finances was an ever-present major problem of the medical school in 1953, as it had been for many decades. There obviously had to be great dependence on private foundation grants for financial sustenance. Such was a gift of $2 million from the Ford Foundation in 1957, much of it earmarked for faculty salaries. The major continuing source of funds for the salaries of medical school faculty was the Medical Center, supplemented by teaching and research grants from the United States Public Health Service. Support activities such as plant maintenance, budgetary, and accounting, were all coordinated through the office of the Vice-President for Administration and Finance in Medford - a source of much friction especially in the 1960s, according to President Hallowell. The professional schools wished to be as autonomous as possible. This was particularly noticeable in the medical school. In general, they had only a minimal connection with the rest of the institution. In order to provide for as much contact as possible between the Medford and | |
337 | Boston campuses, President Wessell arranged for an office in the medical-dental schools and spent an average of three days a week there. He went over every faculty and staff appointment with the dean each year, reviewed budgets, and presided at almost all faculty meetings on the Boston campus. More than 80 percent of an operating budget in excess of $1.3 million in 1954 came from tuition and fees, while only 3 percent of income from Tufts endowment was assigned to the medical school. A minimum endowment for the medical school alone of $9,750,000 was recommended by the Tufts-Carnegie Self-Study in 1958. A perpetual source of difficulty arose from the fact that fund raising for the medical school was conducted through the Development Office on the Medford campus, on behalf of the entire university, rather than by the professional school itself. Dean Hayman, like his predecessor, pointed out that the majority of medical school alumni were not graduates of Tufts and had little or no allegiance to it. He argued that solicitation of funds should be directly in the hands of the medical school rather than in the name of Tufts at large. In fact, he argued that funds for the medical school should be carried in a separate account. |
The medical school, which had not been evaluated since 1943 by the Association of American Medical Colleges and the Council on Medical Education and Hospitals of the American Medical Association, was the subject of review in 1954. The report in general was "helpful and complimentary" and "full approval" was recommended although certain curricular weak spots were detected, and salaries in the preclinical departments were considered too low. School officials were surprised to be informed that their school had been on "confidential probation" in the entire period from 1934 to 1954. The school was fully accredited after an inspection in 1962-63. No difficulties were reported except "a lot of useless paper work." Dean Hayman and other medical school officers were committed both to improving and to expanding services, and in the fall of 1957 the trustee Executive Committee authorized the establishment of a Department of Preventive Medicine. The home care program of the Boston Dispensary and offerings in the public health field were also expanded. Fourth-year students were thus enabled to gain practical experience in the care of ambulatory patients both at home and in the office. Count D. Gibson assumed the professorship of Preventive Medicine in 1958 and became a leading figure in two federally funded community health programs under the auspices of the medical school - Columbia Point in Boston and Mound Bayou in Mississippi. | |
338 | A new Department of Microbiology was established in 1962 as well as a PhD program in surgery, and the Department of Anatomy was reorganized in 1963-64 with Lauro F. Cavazos as chairman. New master's and PhD programs in the department were approved in 1964, and by 1966 there were academic doctoral programs in five departments, with a total of thirty-two students. A curricular innovation that year was the introduction of an interdisciplinary PhD program in the Molecular Basis of Biological Phenomena in cooperation with the Department of Biology on the Medford campus. This evidence of interaction between the two geographically separated campuses of the university was the exception to the rule. Although sixty medical and dental faculty representing departments which awarded advanced academic degrees were technically members of the Graduate School of Arts and Sciences faculty, they seldom attended meetings unless their departments happened to be on the agenda. |
There were changes in both the administration of the medical school and the sources of the student body in 1966. William F. Maloney replaced Hayman as dean, and the proportion of students from Massachusetts dropped dramatically from 65 to 40 percent. Of the 120 new students enrolled in 1969, only 44 were from New England. It was apparently no longer to be a local or regional school. One trustee responded to this turn of events by recommending that the admissions policy be reversed "to produce a preponderance of New England students." His argument was that the school would obtain much greater financial support from alumni if they were "locals" rather than recruited from all over the nation. | |
Many medical faculty and administrators on the Boston campus had been much agitated in 1951-52 when a proposal was made that a state medical school be established to meet the growing needs of the profession which private facilities seemed unable or unwilling to meet. Dean O'Hara and others at Tufts were relieved when the proposal was defeated by the state legislature in the summer of 1952. The idea was revived early in 1961, and there was talk of using the Lemuel Shattuck hospital in Boston as a nucleus. Nothing came of that effort, but a state school was finally authorized and a site in Worcester was selected in 1965. There was so much delay in constructing the school that Tufts was accused in 1968 of not only opposing but of attempting to block it. Hallowell did not oppose the establishment of the school, and the Tufts dean vigorously denied the allegations. He announced in the press that he favored any plan which would increase the supply of physicians in the state. There was indeed a temporary overall downward trend in medical school | |
