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Psychology in a Medical School: a Personal Account of a Department's 35-Year History

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Psychology in a Medical School: a Personal Account of a Department's 35-Year History PSYCHOLOGY IN A MEDICAL SCHOOL: A PERSONAL ACCOUNT OF A DEPARTMENT'S 35-YEAR HISTORY JOSEPH D. MATARAZZO Oregon Health SciencesUniversity In 1911John Broadus Watson and ShepardIvory Franz proposed that the teachingof psychologywas as essentialto the education of medical students as were anatomy, pharmacology, surgery, and the other basic and clinical sciences.Today, our country's 126medical schoolseach employ an average of some 35 full-time faculty psychologists; 6 have establishedfull-fledged departmentsof psychologythat are comparable(administratively) to depart- ments that include faculty from the more traditional basic and clinical sciences.Thirty-five years ago (in 1957)the University of Oregon Medical School was the first medical school to create a department of Medical Psychology. The present writer was hired that year to chair that newly establisheddepartment and has servedcontinuously in that capacity since then. This Presidential Address to the AP A Division of the History of Psychologyoffers the writer's personalperspective on the history and develop- ment of that department during its first 35 years of existence. OREGON'S MEDICAL COLLEGE In 1842, 17 years before Oregon achieved statehood, Willamette University was founded in the Oregon Territories in a small frontier town (Salem) with a population of about 1,200by JasonLee, a Methodist minister. Historical recordscompiled by Larsell (1947) and Wilson (1967, 1974) record that two decadeslater (February of 1865), at the request of the Governor of Oregon and a subgroup of Oregon's small contingent of frontier physicians, the board of trustees of Willamette University establishedthe Oregon Territories' first medical school as the Medical Department of Willamette University. For shorthand, the department also was referred to as "The Oregon Medical College." The site selectedby Willamette for its new unit was Portland, the state'slargest town, which was located 50 miles north of Salem. Despite the planned appointment of eight men to the faculty, this fledgling medical department never could take root in Portland, and, in November of 1866,the department was relocated to its parent univer- sity in Salem. The first lectures in the department's Salem site were offered on March 3, 1867to 24 students in a physical plant typical of this country's medical schools of the era, which consistedof a lecture room, a blackboard, and an area for the dissection of a cadaver.Later that sameyear a commencementwas held for the school'sfirst three recipientsof the Doctor of Medicine (M.D.) degree.In those immediate post Civil War days, admission standardswere nonexistent in our country's medical schools. (In fact, it was only in 1883 that the number of coursesa student enrolled in this school had to complete to sit for medical examinations was increased from two to three.) This article is basedon the presidential addressdelivered to Division 26 (History of Psychology) at the meeting of the American Psychological Association, Washington, August 16, 1992. Correspondenceshould be addressedto JosephD. Matarazzo, Department of Medical Psychology,School of Medicine, Oregon Health SciencesUniversity. Portland, OR 97201. 8 Journal of Clinical Psychology, January 1994, Vol. 50, No.1 THE UNIVERSITY OF OREGON MEDICAL SCHOOL Becausethe city of Portland's population numbered about 19,000and for a host of other reasons, including friction among the small group of faculty members, after its relocation in Salem in 1866, the Board of Trustees of Willamette University moved the medical department from Salem back to Portland (1876) and, again in 1895,back to Salem. In the interim, at the instigation of the recently formed (1874)Oregon Medical Association, and after a number of schismswithin the faculty of Willamette University's Medical Department, in 1877 a second and rival medical college (which subsequently was chartered in 1890by the Regentsof the University of Oregon as the University of Oregon Medical School) was formed in Portland. Experience revealed that a frontier state could not accommodate two medical schools, and the two were merged in 1887 into a single Oregon Medical College, only to split up again a few years later. However, due to Portland's larger population from which to draw to support a medical educa- tion, better hospital facilities, a larger pool of physicians,the strong backing of the state medical society, and criticism of Willamette's medical college for its poor quality by the Association of American Medical Colleges (which earlier had accredited it), the medical school in Salem was unable to survive. In fact, as part of his decade-longtour of the country's