Medical school

An institution of worldwide responsibility

As many of us spend our evenings watching the Olympic Games in China we have the opportunity to learn more about the country and people who are hosting this year’s games. Television, radio, newspaper and Internet news stories communicate the hardships and advances taking place in one of the world’s most fascinating places.

Twenty-nine years ago, a delegation from the University of Minnesota had the opportunity to learn more about China first hand. Sent by the University administration in support of the recently adopted mission statement of the Board of Regents that cast the U of M as “an institution of worldwide responsibility.” The delegation consisted of twelve members including representatives of the College of Liberal Arts, the Institute of Technology, U of M administration, and two from the Medical School: Dean Neal Gault and Professor Yang Wang. The delegation traveled to various locations during the three week trip in an effort to promote scholarly exchange.

In his own report chronicling the trip, Dean Gault recounted in vivid detail his impressions and thoughts on the hospitality of the officials who welcomed them as well as an account of the infrastructure and institutional challenges China faced as it emerged from the Cultural Revolution.

In one account in particular, Dean Gault captured both the enthusiasm of their hosts as well as the sentiment of friendship when visiting Jilin University.

Smiles, smile, smiles—a[n] ocean full of smiles. Never have I had such a surging within me to imbibe the exhilarating fellowship that was being extended to me; it was a powerful and moving experience that I trust I will never forget. Of course I know such a welcome is extended most visitors and although I think they were so pleased to have the University of Minnesota there I suspect others who come will get the same first class treatment. For the Chinese are very hospitable people who are very kind and gracious.

Dean Gault’s praise and excitement came from a man whose own experiences at Seoul National University and the Okinawa General Hospital made him quite qualified to make such an assessment.

Read the full text of Dean Gault’s Report of the University of Minnesota Delegation to the Peoples’ Republic of China, September 1-21, 1979 below. Page ten is missing from the report copy.

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100 years of service

The AHC and its health science programs are commonly thought to focus on the health of the individual and larger populations. However, one program focuses on serving the individual and their families long after traditional forms of health care are no longer applicable. The Mortuary Science Program educates students in behavioral and applied sciences in order to provide a service to grieving families and individuals planning for end of life decisions.

Uniquely housed within the University’s Medical School the Mortuary Science Program traces its origins back to the School of Embalming in 1908 and is marking its 100th anniversary this year.

From 1908 until 1927 the School of Embalming provided vocational training. During the 1930s the program changed to require a high school diploma and at least one year of college to receive state licensing through an expanded 36 week course overseen by the General Extension Division. In the 1950s the University offered the first associate degree in mortuary science and by 1968 the University offered a Bachelor of Science degree and transferred the administrative authority from Extension to the College of Medical Sciences.

The commemorative pamphlet below is from the Program’s 50th anniversary in 1958.

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Ten rules for Med School (and 5 absolute truths for the rest of us)

img0076.jpgA recent reference question asked if it was possible to track down the ten tips Dr. William Albert Sullivan, former Associate Dean of the Med School used to give incoming students. My original answer was a hesitant maybe.

Dr. “Sully” Sullivan was Associate Dean for Admissions and Student Affairs from 1968 until his death in 1990. Originally from Nashville, TN, Dr. Sullivan came to the U of M in 1947 as a resident under Dr. Owen Wangensteen. Dr. Sullivan is probably most well-known for his personal interviews with each Medical School applicant. Dr. Sullivan had the ability to separate the self-assured from the self-absorbed. He was a strong believer in a well-rounded education that gave physicians the ability to relate to their patients on a personal level.

I could find little archival material related to Dr. Sullivan, let alone his 10 rules. I paged through a clippings file with various articles on his service to the Medical School and a few obituaries. It became evident that Dr. Sullivan may have never recorded his advice for medical students.

And then I found it.

In the August 1990 issue of The Cutting Edge, the Department of Surgery’s newsletter, there was a reprint of Dr. Henry Blackburn’s eulogy for Dr. Sullivan. At the end of his prepared remarks, Dr. Blackburn noted that “in keeping with Sullivan’s own fabled love of language and zest for communication, it is fitting to allow him the last word.”

And, here they are for you. Dr. Albert Sullivan’s 10 rules for new med students (and 5 absolute truths for the rest of us):

1. If money is the only thing that leads you into medicine, you might as well give up now.

2. If you want to be in charge all the time, then start your own business where you can call the shots.

3. Medicine is fun, and in contrast to many other professions or skills, people rarely leave it.

4. Any physician who stops learning after medical school is doomed to mediocrity, to poor medicine.

5. The human component of your existence that says you are just as selfish and egocentric as all the rest of those persons who have gone into medicine will keep you going and lead you to that position where you do indeed heal the sick, comfort the afflicted, and have one hell of a magnificent time doing so.

