Medical education

Medical Education began at Brown in 1811. The medical instruction which was given from that date until 1827 is often referred to as the “Medical School,” but it was, in fact, not a separate school, and was called at the time of its existence the “Medical Department,” or, more accurately, the “Medical Lectures in Brown University.” Of such medical departments it was the third in New England, being preceded by medical schools at Harvard amd Dartmouth. In the beginning, there were three professors, Solomon Drowne 1773, professor of materia medica and botany, William Ingalls, professor of anatomy and surgery, and William Corlis Bowen 1803, professor of chemistry. Ingalls had received a medical degree from Harvard in 1794, had a practice in Boston, and came to Providence to deliver his lectures. He resigned his position in 1816. An anonymous pamphlet published the year before had this to say about the conditions of his employment, “On the present plan the medical professors depend for compensation entirely on the fees of attendance. This gives them a most precarious standing. Repeatedly has it been the lot of a professor, as the season for his lectures approached, to visit the college, inquire how many attendants would be had, be informed that for this or that reason they would be very few, and return to his residence, lamenting that he must wait another year because an unfortunate arrangement has made the discharge of his duties dependent on the accidental finances and feelings of fifty or sixty youths.” Ingalls continued to give lectures in Boston, and students attending there could count the lectures as part of their required course at Brown. Solomon Drowne, after service in the Revolution, had received a bachelor of medicine degree from the College of Philadelphia in 1781. He was also awarded the first medical degree from Brown University, an honorary doctor of medicine in 1804.

William Bowen 1803, a fourth-generation physician in the Bowen family in America, had left Brown, graduated from Union College in 1803, and received his medical degree at Edinburgh in 1807. He then studied in Leyden and Paris, and with Sir Astley Cooper in London. He resigned as professor of chemistry in 1813, and his death two years later was said to be from a respiratory disease brought on by chemical experimentation. Providence physician John Mathewson Eddy, to whom Brown awarded an honorary M.D. degree in 1815, was adjunct professor of anatomy and surgery from 1815 until his death in 1817. In 1815 Levi Wheaton 1782 was appointed professor of the theory and practice of physic. Wheaton had left college for the army during the Revolution, and had served in military hospitals. In 1782 he received his degree, which he had requested on the basis of his service and continuing education during the war. He studied medicine privately and was awarded an honorary M.D. by Brown in 1812. Usher Parsons was appointed adjunct professor of anatomy and surgery in 1822, and professor in 1823. He had studied medicine with Dr. John Warren of Boston, been a navy surgeon in the War of 1812, earned an M.D. degree at Harvard in 1818, and taught anatomy and surgery at Dartmouth from 1820 to 1822.

The anatomical work was carried on in the old University Grammar School building, where the upper story became a dissecting room with a trap door for lowering the specimens into the lecture room below. The medical course included a fourteen-week term of lectures each year. Medical students were required to attend two lecture courses, study with a physician for three years, present a thesis, and pass an examination.

When Francis Wayland arrived as president in 1827, he was determined to improve the discipline in the college, and convinced the Corporation to vote in March 1827 that thereafter no member of the faculty should receive his salary unless he occupied a room in the college and helped to preserve order among the students. The medical department was not blameless in the state of disruption into which the college has fallen, according to Usher Parsons’ son, Charles W. Parsons, in a paper read before the Rhode Island Historical Society in 1881:

“A story is told of a certain skeleton in the course of preparation, which was left in a barrel in front of the ‘anatomical building,’ and hence involved Professors Wheaton and Parsons in trouble. By some forgetfulness, it was allowed to remain out-of-doors till college students began to roll and kick it down the steep of College street, and at the level of Benefit street it ran against some obstacle, I think the steps of the old town house. Out came the head of the barrel, followed by another head, and great was the consternation and excitement. A startled crowd gathered around the spot; stories were soon astir of desecrated graves; search was even made in one place of a recent burial, which was found not to have been disturbed.... Dr. Parsons returning from Boston, – I think the next day, – claimed the bones as his own property, but public opinion demanded a prompt and decent burial.”

From time to time the subject of medical education was raised. In his annual report for 1911, President Faunce justified his continuing resistance to entreaties to establish a medical school, when he wrote, “A medical school, if first-class, requires enormous expenditure; if not first-class, it is a public menace.” On June 19, 1944, the Corporation voted to establish a Department of Medical Sciences “for instruction and research in the medical sciences ... the importance of health and hygiene ... a better orientation for students who are preparing for the art and science of medicine ... opportunity for advanced study ... cooperation of the University with the Hospitals of the community in programs of post-graduate education.” Dr. Charles A. McDonald and Dr. Alexander M. Burgess, both of the infirmary staff with title of assistant professor of biology, were named professors of health and hygiene. Dr. McDonald was designated chairman of the new department. A medical convocation was held in the Faunce House Theatre on August 9, 1944, to inaugurate the new department. The department offered no formal courses, but began a monthly colloquium which, being scheduled for the same evening that both the Biology Colloquium and the Friday Night Medical Club met, was poorly attended. Attendance did not pick up for several years, and then only when the lectures were on more general topics and open to the public. The Haffenreffer Fellowship was established by the R. F. Haffenreffer Family Foundation and was awarded to Dr. William J. Fisher in 1945-56 and to Dr. Michael DiMaio and Dr. Robert Lewis in 1947-48. In 1945 Dr. McDonald was given the title of Director of Health Services, and in 1947 Dr. Burgess’ title was changed to Professor of Medical Science. The department, however, quietly disappeared, and President Wriston announced to the Advisory and Executive Committee on December 8, 1950, that the Department of Medical Science had been discontinued.

