Light on the Hill, Volume II
THE DENTAL SCHOOL. The Tufts School of Dental Medicine in the 1950s entered its second half-century as a part of the university with a record of substantial accomplishment locally and a favorable reputation in dental circles in the nation at large. Because the number of applicants far exceeded the number of places available each year
|for entering classes, the school could be highly selective in its admissions policy. The minimal requirement for entrance then was two years of completed college work. It was not until 1972 that the minimum was raised to three years of college. Any specific statement about college preparation was omitted from the catalogue thereafter, but the tendency was to expect completion of a four-year degree program. Out of the 540 completed applications in 1955, only 97 were enrolled. Of these, 74 were from the Northeast and a majority of these were from Massachusetts. This was a reflection of the same "New England Policy" followed by the medical school, which gave preference to that region. Total enrollment was slightly smaller than in the medical school, averaging 370 students a year between 1952-56, as compared with an average of 445 for the same period in the medical school. As a result of adherence to the New England Policy, 80 percent of dental school graduates were practicing in New England in 1958, and half of the dentists in Massachusetts had received their training at Tufts.|
Student organizations and publications were represented in the 1950s by the Tufts Dental Outlook, established in 1928 as a vehicle for publishing student papers, and by the Explorer, the senior class annual first published in 1921 and bearing subsequently a variety of names. Both were still in existence in the 1980s. The Robert R. Andrews Society, created in 1921,was an honor society for members of the junior class, and was intended to encourage research. Like the Andrews Society, the George A. Bates Society, founded in 1935, was named in honor of a former dental faculty member. There was also a chapter of Omicron Kappa Epsilon established later at Tufts as a unit of the national honorary dental society.
The offering of graduate, postgraduate, and refresher courses for practicing dentists, begun in 1946, had reached impressive proportions, with several hundred dental students and dentists simultaneously taking advantage of various programs. Many of the post-graduate courses were sponsored by the Dental Alumni Association (founded in the 1890s) and were offered in connection with their annual midwinter meeting. Community activity was illustrated by an arrangement worked out in 1954 with the town of Brookline to provide dental service for 9,000 school children.
In national terms, the dental school in 1953 had the best record of all the forty-five existing dental schools in terms of the small number of failures on the National Licensing Board examination. In 1957, it was one of only two in the country whose student performance rated "high" or "very high" in all six of the basic science subjects. The dental school was fully accredited in 1958 by the
|Council on Dental Education of the American Dental Association after a visitation in 1956 - the first such in thirteen years. School officials were much gratified to note that in a five-year summary published by the American Dental Association covering all dental schools in the nation, "Tufts has consistently enrolled students with a total academic average, a total science average, and a total ACE or mental level average considerably higher than the national average." This highly favorable assessment was tempered by the complaint voiced most loudly by John H. Barr, chairman of the Department of Oral Diagnosis and Roentgenology and Director of Clinics, that 50 percent of the students were ignorant of (or oblivious to) the basis rules of written communication- from sentence construction to the "universally lost art of spelling." In order to emphasize the view that dentistry was intimately related to medicine, dental school students were enrolled in the same departments of basic science as the medical school students, although they were taught in separate courses and classes by medical school faculty. The close relationship between the two schools was also illustrated by the fact that they not only shared the same quarters but that the official designation of the latter had been changed from the "Tufts College Dental School" to the "School of Dental Medicine" when the institution became "Tufts University" in 1955. One of the less happy consequences of the close relationship between the two schools was the existence of considerable tension and dissatisfaction because many of the dental students taking basic science courses considered themselves "second-class citizens." Another unhappy situation which the dental school shared with the medical school was its almost complete lack of endowment. Like the medical school, it had to depend almost exclusively on tuition for its income, supplemented by special grants, both public and private, and by revenue from its clinics. When dental school tuition was raised to $1,000, effective in 1956, Tufts shared with Harvard the highest tuition in the United States. Average total academic expenses (tuition and fees, exclusive of living costs) was estimated at $5,000 for four years - an exceptionally high figure for that time. On the more positive side, Tufts and Harvard shared the two highest dental research budgets in the nation from the United States Public Health Service. Overall dental research grants to Tufts in 1956 were exceeded only by New York University. Approximately 5,ooo new patients were selected each year to provide "teaching material," and the need for a new and enlarged clinic building was becoming more pressing than ever in the 1950s. President Wessell, sensitive to the need of the dental school for|
|enlarged facilities, recommended to the trustees in 1956 that they create a dental clinic building fund. The main clinic was located in the 1950s in a building formerly housing a factory, and was obviously not designed for dental use. For much of its history after World War II the dental school, much like the medical school, was caught between its own efforts to maintain high quality and pressure to increase enrollment from the New England Board of Higher Education, which tended to stress quantity rather than quality. The state, beginning in 1958, offered a special individual subsidy, through the Board, of $1,500 a year for every dental student in excess of enrollment in 1956.|
Dean Cyril D. Marshall-Day resigned in 1959 after ten years at Tufts, and was succeeded by John W. Hein, an honor graduate of the dental school in 1944 who had headed most recently the Division of Dental Medicine at Rutgers University. The new dean was faced immediately with a series of problems. There was a brief but sharp decline in the number of applications, accompanied by a significant decline in the test scores of those admitted. Partly because of faulty accounting procedures and inaccurate budget projections, the school experienced a deficit of $125,000 in 1958-59. The school suffered from alumni indifference, reflected in distressingly small financial contributions. Research activity reached the lowest point in a decade.
