Then and Now: Always Teaching
1840s - 1950s
The Board of Regents establishes a three-member medical department, known today as the University of Michigan Medical School.
The medical school opens its doors to more than 100 students. They are charged $5 a year for two years of education.
University enrollment reaches an all-time high of 1,255 students, nearly half of whom are enrolled in the medical school.
The annual session is extended from six to nine months, the first of a series of reforms that immediately places Michigan in the vanguard of medical education.
The medical school moves to a three-year curriculum, introduces laboratory instruction and assigns grades for the first time.
U-M adopts the four-year medical school program still in use today. Courses on diseases of the nervous system and “insanity” are included for the first time.
Frederick Novy begins teaching a course in microbiology and bacteriology to medical students. It was the first, full-semester laboratory bacteriology course taught in the United States. The course is still taught today by faculty from the Division of Infectious Diseases and the Department of Microbiology and Immunology.
The Michigan Difference
Johns Hopkins Medical School first opens in 1893 with eight full professors. Four have medical degrees from Michigan and two are directly from the faculty, an indication of U-M’s standing as the strongest scientific medical school in the country.
George Dock introduces the clinical clerkship at Michigan and produces a clinical teaching program that will become a model for other medical schools across the country. The breakthrough is made possible by the fact that U-M owns its own hospital. (Privately owned hospitals would not allow medical students to care for patients.)
The cornerstone of the large Medical Building (now the School of Natural Resources and Environment) is laid with great ceremony. In addition to offices and museum space, the building will contain spacious laboratories, two large amphitheaters and two recitation rooms.
Abraham Flexner’s influential study of American medical education gives high praise to the U-M Medical School, noting that its faculty are “productive scientists as well as competent teachers.”
Nellis Barnes Foster (MEND), one of the leading diabetologists in the U.S. in the early 1900s and head of the Department of Internal Medicine, writes a textbook titled “Diabetes Mellitus: Designed for the Use of Practitioners of Medicine.”
The Rackham Arthritis Research Unit is established and becomes one of the first places in the nation to provide training in the investigation of the rheumatic diseases.
To meet military demand for doctors during WWII, 66 of 78 medical schools in the U.S. and Canada, including the U-M Medical School, institute an accelerated program to graduate students in three years rather than four.
In 1950, the Cardiology Fellowship Program is launched under Franklin Davis Johnston (CVM).
The U-M Medical School pledges to the state of Michigan to do everything it can to increase “medical manpower.” The size of the entering freshman class increases 30 percent, to 204. Concurrent with a plan to build a complete medical center, the UMMS curriculum committee seeks to modernize medical instruction at Michigan by enlarging and refitting the basic science departments.
After four years of admitting first-year classes of approximately 200, total fall enrollment reaches 760, making U-M the largest medical school in the U.S. and Canada.
The Division of Allergy begins training fellows. It is the very first allergy division and training program in the United States.
The Division of Rheumatology is awarded its first NIH Training Grant — three years before it is established as a distinct clinical unit in 1960.
Robert Green (PCCM) arrives to head the pulmonary program at the VA Hospital. He promptly broadens the teaching, consulting and patient care activities. Most notable was his weekly chest conference, which was a highlight of the educational activities.
William Hubbard joins the University of Michigan as professor of internal medicine and dean of the medical school. At age 39, he was one of the youngest in the nation to hold such a position. He was the medical school’s first full-time dean — without private practice and departmental administration responsibilities. In 1969, the U-M Regents will make him the first dean to also have responsibility for directing the medical center. He helps redefine this role until resigning in 1970 to become vice president of the Upjohn Company.
1960s - 1990s
The medical school incorporates increased clinical training into the first two predominantly basic science years of medical school. An interdepartmental Introduction to Clinical Medicine and senior year sub-internships are introduced and are still part of the curriculum today.
The 30,000-square-foot Towsley Center for Continuing Medical Education and Medical Science Building II open. Med Sci II brings all medical school students and departments to the U-M Medical Center for the first time.
Jeoffrey Stross (Gen), originator of seminal contributions on the “educationally influential physician,” becomes first chief of the Division of General Medicine. Over the next 12 years, he goes on to establish the primary care training program and develops the forerunner to modern resident ambulatory care clinics.
Timothy Nostrant (GI) trains key clinical faculty members as the lead physician of the Faculty Diagnostic Unit, which serves as a national model for the development of the clinician-scholar track. He will also develop the curriculum for the GI Fellowship Program. Much of it is still used today.
A $6.1 million grant from the National Institute on Aging establishes the U-M Geriatric Research and Training Center, the first of its kind in the country, to enhance research and training in geriatrics and aging.
