A Century of Medical Training

June 11, 1993

The medical school as we know it today was born a century ago this year in Baltimore. Like the hospital it is inextricably intertwined with, the Johns Hopkins University School of Medicine set the pattern for the subsequent development of medicine in this country and to a considerable extent throughout the developed world. It is still a pioneer, producing doctors who are at the forefront of medical research. Other medical schools produce a higher proportion of doctors whom people rely on most of their lives -- the general practitioners and family physicians -- but Hopkins graduates develop the treatments the others employ.

Like so much else at Homewood and at the intersection of Broadway and Monument street, the Hopkins medical school is a monument to the vision of the Baltimore merchant Johns Hopkins. On his death he left $7 million (the equivalent today of $181 million) to establish a university and a hospital that he wanted eventually to become part of the university's medical school. As the school's retired dean, Dr. Thomas Turner, recalled in a talk at yesterday's anniversary celebration, that didn't quite happen. They are administratively separate but it is hard to think of one without the other.

Before establishment of the Hopkins medical school, as noted yesterday by Sun medical reporter Jonathan Bor, doctors were trained in classrooms, listening to lectures and reading texts. Hopkins moved them into the hospital, to learn that real people have diseases and that the doctor-patient relationship is an important factor in care. Remarkable for that time, the first 18 students included three women. If that was due more to the insistence of a woman benefactor than it was to early enlightenment, it still opened a door for some of the school's most distinguished graduates.

Among the Hopkins' innovations a century ago that are now commonplace in medical education are the residency system for the further training of graduates, a full-time faculty (a notion that Dr. Turner said is under some pressure now), continuing education for doctors already in practice and a tradition of public service. Not to mention that some of the Baltimore area's finest cultural events -- musical as well as verbal -- are sponsored by the Hopkins medical community.

The practice of medicine today, training for it and the staggering growth of federally financed medical research have rendered the field unrecognizable even to its most visionary pioneers 100 years ago. But the essential foundation has changed remarkably little. The Hopkins medical school is still dedicated to graduating leaders in the profession and they are still taught by practicing doctors on real patients in one of the world's foremost hospitals -- a "heritage of excellence" that should endure for centuries to come.

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