6. You must continue to utilize [your] other interests while in medical school, whatever they may be – athletics, music, painting, etc. If you don’t you’ll be perfectly miserable, and you’ll make a lousy physician.

7. There will be many times when situations arise in which you will need assistance. You are equipped to handle these crises if you take advantage of the resources common to all Medical Students: your own good brains, the support of friends and family, and our Office of Student Affairs.

8. Medicine is not a science or an art. Things are not black or white, but rather shades of gray. The make of really mature medical students is that they can tolerate the ambiguities and uncertainties, as well as the discrepancies of different teachers, knowing that each represents the truth as he or she sees it.

9. As a group you have a high degree of social orientation and desire to be helpful to the patients you will treat. However, it does no good whatsoever to sympathize completely with patients if you don’t know what is happening at their cellular level or if you don’t know what organism is causing their infection.

10. Don’t ever get so over involved with the technical aspects that you forget about the humanness of the people you are treating. This sensitivity and feeling must be combined with your scientific competence in order for you to become a competent and thoughtful physician.

Five fundamental and absolute truths:

1. E=MC2
2. There is no cure for the common cold.
3. There are more horse’s asses in the world than there are horses.
4. Excrement always flows downward.
5. If you’re treed by a bear, enjoy the view.


Seen your video

Yesterday, Peter Brantley of the Digital Library Federation was on campus to discuss areas of focus for future initiatives. One of those areas was the use of moving images as a source of information.

Without quoting him directly, Peter discussed how YouTube has demonstrated the online use of video to communicate complicated stories through moving images. These videos are compelling and promote the passing of first hand experiences and knowledge onto an audience.

A quick search of YouTube for related University of Minnesota health sciences content produced the following video that is an example of Peter’s discussion. It features prominent U of M medical researchers, Dr. Richard Bianco, Director of Experimental Surgical Services and Dr. Doris Taylor, Director of the Center for Cardiovascular Repair.

Of course, not all University of Minnesota health sciences content on YouTube was of the same caliber, as is seen in this medical student film documenting student housing by mimicking the popular MTV show Cribs.


Medical School admission, then & now

The origin of today’s Medical School at the University of Minnesota dates back to the formation of the University in 1851. The territorial act establishing the University provided for a Department of Medicine, however, it was not created until 1882.

img0060.jpgThe Department of Medicine was not a teaching department but rather a credentialing board that provided examinations and conferred MDs upon physicians who had learned to practice medicine by studying with a preceptor.

In April 1887, Percy Millard, Charles Hewitt, D. Hand, and President Cyrus Northrop presented to the Board of Regents their request to abolish the Department of Medicine and replace it with a new department that would consist of the College of Medicine and Surgery, the College of Homeopathic Medicine and Surgery, and the College of Dentistry. The Regents approved of the reorganization of the Department of Medicine in February 1888. The first class began in October 1888.

As part of the approval process, the Regents specified the admission requirements for the Department of Medicine. Students were evaluated by

1. Writing legibly and correctly an English composition of not less than two hundred words.

2. Translation of easy Latin prose, or, in lieu thereof, by passing an approved examination in any one of the following subjects: French, German, or one of the Scandinavian languages.

3. Passing an examination upon either of the elements of Algebra, Plane Geometry, or Botany.

4. Showing such a knowledge of Physics as may be obtained from the study of Balfour Stewart’s Elements of Physics.

However, examinations were not required for matriculated students or graduates of any reputable college, high school, or normal school, nor of persons holding a first-class teacher’s certificate or certificate of the State High School Board.

By contrast, today’s admission requirements are a little more demanding.

Select the image above to see the full page from the April 26, 1888 minutes.


U of M health sciences in Asia

A delegation of leaders from the AHC recently returned from a trip to India to meet with their counterparts and establish connections between their respective programs in the health sciences.

img0054.jpgHowever, collaborations between the University of Minnesota’s health science programs and universities in Asia have a long history. In 1954 the U of M began such a partnership with Seoul National University to provide technical and advisory support for educational programs and administrative organization in medicine, nursing, public health, and veterinary medicine. The project with Seoul National University ran for seven years until 1961. The benefits of the project are still evident today through the AHC’s continued outreach and partnership with other international institutions.

To learn more about the project with Seoul National University, see “Korea – A New Venture in International Medical Education” by Dr. N. L. Gault, Jr. (then Assistant Dean, College of Medical Sciences) from the November 1961 edition of the Medical Bulletin.


Dr. Verby and the Rural Physician Associate Program

img0051.jpgOn October 23, 2007, Dr. John Verby, the founder of the Rural Physician Associate Program, passed away.

