One Year At A Time
Even before the University of Kansas had a physical presence, the theoretical underpinnings of the KU School of Medicine were already in place. The legislation that formally chartered the University, signed into law by Governor Thomas Carney on March 1, 1864, contained a provision authorizing the creation of a “Medical Department.”
This was a bold undertaking for a frontier state that had formally entered the Union just three years earlier. Practically though, it was more a conceptual marker than an actual milestone. Without any dedicated funds to develop a medical education program – and none were forthcoming from the Kansas legislature – it was simply an idea whose time had not yet come.
In truth, the fledgling state university was hardly ready to establish a Department of Medicine during these early years. As KU historian Clifford Griffin has observed, when the University opened its doors for the first time in September 1866, “not one” of the original 55 students even had “an adequate secondary education.” The University, in short, was more akin to a high school in the mid-1860s, and the budding young scholars had far more use for the remedial Preparatory Department than they ever would have had for a course of medical study.
To its credit, the KU Board of Regents fully understood the new University’s limitations. Others were perhaps a bit less informed. For example, in 1866, KU’s first year of actual operation, members of the Leavenworth Medical Society petitioned the Board to seek a $5,000 legislative appropriation “for the purchase of apparatus, fixtures and rent of [a] building” that would house a KU Department of Medicine – to be established, incidentally, in the city of Leavenworth. The request was denied. As the Regents explained to the Leavenworth worthies, forming “any department … other than that of the Literary” so soon would be “premature, inexpedient, and fatal to the first great object of a State University.”
The year 1869, however, saw some rumblings of movement toward formal medical education. The University’s enrollment had just about tripled in three years and a new chancellor, General John Fraser, seemed determined to revisit the medical department issue. At his urging, the Board of Regents voted to establish not only a Department of Medicine “as soon as practicable,” but also a Department of Law. The Kansas legislature, on the other hand, remained skeptical. The word came down from Topeka that no new money would be appropriated for the University.
At this time, the entirety of KU was housed in a small three-story building known as North College. Fraser recognized the student body was outgrowing the structure, and when the legislature balked at funding new construction, Fraser and the Regents turned to the citizens of Lawrence.
They asked the townspeople to approve a $100,000 bond issue to pay for the erection of three new KU buildings, one of which would house the proposed Department of Medicine. The measure passed but, in the end, all of this money was used to build only one new structure – the grand edifice now remembered as “old” Fraser Hall. The hoped-for, stand-alone medical education building and with it, the new KU Department of Medicine, remained on the drawing board.
That’s where it stayed for the remainder of the 1870s. Indifference from a parsimonious state legislature was part of the reason. But there were also practical concerns about staffing and outfitting costs, as well as the paucity of clinical medical facilities in Lawrence. In combination, these issues kept medical education at KU in the idea stage for more than a decade.
Typical of the negative reaction to opening a KU Medical Department on Mount Oread came from Leavenworth physician Dr. Cornelius A. Logan. “It would be a great outrage to locate the Med. Dept. in a little town like Lawrence with no hospital facilities for teaching, either present or prospective,” he complained in 1870. A Leavenworth partisan, Logan insisted a medical program could “only succeed” in his hometown, and he railed against planting a “little fourth rate medical school in a little fourth rate Yankee town.”
None of these matters escaped the attention of KU Chancellor James Marvin, Fraser’s successor as the University’s chief executive. Marvin, an avid amateur horticulturalist and the progenitor and namesake of present-day Marvin Grove, certainly must have been familiar with the old adage about great oak trees beginning with little acorns, and he proceeded to act accordingly.
While recognizing KU’s unsuitability for a full-fledged medical curriculum, he nonetheless sought to introduce some kind of program that would befit, in size and scope, the capabilities KU then possessed. This goal became all the more paramount in 1878 following the successful establishment of KU’s Law Department, nine years after Chancellor Fraser had initially recommended it.
To this end, Marvin proposed creating an introductory (or preparatory) course of medical study – a one-year program in which aspiring physicians could enroll, gain basic but valuable scientific knowledge, and then go on to complete their training elsewhere. “Let the University for the present be content with laying well the foundations,” Marvin told the Board of Regents in 1880, “though others may exult in setting the cap-stones.”
At this point in American history, a three-year medical education program was the national standard, and would remain so until the early 1890s. But for KU to venture beyond offering a single year’s instruction, the chancellor insisted, would do its students no good, and actually might well do them – and their future patients – a good deal of harm.
“To attempt to furnish this finishing part of a physician’s education in a rural district, however complete the outfit of manikins and skeletons,” Marvin cautioned the Regents, “is to trifle with the dearest interests of civilized life.” Referring to the prevalence of medical quacks in Kansas, he reminded the Board that “the results of such charlatanry are seen in the awkward empiricism which fills our cemeteries with the prematurely dead.” Marvin was determined that KU not add to their numbers.
