The problems of the Tufts Medical School in the 1930's were serious and extended far back into the past; they all somehow centered around the word "finances." The school had been able to maintain its Class A standing but had "always been on the border line." Every inspection under the auspices of the American Medical Association had revealed a more or less disturbing list of shortcomings. In 1935 the Council on Medical Education launched a campaign more vigorous than ever to weed out weaker schools. The system of letter classification (A, B, and C) was abandoned, and schools were either recognized or not, usually after a period of probation in which it was hoped that they would mend their ways. The Tufts Medical School in 1937 had found itself in this

The school faced a crisis of major dimensions, and a year before his death President Cousens, fully recognizing the gravity of the situation, worked out in conjunction with the Medical School Alumni Association a campaign to seek substantial financial support for the school. The professional fund-raising team of Ward, Wells, and Dreshman was employed and immediately went to work in the spring of 1937.[24]  The biggest difficulty seemed to be, not a paucity of potential sources for funds, but the lack of a general development plan that would attract gifts. The generalized goals of raising faculty salaries and increasing personnel were insufficient inducements to attract money. Prospective donors wanted to contribute to something less nebulous than "increased unrestricted income." One suggestion was to create a fifty-bed surgical unit at the Boston Dispensary and in that way establish the Department of Surgery on a permanent basis. This unquestionably would have been attractive as a money-raising project and would have strengthened the school. However, analysis of the project showed that it would be prohibitively expensive to maintain and would absorb the entire campaign effort; therefore, a compromise was worked out. It was proposed to use part of the Bingham gift, which was for a diagnostic clinic at the Dispensary, to enlarge the

The results of the fund drive were disappointing. The campaign, which was the ultimate responsibility of the school's alumni organization, was left leaderless with the death of President Cousens in 1937. To complicate the situation, the nation at large experienced a so-called economic "recession" in its attempt to climb out of the trough of the post-1929 depression, and money was correspondingly hard to come by. Canvassing of foundations produced only minimal amounts, the largest of which was $35,000 contributed by the Charles Hayden Foundation. Only $422,000 had been given or pledged by the fall of 1940, the great bulk of it coming from alumni and faculty. During the period up to the Second World War, some support for student financial needs was made possible by the aforementioned Hayden Foundation, together with the W. K. Kellogg Foundation and the Charles H. Hood Dairy Foundation. Some important faculty appointments were also made possible by grants from the Rockefeller Foundation. By 1939 the school still had some distance to go in meeting the criticisms of the American Medical Association. The student body was gradually being reduced, although there were still too few instructors in the basic sciences. The greatest progress made in the two years since the American Medical Association's adverse report of 1937 was in the supervision of clinical work during the third and fourth years, a large part of it under the direction of Vice-Dean Dwight O'Hara. Clinical facilities were also greatly strengthened by the opening of the Pratt Diagnostic Clinic.

The coming of the Second World War had immediate and significant effects on the school as it plunged into the task of training hundreds of sorely needed doctors. Questions of fund-raising,

The years between 1945 and 1952 were eventful ones for the medical school. Curriculum, standards, physical plant, and finances all had to be reassessed, and a student body reflecting the experiences of wartime dislocations had to be accommodated. One interesting by-product of the Second World War was the sharp increase in the percentage of married students in the fourth-year classes, which for a short period had an average age significantly lower than those who entered as first-year students. A tangible reminder of the continuing crucial need for specialized national manpower, in war or in peace, was the establishment of an Army ROTC unit in 1947-48. Military instruction, limited initially to the first three classes, was extended to all four in 1948-49, as part

While the United States was still in the midst of war, considerable thought was devoted to the effect of acceleration on the student body and the course of study. The Tufts Medical School, like most of its counterparts, returned to an annual entering class in the fall of 1945. Although there were advantages in continuing the accelerated program, experience indicated that the middle group, academically speaking, was having a difficult time, and the performance level was distinctly lower than it should have been. The students at the bottom were "more of a problem than ever," pedagogically speaking, and if an accelerated program became a permanent policy, it was seriously doubted if border-line applicants should be admitted at all. Because Tufts, like most medical schools (according to Acting Dean O'Hara), had so few really superior students, he favored a return to prewar scheduling which would stress "character and stability quite as much as ... scholarly aptitude and cleverness." He also called for stability in another direction: the adoption of some kind of policy that would provide minimum and maximum faculty salaries, particularly for those at the lower ranks. The obtaining and retention of a competent and responsible staff made such a policy mandatory.