medical schools Abraham Flexner visited both Oregon schools and, in his published report to the Carnegie Foundation (Flexner, 1910), offered a scathing criticism of the Willamette school and added that only the state medical school met the requirementsto continue offering an acceptablemedical education. As a result, in 1913 the Willamette Medical Department in Salemofficially was discontinued by the trustees of the university and concurrently merged with its Portland rival, the University of Oregon Medical School; the new unit retainedthe nameof the latter. The higher standards for all medical schools mandated by Flexner soon thereafter stimulated Oregon's state legislature to provide the newly combined, state-supported medical school with more financial resources.Concurrently, in 1914the Oregon Railway and Navigation Company donated 20 acresof land on Marquam Hill in Portland for a new site, on which a Medical ScienceBuilding was erectedin 1918.In 1920the local county electedofficials donated 9 acresof adjacent land, on which in 1923they finished construction of the Multnomah County Hospital for the University of Oregon Medical School to usein its teaching pro- grams. Then, in 1926the United StatesGovernment deeded25 adjacent acresand built a veterans hospital to serve as the medical school's second teaching hospital. The full-time faculty of the University of Oregon Medical School remained few in number during the whole of the first half of the twentieth century. Nevertheless,a few critical positions were filled after the publication of Flexner'sevaluation. Specifically, during 1914-1921a full-time faculty member was recruited to provide instruction in and serveas head of formally establisheddepartments of anatomy, physiological chemistry, pathology, physiology, bacteriology, and materia medicaand pharmacology.In common with most of this country's medical schools of the era, during the years 1910-1945the small full-time faculty of the University of Oregon Medical School consisted almost exclusivelyof individuals who weremembers of thesejust-cited basicscience departments. One exception was Edwin Osgood, M.D., who was hired in 1926to teach biochemistry, laboratory diagnosis, and medicine and who, in 1941, was made the head of the newly created Division of Experimental Medicine. (Osgood shortly thereafter gained inter- national eminencefor his researchon chromosomesand the study of leukemia.) In fact, as documentedby Larsell (1947),in 1943thefu/l-time faculty of the University of Oregon Medical School numbered only 14 and was made up primarily of chairmen (plus one additional faculty member) of basic sciencedepartments. In 1943those chairmen were E. F. Allen, Ph.D. (Anatomy); W. F. Youmans, M.D., Ph.D. (Physiology); Edward S. West, Ph.D. (Biochemistry); Norman David, M.D. (Pharmacology); Warren C. Hunter, M.D. (Pathology); and Harry Sears, Ph.D. (Bacteriology). The rest of thp A Medical Psychology Department 9 faculty consistedof volunteer physiciansfrom the community, who took time from their practicesto provide instruction in medicine,surgery, and the other clinical coursesoffered in the third and fourth years of the medical school curriculum. However, thesestaffing patterns would change during the Second World War as Oregon's and this country's other medical collegesbegan a processof building and self-renewalthat would continue unabated for the next half-century and transform our nation's medical schools' basic scienceand clinical departments, plus their associatedand medical care services,into the best in the world. THE ESTABLISHMENT OF FULL-TIME CLINICAL DEPARTMENTS With a minusculefull-time faculty, just before mid-century the University of Oregon Medical School hired its first full-time clinical department heads. These were Adolph Weinzirl, M.D., in public health and preventivemedicine (in 1942);Kenneth Swan, M.D., in ophthalmology (in 1945);and Kenneth W. Livingston, M.D., in surgery (1947). Ad- ditionally, Howard Stearns,M.D., was hired as the part-time salariedhead for obstetrics and gynecology(in 1945).Much earlier, Laurence Selling, M.D., one of Portland's emi- nent local practitioners, had been installed as a volunteer clinical professor and chair- man of the school'sDepartment of Medicine as well as headof the Division of Neurology within that department. He servedin those volunteer teaching roles from 1928to 1946. In 1946 Howard Lewis, M.D., recently discharged from the Army, acceptedthe full-time appointment as associateprofessor of medicine offered to him by David W. E. Baird, M.D. The latter had beeninstalled as the school's fourth dean in 1943,a year in which, as indicated above, the full-time faculty of the school consisted of only 14 members. In 1947Lewis was promoted to professor and chairman of the Department of Medicine. As one of his first official actions, Lewis affiliated with his new department
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