Dean Hein's ambitious plan for a comprehensive dental health center met with a cool reception because of financial constraints. The situation did improve, however, in 1960. The number of full-time faculty increased from twenty to thirty-two, and the new Department of Social Dentistry, established in 1960-61, was the first of its kind in the nation. The deficit was cut in half the same year. But even then, President Wessell expressed grave doubts about the future of the dental school, which in his view was turning out mere technicians rather than liberally educated graduates: only two years of college were required for admission, and the school was apparently unable to strengthen its resources.
Hein remained as the dean for only three years, and until a successor could be found, J. Murray Gavel served as acting dean in 1962-63. Louis J.P. Calisti, who had been on the faculty since 1959, became the dean in 1963. He was chairman of the newly created Department of Social Dentistry at the time of assuming the deanship. After fourteen years' association with Tufts, eight of them as dean, he resigned in 1971 to become the first president of the Portland-Gorham campuses of the University of Maine. Dean Calisti was fully aware of the need for shoring up both the academic and financial base of the school. He called public attention
|to the almost complete lack of endowment, and to the differential between tuition paid ($1,500 in 1963) and the annual cost of educating a student ($3,500), which had to be made up by gifts or taken out of university funds. The total dental school endowment was all of $10,000 at the time. He saw the only answer in greatly enlarged state subsidies, and pointed also to the fact that little more than 10 percent of the teaching faculty of 260 were full-time. Some progress was made in 1965 in regularizing the status of full-time dental faculty by extending the trustee policy on tenure adopted in 1964, and a standing Committee on Faculty Appointments was created.|
The first priority during Calisti's deanship was the provision of a new dental clinic building. Negotiations were started for federal funding (on a matching basis) in 1964, largely through his efforts.
In the following year the proposal was enlarged to provide a complete Dental Health Sciences building to cost an estimated $8.5 million, half of which would be matched by Tufts. This would be the first of three projected phases of a capital gifts campaign for the entire Tufts-New England Medical Center, and if successful would commit the dental school to a 20 percent increase in the size of the entering class. The complicated paperwork involved in applying for the federal funds was begun in 1965, with a request filed with the National Institute of Health under the Health Professions Teaching Facilities Act. A capital drive was launched simultaneously at Tufts to raise almost $6 million. The effort dragged on for a much longer time than anyone had anticipated, and according to Arthur Vanderhoof, chairman of the trustee Development Committee, was "the most difficult campaign ever conducted by Tufts." Burton C. Hallowell became president in the midst of the campaign in 1967, and of course had to be briefed on the nature and progress of the fundraising effort before his name could be associated with it.
The effort begun in 1965 was very disappointing. Three years after it started, little more than $2 million had been raised or pledged. The raising of the matching funds to be furnished by Tufts was still so far behind schedule that the university was forced to borrow $1.8 million to meet its share. As late as 1972, one-third of the dental campaign pledges remained unpaid. By the time construction had been completed, Tufts had been forced to borrow so extensively that the annual debt service alone was $55o,ooo a year - the equivalent of $1,000 in individual tuition. It was no wonder that dental school tuition continued to be the highest in the nation.