There were matters other than curriculum and faculty to be considered in the busy years after 1945, and they represented a more positive side of the medical school. Completion of the new physical plant was a top priority, and after the delays and frustrations of the war period the expansion of the New England Medical Center proceeded apace. In 1946, the Bingham Associates Fund of Massachusetts became the fourth member of the Center, and the Pratt Diagnostic Clinic was transferred to control of the Associates.[26]  The more than $2,000,000 made available through the Bingham group made possible the erection of a greatly enlarged surgical unit designated as the Pratt Diagnostic Hospital. During the same year (1946), the so-called Harvard Building adjacent to the New England Medical Center was acquired by the Tufts Trustees for the use of the medical school. The final decision to sell the old

Dr. Dwight O'Hara, who had served as dean of the medical school and as Professor of Preventive and Industrial Medicine since February 1946, presented his final report as dean, as of the fall of 1952.[28]  After reviewing his eleven years as dean, Dr. O'Hara could look with satisfaction on a record of solid accomplishment by the school. The move into a new physical plant, beset as it had been with delays and difficulties, had been accomplished. The Departments of Chemistry and Pharmacology had been thoroughly reorganized. Medical research on a scale undreamed of fifteen years before had been undertaken - and this in spite of the abnormalities and uncertainties of the war period. There was also a significant intangible asset acquired by the school, particularly after 1945. The attrition rate, always higher than most individuals like

The Tufts Medical School, following a national trend, was emphasizing quality over quantity in the output of doctors. Even though there were many more internships than available interns, and over twice as many students knocking at the door than were being admitted, medical schools about the country were consciously creating bottlenecks. Numbers alone would not fulfill the needs of a profession devoted to high standards. It was partly for this reason that Dean O'Hara and others greeted with relief the legislative defeat in the summer of 1952 of a proposal for a state medical school.[31]  His argument that the student bodies and faculties of the three existing medical schools in Massachusetts (Boston University, Harvard, and Tufts) would be "diluted" if such a school were authorized was reinforced by the inescapable fact that the Tufts Medical School was drawing 70 per cent of its students from within the state. Creation of a tax-supported medical school would have forced the Tufts school to abandon its "New England policy," for it would have had to compete in a much larger area. This revised policy might, in the opinion of the dean, have tempted, or even forced, the school to accept candidates who did not meet its

Closer home, in a sense, was another problem of long standing -the relation of the medical school itself, and its students and alumni, to the College. Still geographically separated, living much of its life as a distinct entity with, for the most part, only the most tenuous of associations with the College below the highest administrative level, the medical school tended to turn more and more to the medical profession than to Tufts for financial support and endowment. Although the medical school was well represented in the Second Century Fund goals, its needs were much greater than the amount provided there. Dean O'Hara felt that the primary allegiance of the professional school graduate was in reality focused there rather than on his undergraduate school, but that insufficient effort had been made to capitalize on this fact. The medical school graduate had to be "convinced that what he gives is going to his medical school, not to the college or university whose name it bears." The start already made by the National Fund for Medical Education, and the American Medical Education Foundation sponsored by the American Medical Association, seemed to be the "great hope" for future support rather than dependence on the parent institution. The establishment of an aggressive public relations office, located at the medical school, "not at the College in Medford," would be a move in the right direction. Dean O'Hara and President Carmichael, simultaneously stepping down from their respective offices in 1952, left this problem to be worked out by those who followed.

[24] The College also availed itself of the services of the firm of Tamblyn and Brown in 1939.

[25] The medical school was inspected in 1941 by the governing board of the Alpha Omega Alpha fraternity and was authorized to establish a chapter, the third such in New England; the others were at Harvard and Yale. The school received, in the same year, a favorable report from the Approving Authority for Colleges and Medical Schools for the Commonwealth of Massachusetts; and in 1943-44, in anticipation of a return to peacetime conditions, the Council on Medical Education of the American Medical Association scheduled an informal inspection of the school. The exigencies of wartime and the accelerated program precluded a thorough review such as was made in 1954.

[26] Tufts was in this way released from the agreements and obligations undertaken in 1937.

[27] The Trustees had hoped to realize $400,000 on the sale. In actuality, they accepted an offer of $200,000 from Northeastern University.

[28] Although Dean O'Hara's resignation was to have been effective in September, he actually continued to serve until March 1953, when Dr. Joseph M. Hayman, Jr., assumed the deanship. Dean Hayman also held the rank of Professor of Medicine and Senior Physician at the New England Center Hospital.

[29] The attrition rate for first-year classes was less than 3 per cent for each of the years 1950 and 1951.

[30] Prior to that date, students might, with the approval of successive promotion committees, make up failures in two major courses each year.

[31] Such a school was finally authorized ten years later; it was not until 1965 that a site was selected.

[32] The American Medical Association had already exerted considerable pressure on schools not to restrict applicants geographically. In 1948, 109 of the 111 members of the entering class of the medical school were from New England, and 77 of those were from Massachusetts.