Background

BACKGROUND INFORMATION ABOUT THE SCHOOL

a. Insert a copy of the school’s current entry in the AAMC Directory of American Medical Education.        

b. Indicate on a separate page any changes in administrative positions or personnel that have taken place since the directory was published.

The following changes in administrative positions have taken place:

Medical Genetics is no longer a Division of Medicine

c. Provide a brief history of the school, indicating key points in the school’s historical development.

THE UNIVERSITY           

     Johns Hopkins was a Quaker merchant of Baltimore who bequeathed $7,000,000 for the establishment of a university and hospital. The University was incorporated in 1867 under the terms of his bequest, and instruction began in 1876, three years after his death.
     Daniel Coit Gilman, a graduate of Yale in the class of 1852 and president of the University of California, was elected first president of The Johns Hopkins University. It was a most propitious choice. In his inaugural address in 1876, Gilman elaborated his philosophy of education, in terms both prophetic and practical, which was to become the guiding principle of the University. Students should be free to select under guidance their courses of study; professors should be free of routine; investigators should be “free, competent, and willing” research and teaching should supplement one another.
     “The object of the University,” said Gilman, “is to develop character-to make men. It misses artisans, or cunning sophists, or pretentious practitioners. Its purport is not so much to impart knowledge to the pupils, as to whet the appetite, exhibit methods, develop powers, strengthen judgment, and invigorate the intellectual and moral forces. It should prepare for the service of society a class of students who will be wise, thoughtful, progressive guides in whatever department of work or thought they may be engaged.”
     During President Gilman’s twenty-five years of enlightened leadership, his high hopes came to full fruition. It was in this environment of the first true university in America that the School of Medicine was evolved.

THE SCHOOL OF MEDICINE

     The School of Medicine was opened in 1893, seventeen years after the University’s founding. Part of this delay was occasioned by the desire to have a fully equipped hospital before students were accepted. The Johns Hopkins Hospital was completed in 1889, and from the outset its destiny has been inextricably woven with that of the School of Medicine. This policy was established in a letter from Mr. Hopkins to the first trustees of the Hospital: “In all your arrangements in relation to this hospital,” he wrote, “you will bear constantly in mind that it is my wish and purpose that the institution shall ultimately form a part of the Medical School of that university for which I have made ample provision by my will”. Unfortunately, what was ample in 1867 was no longer so twenty years later. The final establishment of the School was made possible by the generosity of a number of Baltimore women, of whom Miss Mary E. Garrett was the principal donor.
     President Gilman took steps to lay the educational foundation of the School of Medicine soon after his investiture. He was duly concerned with the lack of fundamental knowledge of biology, chemistry, physics, and modern languages in students undertaking the study of medicine. He therefore organized a “preliminary medical course” in the Faculty of Philosophy, setting a standard which ultimately became a prerequisite for admission to many medical schools in the United States. His action influenced Miss Garrett to make her grant to the School contingent on its admitting only students whose preparation had been equivalent of the Hopkins preliminary medical course. This was a great departure from the accepted requirements for admission.
     Although it occasioned disappointment at the time, the delay in opening the School of Medicine was a blessing in disguise, for it allowed time to assemble an excellent faculty. The first appointments, made in 1884, were those of Professors H. Newell Martin, Ira Remsen, Johns Shaw Billings, and William H. Welch. Assisted by William T. Councilman, Welch began to organize courses in pathology and bacteriology for practicing physicians. He also assembled a group of young men, among them Mall, Flexner, Nuttall, and Abbott, with whom he carried out fundamental research which reflected great credit on the Hospital and University. Thus, the principles of postgraduate medical education and research were established even before the School was officially in existence.
    In 1888 William Osler was called from the University of Pennsylvania to be Physician-In-Chief to the Hospital and Professor of the Theory and Practice of Medicine in the University. The following year William S. Halsted and Howard A. Kelly were summoned to the chairs of Surgery and Gynecology and Obstetrics, respectively. Also called from many parts of the country to serve on the faculty when the school opened in 1893 were Henry M. Hurd, Superintendent of the Johns Hopkins Hospital and subsequently Professor of Psychiatry, Franklin P. Mall, Professor of Anatomy, John J. Abel, Professor of Pharmacology, and William H. Howell, Professor of Physiology. William H. Welch served as Professor of Pathology and Dean of the Medical Faculty.
    The opening of The Johns Hopkins University School of Medicine marked a new departure in medical education in America because it was the first time that all professors in the preclinical branches served on a full-time or university basis. The chairs of Anatomy, Physiology, Pharmacology, and Pathology in the School were from the outset true university chairs, filled by men who gave their “entire time and strength” to the University, to use Gilman’s words. Available to their respective departments were funds, all too meager, making it possible for the professors and their assistants to carry out research in fields of their own choice. Thereafter, medical schools all over the country would follow the lead, and medical education, instead of being largely a proprietary business conducted for profit, would become a major concern of university endeavor.
    The clinical as well as the preclinical departments of the School continued to prosper in the succeeding years. Osler contributed to the development in America of exact diagnosis, with the assistance of the laboratory, and of detailed description of disease. He also laid the foundations for intern and residency training in American hospitals. Halted and his colleagues developed I the laboratories and clinics a new approach to surgery based on meticulous operative technique. He also, with Welch, championed the system of full-time clinical departments. The General Education Board’s establishment, in 1913, of The William H. Welch Endowment for Clinical Education and Research made it possible for the responsible instructors in Medicine, Surgery, Pediatrics, and Obstetrics to devote their entire time to their university duties. The endowments of the Henry Phipps Psychiatric Clinic and the William Holland Wilmer Ophthalmological Institute accomplished the same ends for the Departments of Psychiatry and Ophthalmology. Each of the clinical departments of the School is now staffed by men and women who devote their entire time to teaching, hospital practice, and research, as well as by practicing physicians who perform these duties on a part-time basis.
    The organization of the preclinical and clinical departments as full-time university faculties was an innovation that has been accepted by many American medical schools. Of comparable significance, perhaps, was the development of the graduate school concept in medical education. Students in their clinical years at the Johns Hopkins School of Medicine became an integral part of the staff of the Hospital, learning largely by actual participation in patient care rather than by attendance at lectures. They were also encouraged to participate in research activities in the laboratories and clinics under the supervision of members of the faculty. Graduates of the School introduced the Hopkins practices elsewhere when called to fill posts at other institutions.