There was so much delay in raising the necessary funds and in getting construction actually started that a series of renovations costing almost $200,000 had to be made meanwhile (in 1969) to enlarge
|and rearrange part of the constricted area shared with the medical school in order to create much-needed additional space. The necessity for this outlay came just as Tufts was experiencing a period of severe financial stringency and the dental school was living through another series of budget deficits.|
The project was ready for construction bids in the spring of 1970. The original plan called for a twelve-story structure, but rapidly rising costs necessitated a decision in 1969, when ground-breaking actually took place, to eliminate two floors, with only eight of the remaining floors to be completed for immediate use. When construction actually commenced, the total number of floors was further reduced to eight. Simultaneously, the total cost was revised upward to almost $15 million, creating a funding gap of some $3.5 million. The final total cost of the building was $15,038,497, of which the federal government made a direct contribution of $5,843,000, and an additional contribution of $500,000 through the New England Regional Commission.
The move to the new building was made in September 1972 in spite of the fact that it was not completed until the following January. The new Dental Health Sciences building was dedicated, with appropriate ceremonies, on 4 April 1973. The dedicatory address was
|delivered by Francis W. Sargent, governor of Massachusetts. (Spiro Agnew, Vice President of the United States, was invited to be the featured speaker but declined.) It was indeed a long-awaited and festive occasion, for the Tufts Dental Alumni Association timed its annual spring meeting to coincide with the event, and included Reunion Night for the Classes of 1918 and onward. The new building was designed by The Architects Collaborative of Cambridge, Massachusetts, and was built by the Barr & Barr Construction Company. The structure was located contiguously with the newest wing of the New England Medical Center, the Samuel Proger Health Services Building, also dedicated in 1973, with all floors interconnected between the two structures. Proger, who had a distinguished career as the first physician-in-charge of the NEMCH and Professor of Medicine in the medical school, had retired from both positions in 1971 but continued to hold numerous administrative positions in both the Medical Center and in the hospital. The new dental building was furnished with the latest equipment, much of it carrying the names of various donors. Audiovisual facilities, including a fully equipped TV studio, were considered "among the most sophisticated in the nation." At the time the new building was dedicated, the dental school entering class increased to 134, and with the new facilities had the potential of expanding to 150. The increase in 1973 had been the result of a Federal Basic Improvement grant in 1966 which had required an enlarged student body. However, no significant increase could take place until 1973 because space was so cramped, and the cost of enlargement in effect cancelled out the amount of the grant.|
Several important curricular developments occurred in the 1960s and early 1970s. Two-year programs leading to the degrees of Master of Science and Master of Dental Science (MDS) were adopted in 1961. (The MDS degree was discontinued in 1968.) A single integrated multidisciplinary course in the basic sciences was tried in 1963-64 but was soon abandoned in favor of the traditional separate courses. The faculty of the dental school spent much time in 1965-66 reviewing and revising the curriculum. The first year was still to be devoted to the basic sciences; the second to pre-clinical training, with improved integration; and the final two years to clinical teaching and experience, utilizing small-group seminars instead of the usual lectures. In the following year (1966-67), a dental department was established in the NEMCH, and the school received a five-year grant
|from the Nutrition Foundation to teach the fundamentals of nutrition to dental school students. In order both to achieve greater administrative coherence and to broaden the scope of dental training, four clinical departments were consolidated into a new Department of Oral Health Service.|
In 1969 a contract was entered into by Tufts, the state of Maine, and the New England Board of Higher Education, based on the fact that Tufts supplied the majority of dentists practicing in New England. The contract provided that Maine paid Tufts a stipulated sum for each resident of Maine enrolled in the Tufts dental school. Relations between Maine and Tufts were further strengthened when, by an agreement concluded with the children's dental clinic in the Maine Medical Center, located in Portland, dental internships were established for Tufts students. The clinic paid transportation, room, board, and a $1oo monthly allowance for each Tufts student. An accrediting team of the Council on Dental Education made its fourth evaluation of the dental school in 1970 which had resulted in continuing accreditation. There were no unusual findings. The lack of a higher proportion of full-time faculty was considered "the single most critical problem" facing the school and was a reflection of lack of funds rather than any unwillingness to augment the staff.
