A Persistent Vision

Notes on the Origin of Medical Education in the Pacific Northwest

Willamette University – A Valiant Endeavor

The origin of formal medical education in Oregon was the establishment of the medical department of the Willamette University in 1865. After an aborted attempt at establishing the Oregon Medical College in Portland, the first real endeavor at professional medical education began on March 3, 1867 at the University in Salem with three graduates in medicine. But from the beginning, trouble was palpable. Discord among the faculty of the new school was formidable, but proved not to be without resolution. In spite of the stops and starts and despite the initial adversity, as evidenced by the more than 150 years of continued success of medical education in the Pacific Northwest, due diligence moved obstacles and set a precedent of perseverance. It was just such doggedness that has distinguished the pioneering spirit that was essential in the men and women who ventured to establish standardized medical education and practice in the territories of the Pacific Northwest.

As the story goes, the faculty of the newly formed Willamette University Medical Department were constantly fighting against the Board of Trustees and against one another and were better known to some, as a “…cadre of renegades”. It was well known that there was a lack of qualified physicians in the region with sufficient experience or education to man the newly formed medical department. So it was that every man “with a diploma or who declared he was a graduate of some medical college” found himself on the faculty. Some of those elected to the faculty not only lacked credentials but none had prior experience as faculty of any medical institution. “… A spirit of jealousy and bitterness could hardly be suppressed.” A few examples can illustrate the spirit of the times.

Dr. Joseph Henry Wythe proved to be an exception to the other men of the faculty of the new department of medicine. Dr. Wythe became the president of Willamette University in 1865 and it was due mostly to his efforts that the medical department was established. It might have seemed that his experience as a professor of physiology, pathology and microbiology at the Philadelphia Medical College, from which he graduated in 1850, and his military service as a surgeon during the Civil War, would warrant his candidacy for the professorship of surgery of the new medical department, but it was not to be so.

Dr. Horace Carpenter, a good, well-thought of and conceivably well-intentioned army surgeon, settled in Salem in 1865 and also played a prominent role in the effort to establish the medical department. He became the first dean of Willamette University Medical Department in Salem and was the self-appointed professor of civil and military surgery and chair of the department of surgery, while Dr. Wythe became professor of physiology and hygiene. Of Dr. Carpenter’s nine years of service at the school, he spent seven years as dean.

It was clear to all that the facilities and funds were meager and experience was lacking at the very young school but all had joined together in the effort to establish it as a first class institution of learning; but it was only after a few months that petty jealousies rose to quash what camaraderie had existed and nearly resulted in the termination of the infant department. The aforementioned controversy over the chair of surgery seemed to be its nemesis. At one time “all the members of the faculty…agreed to request the professor of surgery [Carpenter] to resign or meet charges of gross incompetence and want of knowledge of his profession.” The entire faculty reorganized under a new Dean, J. W. McAfee, and Dr. Carpenter was reinstated as chair of surgery.

In this milieu, Wythe came under attack by the faculty and was expelled, presumably because he wanted the medical department more closely tied to the university. He demanded that the written proceedings of his expulsion be delivered to the secretary of the Board of Trustees but dean McAfee denied this appeal stating that the actions of the faculty were final. Wythe eventually left Salem for Portland and severed his ties with the university. The deanship changed hands numerous times thereafter and Dr. Carpenter continued to be assigned interim dean.

Reorganization of the faculty of the medical department was the one persistent invariable. When Dr. Carpenter finally resigned in 1876, the Board demanded that “the books, papers and other effects of the Medical Department” be returned to the University. But not surprisingly, Dr. Carpenter refused to surrender the documents. A chasm among the faculty had opened so wide that it swallowed what little trace of history that might have been left to us.

In spite of the controversies among the faculty, the school continued in operation; the year Dr. Carpenter resigned, there were twenty three matriculates. It was a decision of the faculty to remove the department to Portland in 1878, where there was a larger population and better opportunities for clinical instruction at the St. Vincent and Good Samaritan Hospitals. But in 1895, the University returned the medical school once again to Salem. Raising standards at the school was continually pursued but the attempts failed to meet the growing regional and national standards and the result was the schools merger with the newly formed University of Oregon Medical School in 1913.

By this time, it was no longer acceptable to apprentice oneself to a self-made or East Coast preceptor; licensure and the establishment of a State Board of Medical Examiners, the State Medical Society and a Board of Health had surely helped to weed out the “hucksters” boasting expertise. A report from the committee on medical education of the State Society in 1879 reads, “...the right to be called Doctor is possessed only by those who have that degree legally conferred upon them… If we would be respected, we must respect ourselves.”