In 1957 Brown was selected as one of fourteen child-study centers by the National Collaborative Study of Cerebral Palsy, Mental Retardation and Other Sensory and Psychological Defects. In the late 1950s, through the efforts of Professor J. Walter Wilson and Congressman John E. Fogarty, the Institute for Research in the Health Sciences was established at Brown with Glidden L. Brooks as director. From this Institute the concept of a medical school grew, and in 1960 President Barnaby Keeney appointed a committee to consider the feasibility of a program in medical education. In 1963 the six-year program leading to the degree of Master of Medical Science was inaugurated with a grant of over a million dollars from the W. K. Kellogg Foundation. The program allowed a student to obtain his pre-medical education including both science and the humanities, and in two years of graduate study to take the non-clinical part of his medical education before transferring to a four-year medical school. The medical graduates of the classes of 1969 through 1972 all transferred to the third year of conventional medical schools. In 1969 the University signed an agreement of affiliation with five local hospitals – Rhode Island Hospital, Roger Williams General Hospital, Miriam Hospital, Lying-In Hospital (now Women and Infants Hospital), and Memorial Hospital of Pawtucket (now Memorial Hospital of Rhode Island). Professor Mac V. Edds became chairman of the new Division of Medicine, and in 1965 became Director of Medicine in the Division of Biological and Medical Sciences. In 1972 a program in medicine leading to the Doctor of Medicine degree was incorporated into the Division of Biology and Medicine with provisional accreditation and an entering class of sixty. Full accreditation as a four-year medical school was granted in 1975, and 58 students (thirteen of whom were women) received their M.D. degree in June of that year. At their Commencement exercises at the Unitarian Church on Benefit Street the first graduating class recited a modernized Hippocratic Oath, written by a committee of the class, in which they pledged themselves “to the care of the sick, the promotion of health, and the service of humanity,” and omitted outdated elements of the traditional oath. In 1976 an early identification admission program was initiated with the University of Rhode Island, Providence College, and Tougaloo College.

In 1980 an agreement was reached between the Brown Medical Program and Dartmouth Medical School, which did not have facilities for the clinical education of the number of students it wished to admit. The Brown program with its eight affiliated hospitals agreed to accept students from Dartmouth for the last two years of medical school. In 1984 an extra large class of 75 was admitted of which 50.7 per cent were women and 34.2 per cent were minority students. The new Program in Liberal Medical Education (PLME), initiated in 1984-85, is an eight-year continuum beginning in the freshman year, which involves six years of pre-medical and other undergraduate courses and two years of clinical work. Regular admission of college graduates into the medical program was discontinued in 1986-87, after which students have been admitted as freshmen or as transfers from other medical schools at the beginning of the clinical years. The Division of Biology and Medicine offers summer non-credit programs for disadvantaged students and those underrepresented in medicine, namely, the Premedicine for Sure Program for entering freshman premedical students, the Premedicine for Keeps Program for minority premedical students who are entering the sophomore or junior year, and the Medical Summer Studies Program for students admitted to the first year of the Program in Medicine who are minority students or residents of Rhode Island.

The Center for Gerontology was established in 1980. The Centers for Alcohol Studies and for Health Care Research were established in 1983. The Division of Biology and Medicine, which had been formed as a single department in 1968 was reorganized in 1985 into two administrative units, the Program in Biology and the Program in Medicine. The Program in Medicine includes the Department of Clinical Neurosciences, the Department of Community Health, the Department of Family Medicine, the Department of Medicine, the Department of Obstetrics and Gynecology, the Department of Orthopaedics, the Department of Pathology and Laboratory Medicine, the Department of Pediatrics, the Department of Psychiatry and Human Behavior, the Department of Radiation Medicine, and the Department of Surgery. Instead of a university teaching hospital, the Brown Program in Medicine is affiliated with eight local teaching hospitals, the Emma Pendleton Bradley Hospital, Butler Hospital, Miriam Hospital, Memorial Hospital, Rhode Island Hospital, Roger Williams General Hospital, the Veterans Administration Medical Center, and Women and Infants Hospital. A family medicine residency program in conjunction with Memorial Hospital was initiated in 1975. In 1978 a new undergraduate concentration, Health and Society, open to premedical students and others, was created, with a curriculum in the three major areas of health behavior and the social conditions of illness, the organization of health services, and research methods as appled to health services. Pierre M. Galletti, who had been chairman of the Division of Biological and Medical Sciences since 1968, was named Vice-President for Biology and Medicine in 1972. Stanley M. Aronson was appointed Dean of Medical Affairs in 1973, and was Dean of Medicine from 1976 to 1981. David S. Greer was Dean of Medicine from 1981 to 1992.

The International Health Institute was created in 1988 to coordinate efforts at the University to improve health services to the world’s population. The major activities of the Institute are the Program in Geographic Medicine, the Program in Primary Care and Health Services, and a Bilateral International Exchange Program. Overseas field centers have included collaborative programs in the Philippines, China, Tanzania, Indonesia, Pakistan, and Nicaragua. Between 25 and 30 percent of the medical students are from Rhode Island. In 1991 U.S. News and World Report, in an article rating graduate programs in the United States, ranked Brown number one of 66 medical schools specializing in primary care. In October 1991 the Corporation voted to change the name of the Program in Medicine to the Brown University School of Medicine.