Thus, under these general guidelines, members of the KU faculty met on March 25, 1880, to discuss the propriety of setting up a medical program on Mount Oread. “Moved and passed,” their unanimous resolution stated, “that the Board of Regents be requested to establish a one-year course of study to be called ‘Preparatory Medical Course.’” Much thought apparently went into the organization of the proposed course, for members also included a detailed listing of all the classes students would take during their two semesters.
The first 20-week term would consist of lectures, recitations and laboratory practice in chemistry, a class on human physiology, and one on comparative anatomy, which included dissecting work. In the second 20-week term, students would delve into zoology, physiological chemistry, toxicology and “materia medica,” in which they would become familiar with “100 or more of the most common drugs.”
While this curriculum may have seemed impressive at first glance, there was less here than met the eye. The arrangement included no new courses. Instead, this preparatory medical program was simply stitched together from classes already being taught individually at KU. It was, in short, an exercise in re-packaging.
Despite this – or perhaps because of it – the KU Board of Regents was impressed enough at its April 8, 1880, meeting to report favorably on the faculty’s medical course proposal and vote for its adoption. A likely factor in this positive response was the fact that this “new” program would not generate any new expenses, as it was merely a re-jiggered combination of existing classes. Indeed, it offered KU the opportunity for revenue enhancement since the Board chose to assess a $25 annual fee on any student who enrolled in the Preparatory Medical Course.
Once approved, the University moved quickly to organize its new medical curriculum. And by the time fall semester classes began five months later on September 8, 1880, six aspiring physicians – out of a total KU student enrollment of 512 – had signed up for the preparatory course. While they may have constituted barely one percent of the student body, perhaps a more interesting statistic is that one-third of these original medical students were women. Kate Ross and Mabel Wemple joined George Washington Goss, Jay Irving Sweezy, George Artimus Starkey and Oliver David Walker in this first defined program of medical education at the University of Kansas.
After their solo year on Mount Oread, however, they faced limited options. According to the University’s 1880 course catalogue, preparatory medical coursework at KU would be accepted “as the first year of a three years course” by only two institutions -- Ohio Medical College in Cincinnati and Rush Medical College in Chicago. This meant that, upon graduation, KU’s budding medical students would be “admitted to the second year in those colleges on the certificate of the Faculty of this institution.” Just three years later, though, KU’s jerry-built preparatory medical program had apparently been deemed sufficiently rigorous to warrant far greater recognition. The 1883 KU catalogue, for instance, stated that “the course was accepted by all leading medical colleges of the West.”
On campus and among the aspiring doctors, too, growth and interest were on the rise. The year 1884 saw the establishment of a student medical society with a seemingly thriving body of extracurricular activities. Since there was still not a licensed physician among the KU faculty, this society sought out a local Lawrence practitioner named Dr. Punton and recruited him as an informal advisor. As it turned out, he was much more than that.
According to the University Courier, the doctor had “kindly consented to hold quiz classes every week, and occasionally lecture them on some subject of interest…” This level of community support, coupled with the medical students’ great enthusiasm, proved – at least in the Courier’s estimation – that a “more thorough and complete course in medicine should be established in the University.”
(As KU historian Robert Taft has recounted, though, the students once almost enthused themselves right out of business. Upon receiving their petition “to secure a [human] cadaver for dissection,” KU faculty members were “so horrified” that they threatened to abolish the nascent society. Only the adventurous natural science professor Francis Huntington Snow, one of KU’s original three faculty members, perceived the inner precociousness in this outwardly ghoulish request.)
In the years that followed, KU’s preparatory medical course began to win its share of professional admirers. The culmination of this advance came in 1888 when the Kansas State Medical Association requested a sit-down with KU Chancellor Joshua Lippincott to discuss the prospects for the program’s expansion. Upon conferring with these representatives, however, Lippincott reiterated many of the previous objections, chiefly the continued lack of clinical facilities in Lawrence.
He also aggressively fought the idea of locating any portion of the program outside of Lawrence in larger Kansas cities like Topeka or Leavenworth. “To divide it,” the chancellor insisted in a report to the Board of Regents, “establishing one department in one place and another in another, is to weaken it, and to enormously increase the cost of its maintenance. Every true friend of the University of Kansas will resolutely oppose any measure looking to such dismemberment.”
This statement did not mean Lippincott inherently opposed expansion of any kind. He just wanted it to proceed on his terms, which – as he saw them – were also in the best interests of KU, medical students, and Kansas residents. As he admonished the Regents, the “demand is not for more physicians, but for a more thorough preparation of those who seek to enter the profession.” To this end, Lippincott suggested increasing KU’s preparatory medical course from a one-year program to a two-year course of study. This proposal was never acted upon during his administration, but another seed had been planted.
In 1890, Francis Huntington Snow became KU’s fifth chancellor. An individual who in many ways had spent the previous quarter-century preparing for the job, Snow was an energetic and forward-thinking man of science. He also had some new ideas pertaining to the now 10-year-old preparatory medical course. Early in his tenure he recommended establishing a full three-year medical (as well as dental) course of study, complete with clinical training in Lawrence.
