Dartmouth Medical School - A Short History of DMS

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Two Hundred Years of Medicine at Dartmouth

By Barbara Blough and Dana Cook Grossman

In 1896, the first clinical use in the U.S. of Roentgen's brand-new x-ray technology was made by a member of the DMS faculty.

By the turn of the century, there were 150 medical schools in the United States (compared to 125 today), and Dartmouth's was considered one of the best, its graduates consistently placing in the first rank on examinations. For a hundred years Dartmouth had been a leader in the continuing effort to improve medical education. It was ironic, therefore, that soon a drive to strengthen clinical teaching would so adversely affect Dartmouth.

A national study begun in 1908 by the Carnegie Foundation looked at medical education in terms of the new emphasis on bedside teaching, which required large numbers of patients and varieties of illnesses. Concluding that the patient pool of this remote and thinly populated area was insufficient for clinical training, the Foundation's Flexner Committee recommended that Dartmouth abandon the M.D. program and merely offer preclinical instruction.

This was a bitter pill for the College and the Medical School, but the justice of the Committee's criticism could not be denied and, on April 26, 1913, the Trustees voted that "the clinical years of the course in Medicine be suspended for the present" and that resources be concentrated "upon the first two years of the course, which may be elected by undergraduates of the College." The wording (emphasis added) clearly indi-cated the College's desire to eventually reinstate the M.D. program and its commitment to a continuing relation-ship between the medical and the under-graduate programs.

The Class of 1914 was the last to receive the M.D. degree; subsequent students, upon finishing the two-year program in the medical sciences, transferred for the two clinical years to other schools, pri-marily Harvard, Cornell, Penn, and a few others. Dartmouth Medical School had entered a new phase with its reputa-tion for excellence intact and the intense loyalty of its students preserved.

As the clinical faculty gradually left, the Hospital began to have difficulty recruiting well-trained physicians and specialists because it was unable to offer positions with academic appoint-ments. In 1927, Dr. John Bowler arrived from the Mayo Clinic to become dean of the Medical School and moved quickly to remedy this problem. He and four colleagues formed the Hitchcock Clinic, a group practice arrangement then rela-tively new; it soon reversed the Hospital's talent drain and raised the quality of medical care for the entire region.

John Bowler, a 1917 graduate of DMS, in 1927 founded the Hitchcock Clinic, one of the country's early multispecialty group practices.

Dr. Bowler, in addition to directing the Clinic, remained as dean until 1945, when he was succeeded by Dr. Rolf Syvertsen, a 1923 graduate of DMS. "Dr. Sy," as he was known to students and townspeople alike, concentrated all his attention on his 48 students, whom he had known as Dartmouth premedical advisees and had personally chosen for admittance to DMS. He was a stern but affectionate surrogate parent to his "boys," and alumni from his era still tell humorous and reverential "Sy stories." Dr. Syvertsen died in an automobile acci-dent in 1960, just as the Medical School was confronting another challenge.

Since 1914, through two world wars and the Depression, the Medical School had had a superb record for the caliber of its two-year program, with graduates consistently distinguishing themselves at their transfer schools. But changes were again taking place in medical education, putting the School at yet another crossroads.

Since the end of World War II, medical education had slowly but inexorably reflected increasing emphasis on research. Dartmouth had come in for criticism because the faculty was small and had little interest in research and because the student body came almost entirely from Dartmouth College. These com-plaints eventually led the Association of American Medical Colleges and the Council on Medical Education to place the School on "confidential probation" in 1956. Once again, the Trustees were faced with a major decision.

Actually, the College, recognizing the handwriting on the wall, had already begun to make plans for revitalizing the Medical School and now restated its commitment to medical education and to securing new capital for expansion of DMS's faculty, facilities, and programs. In 1956, the Trustees authorized the "refounding" of DMS and invited Dr. S. Marsh Tenney, a 1944 graduate of the Medical School and a physiologist renowned for his research on human adaptation to high altitudes, to take on that herculean but overwhelmingly successful effort.

The refounding was celebrated in 1960 with a three-day symposium on which this year's bicentennial symposium was modeled. The 1960 event, whose hon-orary chair was René Dubos, brought to Hanover a slate of speakers that included Sir Charles (C.P.) Snow, Aldous Huxley, Sir George Pickering, and Brock Chisholm.

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