While teaching the clinical skills course, James Woolliscroft (Gen) introduces the concept of ambulatory-based education by having medical students interview residents at nursing homes. Once he becomes clerkship director, he moves third-year medical students out of the hospital for one month into clinics in the community. U-M becomes among the very first schools in the nation to make this a requirement for all medical students. He will work with the National Board of Medical Examiners in 1991 to create the Comprehensive Clinical Assessment for medical students. The test, based on real-patient scenarios, assesses students’ ability to make critical connections and correctly diagnose patients at the end of their third year. This assessment will become a model of clinical testing nationwide.
Chair of Human Genetics Thomas D. Gelehrter and Francis Collins (MMG) publish a textbook titled “Principles of Medical Genetics,” the first to integrate modern molecular biology and medical genetics. It becomes the definitive text in the field of medical genetics. A second edition of the book will be published with David Ginsberg (MMG) in 1998.
The NIH/NHLBI T32 Multidisciplinary Training Program in Lung Disease begins serving as an ideal vehicle to train MD and PhD scientists in the PCCM Division. It will become one of the largest and most successful post-graduate training grants focused on lung disease.
Laurence McMahon and Joel Howell (Gen) are named co-directors of the new Robert Wood Johnson Clinical Scholars Program at U-M, a program that will endure for more than 20 years producing hundreds of scholars trained in quantitative and qualitative research methods who have gone on to be national leaders in health and health care.
Ronald Koenig (MEND) becomes director of the Michigan Medical Scientist Training Program that facilitates the combined MD-PhD degree education of outstanding, dedicated students. Since its inception in 1979, the MSTP has graduated 217 fellows and includes 92 participants as of the 2015-2016 academic year.
Wendy Uhlmann (MMG) co-edits the first textbook on genetic counsel¬ing: “A Guide to Genetic Counseling”. It is currently used to train students around the world. A second edition will be published in 2009.
2000s - 2010s
Monica Lypson, James Woolliscroft (Gen) and colleagues at the U-M Medical School develop and imple¬ment the Postgraduate Orientation Assessment, an eight-station, objec¬tive-structured clinical examination for incoming residents that will become a template for residency programs across the country.
The VA Special Fellowship Program in Academic Geriatrics begins. It is administered by the VA Office of Academic Affiliations, and is offered at seven VA Geriatric Research, Education and Clinical Center sites, including Ann Arbor. Robert Hogikyan (GPM) directs the Ann Arbor site.
The U-M Medical School begins to implement a new curriculum that integrates biomedical, clinical and psychosocial sciences with clinical skills and professionalism.
The University of Michigan Training Program in Gastrointestinal Epidemiology is established to develop academic gastro-enterologists who are thoroughly trained in the design and execution of prospective clinical trials and classic epidemiologic research. It is one of only three programs funded by the NIH in the U.S. for this mission.
One of the very first clinical simulation centers shared by multiple departments opens at U-M. Every resident now logs time in the Sim Center and many practicing physicians use it to keep their skills sharp. The single-room facility will expand to a multi-room area for virtual learning at Towsley Center in 2008.
When the U-M Medical School eliminates pharmaceutical funding for all continuing medical education offerings, the Department of Internal Medicine begins coordinating and executing its own CME courses. In 2015, 11 internal medicine courses were attended by 1,417 health professionals. The department’s CME group also assisted in the creation of seven courses outside of internal medicine.
The American Medical Association launches “Accelerating Change in Medical Education.” U-M is one of 11 medical schools chosen to receive funding to transform its curriculum. Rajesh Mangrulkar (Gen), the associate dean for medical student education, is the principal investigator on the grant and spearheads the initiative. The new curriculum is planned, designed and implemented through a phased approach that will extend from 2013 to 2018.
The Department of Internal Medicine Residency Program initiates a primary care track to help meet the growing need for primary care physicians. Funded by the U-M Hospital, these two new resident positions focus on expanded exposure to ambulatory care rotations and interactions with primary care mentors.
Dean James Woolliscroft (Gen) receives the 2014 Abraham Flexner Award for Distinguished Service to Medical Education, the most prestigious honor given by the Association of American Medical Colleges and an accomplishment achieved by no prior dean of the medical school.
An ambitious interprofessional education initiative is launched at U-M to transform the way faculty teach more than 4,000 health professions students. It includes a new course, Team-Based Clinical Decision Making, launched by the schools of dentistry, medicine, nursing and social work and the College of Pharmacy. It is the first course of its kind at U-M and one of the largest in the country.
The renovated Taubman Health Sciences Library opens. It is designed to support key elements of the medical school’s new curriculum: collaborative, active learning and interprofessional education.
The Institute for Healthcare Policy & Research Clinician Scholars Program launches to train scholars to lead policy-relevant research and catalyze partnerships to improve health and healthcare. The program fills the gap left after the Robert Wood Johnson Foundation ended its Clinical Scholars Program for physicians in 2014. The new program is directed by Rodney Hayward (Gen), who previously directed the RWJF Clinical Scholars Program.
Sources: Department of Internal Medicine division histories, division chief and faculty interviews and the
U-M Medical School historical timeline.