Such an ambitious plan naturally would require a sizable appropriation from the legislature, but Snow believed that, with enough patients, the expense eventually could be justified. He based this assessment on a visit he had recently made to the University of Michigan’s flourishing medical school in Ann Arbor. Situated no further from Detroit than Lawrence was from Kansas City, the Michigan facility treated up to 1,500 patients a year. Snow was certain, at least initially, that a similar success could be repeated in Kansas.
As the years passed, however, it seems Snow began to reconsider his insistence on retaining all KU medical education in Lawrence. By mid-1894 he began warming to the old idea of splitting the program between Lawrence and Topeka, or perhaps even Kansas City.
If KU was to advance to a three-year medical course, students could spend their third year learning essential clinical skills at hospitals in one of these cities; and if, as was becoming the national norm, KU opted for a four-year program, the final two years could be spent outside of Lawrence.
Snow’s willingness to embrace a campus with multiple locations did not sway the Regents. The Board, echoing former Chancellor Lippincott, continued to oppose dividing medical education between Lawrence and another city, and refused to approach state legislators with Snow’s proposals.
But Snow’s hopes and dreams received a boost in August 1894 when he learned of a “stupendous windfall,” as Griffin put it, that had landed on KU’s doorstep. A Kansas City physician and real estate developer named Simeon Bishop Bell announced his intention to give the University as much as $50,000 in cash, plus parcels of Wyandotte County land he owned in Rosedale (later incorporated into Kansas City, Kansas). KU was free to sell these properties – estimated to be worth some $25,000 – and with the proceeds build and fully equip its own hospital, plus attendant structures. The only condition tied to his gift was that the new hospital had to be built on another piece of Rosedale property also owned by Bell, known as “Goat Hill.”
To Snow, it seemed the stars were finally aligning. Under these terms, KU could expand its current one-year preparatory course into a two-year curriculum, which would still be taught in Lawrence. Following that, an additional two-year clinical program, complete with the most up-to-date training facilities, could be established in Rosedale.
And as long as the Kansas Legislature provided an annual allotment of $10,000 – an amount, in the chancellor’s judgment, that would suffice to maintain the institution on a “creditable basis” – KU would at last boast a real medical school. Once again, though, circumstances intervened to halt the University’s progress.
Although an appropriation bill to this effect passed the Kansas State Senate, a diverse group of objectors combined to engineer its demise in the House. Many Topekans wanted the medical school located in the state capital. Other critics complained the “Goat Hill” land in Rosedale was inaccessible and of poor quality. And a consortium of Kansas doctors charged that the proposed school and hospital – virtually on the border of Kansas City, Missouri – would become little more than an “asylum for harboring the paupers of Missouri … at the expense of the whole people of Kansas.” The anti-Rosedale coalition succeeded in derailing the plan, leaving the KU Regents and faculty “frustrated and disappointed,” noted Griffin.
Eventually, Dr. Bell’s offer would be accepted. But for the time being, its rejection represented a major setback for medical education at KU. By decade’s end, the preparatory medical course was still only a one-year affair. The promise of the program’s early success and growth had faded. Enrollments had been dwindling steadily, and comparatively few medical colleges – having become much more discriminating about accepting transfer credits – were accepting the KU coursework. The time had come either to expand the program and raise its standards or just abandon it altogether. University leaders chose the former path.
Acting on the old recommendation of Chancellor Lippincott, KU resolved in June 1899 to make the course a two-year program, adding classes in pharmacy, embryology, bacteriology, psychology and medical jurisprudence. Along with these enhancements, the University decided to leapfrog departmental status and instantly, if somewhat presumptuously, create the KU School of Medicine, even though the new school provided no clinical training and would offer only the Bachelor of Science in Medicine degree, not the MD. The University tapped Dr. Samuel Wendell Williston for the job of dean. He was a K-State grad and a Yale PhD, and had been a professor of geology and paleontology at KU since 1890.
His non-medical background notwithstanding, Williston proved an inspired choice. From the start, he excelled at his principal task, namely to kick down the doors of the various professional associations, state licensing boards and innumerable medical colleges nationwide that had all previously denied recognition of KU’s medical coursework. Navigating each one’s “peculiar and somewhat mediaeval requirements,” Williston later recalled, was certainly an arduous task, but his persistence succeeded in convincing many to reconsider. Chief among these was the influential Association of American Medical Colleges in St. Paul, Minnesota, “which had hitherto refused such recognition.”
The KU School of Medicine was still admittedly a long way from where it wanted to be by the dawn of the twentieth century, but at least now it seemed to be moving forward, not stagnating. Perhaps the most tangible indication of this new lease on life was the Medical School’s acquisition of its own campus building, made possible when the Chemistry Department relocated from Chemical Hall to Bailey Hall.
Far from luxurious, and even a bit rank, the renamed Medical Hall was nonetheless put to good use. According to Dean Williston, of the 32 students enrolled in the School’s 1899 maiden semester, 23 eventually “completed the course with credit.” Of those, nearly all went on to become “reputable practitioners of medicine.”
John H. McCool
Department of History
University of Kansas