Though there were other endeavors at providing medical education throughout the region, such as the 1885 provision for a department of medicine at the University of Washington, the medical department of the Blue Mountain University in LaGrande (1874), the Washington Biochemic Medical College in North Yakima (1892), which moved to Spokane under the name Northwestern College of Biochemisty, and the College of Medicine at the University of Spokane Falls (1890), none came to full fruition nor did any endure.

University of Oregon Medical Department – A Bright Future

When the University of Oregon Medical School was founded in Portland in 1887, it could be partly attributed to a “serious schism” that had risen once again over the reogranization of the faculty at WUMD; the result being the resignation of the entire faculty at a meeting of the Board of Trustees: There occurred a “…protracted and acrimonious discussion during which much personal bitterness was manifested…” A group of physicians, including those who resigned, organized the new school under a charter from the Board of Regents of the University of Oregon. Dr. Simeon Josephi was elected first dean. The first structure to house the new school was a small two-room building on donated land belonging to Good Samaritan Hospital. Thus began a short rivalry between WUMD and the newly formed University of Oregon Medical School. By 1893, a new and proud building was erected at 23rd and Lovejoy. Facilities to meet the needs of medical students, along with advances in educational standards and opportunities ensued.

The obstacles were difficult, but not impossible to overcome and the vision of a world class medical school in Oregon, once born, was never left to die. By 1913, UOMS amiably absorbed the Medical Department of Willamette University and UOMS became the only school north of San Francisco and west of Denver to offer a full medical course. In that same year the alumni association was organized.

East of Portland, medical education was also advancing; In particular, Harvard, in the 1870’s, was told “clean house or close up shop”, so it was motivated to reach towards higher standards; Johns Hopkins, since its founding in 1893, pioneered advances in medical education.

The 1887 UOMS announcement lists the requirements for matriculation as “a satisfactory evidence of knowledge of the common English branches, including reading, writing, spelling, grammar, geography, arithmetic, etc.” The students were required to attend “two full courses of lectures and at least one course of practical anatomy and clinical instruction. The course was to “embrace two years” with lessons in microscopy, histology and physiology. When the school adopted the standards of the Association of American Medical College in 1898, the course was lengthened to four years and the school established a grading system. Knowledge of Latin and physics became requirements for admission with laboratory sessions added to the course of required classes.

By 1905, the American Medical Association began an investigation into the state of medical schools across the country. These investigations, which included UOMS and WUMD, resulted in criticisms that led to attacks upon the school by the local press. The Abraham Flexner report on Medical Education in the United States, caused schools all across the nation to close, but UOMS received an A listing while the weaker WUMD fell to the C list.

The first full time faculty, Dr. David N. Roberg, was appointed in 1910. By the school year 1912-1913, six salaried instructors joined the staff providing the required number to maintain the schools’ A rating with the American Medical Association. Funds were needed from the Regents of the University as well as from legislative appropriations to provide for the minimum number of salaried professors and for updated equipment and facilities. The school needed assurance of secure financial support to enable them to comply with the new standards in education.

New standards required more hospital and clinical instruction. In 1909 arrangements were made for the students to use the Multnomah County Hospital for instruction. An affiliation with the People’s Institute and Portland Free Dispensary that began in 1910 expanded so that by 1913, attendance was mandatory and provided college credit. Attendance at clinical lectures, given at Good Samaritan and St. Vincent Hospitals, and four clinical lectures at the college, were also compulsory.

“At the close of 1912 the foundation had been laid, and medical instruction in the Northwest was established on a permanent basis. So we may say of medical education in the Pacific Northwest … we have no real reason to either boast or to be ashamed of what has been accomplished. We have but recently furnished with the means necessary to carry on medical instruction in an adequate manner, and for us indeed it is better have a future than a past.”

The Exhibit

The exhibit consists of materials held in the Historical Collections & Archives of the Oregon Health & Science University. On display are handwritten class, lecture and clinical notes dated from as early as 1880 from Harvard Medical School, Willamette University Medical Department, Cincinnati Medical College and the University of Oregon Medical School. Included are notes and study cards on courses given in chemistry, dermatology, obstetrics, medicine, surgery, psychiatry, pharmacology materia medica, obstetrics, otolaryngology, surgery: bone fractures, diseases and their treatments: venereal disease, diseases of the joints, diseases of the veins and arteries and general public health issues.

Also exhibited is a portion of the First Class Collection: A collection of monographs developed from a list of the textbooks used by students in the first session of the University of Oregon Medical School (1887-1888). The collection includes the then-current edition of Gray’s Anatomy. Also on display are various diplomas, certificates and licenses dating from as early as 1863.

Content and design: Karen Peterson & Scott Jeffs, Designer, OHSU Photography & Graphic Design, with the assistance of Ian Terrell, Archive Assistant.