339 | applications from all New England states except Maine in the 1960s, but it had no serious adverse effect on medical school admissions. Indeed, there were more than 1,250 applicants for the entering class of 114 in 1964. The contributing factor to the decline was probably the opening of new medical schools at both the University of Connecticut and Brown University during the decade. With the change in the deanship in 1966 a long-range study of the future of health sciences at Tufts was authorized. Among the recommendations was a broadening of participation in the training effort to include social scientists as well as specialists in biology. The major proposal arising from the study was a ten-year improvement and expansion program which called for an expenditure of some $72.5 million to reconstruct the entire Medical Center. A revised policy on academic freedom, tenure, and retirement adopted by the trustees in 1964 was extended in 1966 to full-time members of the Department of Preventive Medicine on the same conditions as applied to the basic science departments. The Tufts School of Medicine in the 196os was in the forefront in providing educational opportunities for minority and so-called disadvantaged students. It was the only medical school in the entire nation to admit as many as five such students in any one year; in 1972, minorities constituted 17 percent of the entering class, and before the end of the decade they exceeded 18 percent. Career possibilities for such individuals were encouraged by joint facultystudent efforts which extended to recruiting, admissions, and tutoring. A Board of Visitors was authorized in 1965 to serve in connection with the federal Office of Economic Opportunity grant to the Department of Preventive Medicine for community health care for indigent individuals. There was also the intensification of the trend toward interdisciplinary academic programs that would build bridges between the Boston and Medford campuses. Such was the introduction of an MS degree of Life Science Engineering (bioengineering) in 1970 and an interdisciplinary PhD in Immunology adopted the following year. |
The medical school continued to attract increasing numbers of applicants in the 1970s. There was only one admission for every thirty-four applicants in 1971. The limits of physical (including laboratory) space were the governing considerations in holding entering classes under 140. However, the school was forced to exceed that number (to 146) in 1974, partly to meet pressure from the federal government to train more physicians. The 1974 entering class, the largest in the school's history up to that time, was selected from 4,181 applicants. | |
340 | When the medical school was granted full accreditation in 1972 after a visit the previous year, the survey team pointed out that, although the Tufts school was among the top 25 percent of such schools in size, it was among the lowest 10 percent in total expenditures and facilities. The team found it difficult to understand how the school could manage to do so much with so very little. A three-phase renovation program was begun in 1972 to increase classroom and laboratory space at a cost of almost $2.5 million, but plans to build a much-needed new library and classroom building had to be shelved because there was no money for such an ambitious undertaking. One of the largest grants to the medical school was made in 1971 by the National Cancer Institute. Extending over three years, it made possible the establishment of the Tufts Cancer Research Center which finally opened in the fall of 1975. In spite of continued subvention from the federal government (67 percent of the operating budget in 1972), including student financial aid by way of the Health Professions Educational Assistance Act of 1971, tuition had to be raised to $2,950 for 1972-73, which even then constituted less than 20 percent of income. It was estimated that the average indebtedness of a graduating student was $10,000. A strong effort was made to solicit alumni support by way of Millenium ("M") Clubs in both the medical and dental schools. The members pledged to make unrestricted gifts over a period of years, and by 1975 there were 186 Sustaining Members among medical alumni who contributed $1,000 each, and more than twenty Life Members who pledged $10,000 each over a twenty-year period. The medical school ranked first in the nation in 1975 in the percentage of contributing alumni, in the proportion of the school's budget contributed by alumni, and second in the total number of dollars given. |
Anticipated cutbacks in federal funds of almost $3 million in the early 1970s necessitated consideration of several alternatives. Among them were reduction of the four-year program to three, year-round operation, reduction of the 300 salaried faculty, a sharp rise in tuition, and major curricular revision. There was a total of 1,500 medical faculty, but of that number, 1,200 served part-time and with little or no compensation. However, the situation was not as bad as projected, and no drastic actions were required. | |
Lauro F. Cavazos, associate dean of the medical school, was appointed acting dean in 1973 to enable Dean Maloney to take a sabbatical leave. After the latter's return he occupied the newly created position of Health Planning Administrator, as of July 1974, and | |
341 | Cavazos served again as acting dean in 1974-75 before being appointed dean in 1975. When Cavazos assumed the deanship the medical school was in the midst of a period of great activity. Awards totalling $8.4 million were being devoted to research, and training and demonstration projects. There were 7,948 applications for the 146 places in the entering class in 1976. The primarily New England complexion of the student body had been restored, with 60 percent from that region and Massachusetts the leading state in enrollments; Tufts was the major source of entering students. The largest number of women in the history of the school (41) were graduated in 1975, and 40 percent of the total (152) received their first choice in the highly competitive field of internships. It was to a member of the medical school faculty that the first endowed university professorship in Tufts' history was awarded in 1975-76. William B. Schwartz, chairman of the Department of Medicine, became the first holder of the Vannevar Bush University Professorship. In reviewing the state of the medical school at the end of his second year as dean, Cavazos expressed satisfaction that "the positive aspects of the School of Medicine far outweigh the negative aspects." |