There were 218 faculty in 1970, of whom only 54 were full-time. Dean Calisti, who had resigned in June 1971 before the Dental Health Sciences building was completed, was succeeded by Robert B. Shira in December 1971. In the intervening period, Associate Dean Thomas W. Murnane served as acting dean. Shira was a prominent leader in the field of oral surgery, and had served as Assistant Surgeon General and Chief of the Dental Corps of the United States Army. He was chief of dental service at the Walter Reed Army Medical Center for ten years (1954-64). He left military service with the rank of major general after a thirty-three year career. After his retirement from seven years in the deanship, in 1978 he was appointed Assistant to President Jean Mayer, who had assumed office on 1 July 1976. Shira's assignment was to serve as the president's representative on the Boston campus and to assist in fund raising for the health science schools, especially the dental school, effective in January 1978. Shira was appointed as provost in 1980 after Kathryn McCarthy's resignation. He received the honorary degree of DSci in 1981 in recognition of his numerous accomplishments, which included recruitment of women dental students.
The relocation in the new building in the fall of 1972 coincided with a radical change in the academic calendar of the dental school. It tried the experiment of year-round operation, with the degree
|program reduced from four years to three, approved by the trustee Educational Policy Committee in 1971. The continuous 132-week curriculum was developed to meet a dental manpower shortage and was designed "to lower the true cost of education to the student" by making possible an additional year of earning power. The three-year program also made possible a reduction of living expenses by approximately 25 percent, although tuition costs in 1972 remained the same ($4,440) for three years as for the previous four. The decision to make the change was also prompted by purely economic considerations. It meant not only maximum utilization of facilities but anticipated a downward trend in federal funding and meant an increase in clinical income because of continuous operation. A "distress grant" from the Department of Health, Education, and Welfare, part of which was received in 1972, still did not balance the dental school budget. One chronic financial strain was the necessity of reimbursing the medical school for providing instruction in the basic sciences. This expense amounted to $320,000 in 1972-73 alone. The switch to year-round operation had no adverse effect on enrollment; in fact, the number of applications for entrance in 1973 exceeded those of the previous year. The same year that the new program was introduced, the dental school lost by death one of its most active and most prominent faculty members, Irving Glickman, Professor of Oral Pathology and Periodontology and chairman of that department.|
In terms of the geographical distribution of the student body, the trend away from the historic "New England Policy" was temporarily reversed during Dean Shira's administration. Almost as soon as he had assumed office in 1972 he announced his intention of increasing the number of students from New England and decreasing those from New York in particular. The results were obvious the very next year. Of the 137 places in the entering class, 98 were from New England. At first, the Council on Dental Education challenged the enrollment of such a large class, but after an on-site visit to the new building in 1973 the Council approved the enlarged enrollment.
There were two dental school Commencement ceremonies in 1975, held on the Medford campus. One was for the last four-year class (in May) and the other for the first three-year class (in June). The dental school was operating by the mid-1970s at its planned capacity of 150 entering students. It was too soon in 1975 to make a comparative evaluation of the three-year and four-year programs, but some questions about year-round operation had already been raised. There was the matter of the immaturity of the students in the three-year program. The pressure on both students and faculty of
|continuous operation were evident, and there was a clear need for additional full-time faculty for clinical supervision.|
Consideration was being given by 1979 to reinstating the four-year curriculum and the following year the trustee Educational Policy Committee voted to restore it, effective in September 1981. One factor influencing the decision was that Tufts had gotten out of step with all but one other dental school among the sixty such schools then in operation (the College of the Pacific) by retaining the three-year program. As the Hallowell era came to a close in 1976 and a new administration took over, prospects of the Tufts dental school looked brighter than they had for many years. The graduation of the last enrollees in the four-year program in 1975 meant only three classes in attendance. This had lightened the load of the faculty and had allowed time for a complete review of the curriculum, which had resulted in more clinical experience for the students (and increased clinical income). The faculty had remained reasonably stable. Even with a marked reduction in federal support, research activity continued apace and the school was able not only to balance its budget but to show a modest surplus. The Dental Health Sciences building was being effectively utilized. Extern programs, including arrangements with the Massachusetts Department of Mental Health to provide oral health care for patients in six state mental institutions, attracted national attention, and in 1977 the school received the full approval of all of its programs by the Commission on Accreditation of the American Dental Association. After one year in office, President Mayer was convinced that the Tufts School of Dental Medicine was "one of the finest in the nation."
 See Herbert Black, Doctor and Teacher, Hospital Chief: Dr. Samuel Proger and the New England Medical Center (Chester, Conn.: Globe Pequot Press, 1982).