Dr. Verby was a member of the Department of Family Medicine and Community Health from his appointment in 1969 until his retirement in 1993.

Dr. Verby, a graduate of Carlton College and the University of Minnesota’s Medical School, served as a lieutenant in the Army Medical Corps in Korea and had a private practice from 1949 to 1969 before coming to the University.

Dr. Verby was acting head for the Department of Family Medicine and Community Health from 1970-1971 and then became the first director for the Rural Physician Associate Program after developing and implementing the idea.

The document below is a press release from 1975 that highlights the program then entering its fifth year and quotes Dr. Verby in regards to the program’s successes.

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Homeopathy

img0043.jpgMany people who are seeking treatment and advice in the health care system want to be a part of the strategy that maintains their state of wellness. Often, that involvement leads both patients and physicians to apply holistic approaches, complementary therapies, and alternative medicines. At the University of Minnesota, the Center for Spirituality and Healing is partnered with the Life Science Foundation to provide accurate information and empower the individual to make these choices regarding their health.

The University of Minnesota has a long tradition of approaching medicine from multiple vantage points. In 1888, the University established the College of Homeopathic Medicine and Surgery within the Department of Medicine. The new College of Homeopathic Medicine had been in fact the former prestigious Minnesota Homeopathic Medical College. The Medical College transferred its charter to the University in order to avoid competing with the newly formed Department of Medicine as well as to gain more prominence by being associated with the University. The measure also gained additional support for the University from the public who increasingly viewed homeopathic medicine as a preferred option to orthodox treatment methods.

By the turn of the century, the College had grown to fifteen faculty members. However, over the next decade student numbers declined. In 1909 the College of Homeopathic Medicine merged with the College of Medicine and Surgery and by 1911, the Board of Regents removed the final two chairs associated with homeopathic studies within the College of Medicine and Surgery and ceased offering a separate diploma.


Questioning photographs

img0039.jpgThe University of Minnesota has long been a leader in medical advances and technologies. Since the 1960s, the University has been synonymous with advances in transplant procedures. Prior to that, the medical school gave rise to corrective open heart procedures. Two of the men that were involved with this earlier era were C. Walton Lillehei and Richard Varco.

Lillehei’s research focused on maintaining normal oxygen levels within the blood while simultaneously operating on the heart by using an external pump and blood donor to by-pass the heart. Varco’s research along with John Lewis and Mansur Taufic investigated ways to decrease the need for oxygen by inducing hypothermia and creating a longer period necessary for by-passing the heart’s pumping action.

This picture captures a moment when these two men (Lillehei on the left, Varco on the right) are engaged in surgery. However, it does not take a heart surgeon to recognize a peculiarity in the photo. An avid viewer of Grey’s Anatomy or any other medical drama would be able to point out that the men should be wearing their masks and not letting them hang down from their necks.

The answer, however, is simple. Lillehei and Varco are performing surgery, but at the time of the photograph, the work they were doing was still in development. A majority of this work was done on laboratory dogs, as is the case in this picture (likely postmortem).

The photograph is at first simple and then complicated. It carries the weight of the researchers and their efforts and the risks and sacrifices of the subjects (both human and canine) and reminds the viewer of the give and take nature of science.

In archival terms, photographs should elicit questions regarding not only their content (as I have done above) but also their intended purpose and potential consequences. In doing so, the archivist and researcher cannot work in a vacuum. The photograph needs to be placed in its original context by using the archival sources and historical references available.


The future doctor, past & present

A recent article in the Star Tribune highlighted a new program aimed at diversifying medical schools in Minnesota by encouraging minority, immigrant, and rural undergraduate students to become doctors. The program, “Minnesota’s Future Doctors,” hopes these students will apply to medical school, specialize in primary care, and ultimately stay in Minnesota once they begin their practice.

img0028.jpgAt the same time, I stumbled across an article from 1968 that discussed the “New Type of Doctor” that would be needed by the year 2000. The article begins by emphasizing that it is not the physician “assigned to care for passengers and crew of an interplanetary space ship” but instead it will be a “new type of medical specialist – the family practice physician.”

The 1968 program for new doctors established the Division of Family Practice and Community Health at the University of Minnesota, one of the oldest and largest in the nation. It began as a response to the national shortage of primary care physicians during the 1960s.

Forty years later, the need still exists, as is evident from the Star Tribune article, but the emphasis is now on filling the need for specific communities with what the program creators refer to as doctors with “cultural competencies.”

To read the full article from the 1968 September/October issue of mediCALL (a former publication of the University of Minnesota Health Sciences Center) click the image below.

 

 

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