The Plight of Three Medical Schools

As Harvard embarks on a multi-million dollar fund raising drive to modernize the College and ready it for the future, it is obvious that much publicity will be given to the needs and ambitions of the College. While the drive is certainly necessary, it unfortunately runs the risk of obscuring important and equally urgent needs which lie elsewhere in the University.

On the other side of Boston, for example, Harvard's three medical schools are faced with educational and physical problems of the first magnitude. Their needs and hopes--unlike those of the college and the more proximate graduate schools--are seldom considered by the undergraduate unless he happens to have medical aspirations.

Yet these three schools are now facing the same problems of educational and physical change which confront the rest of the University.

Essentially, there is little difference between one Harvard graduate school and another. Each one tries to maintain the highest possible standards of exellence and to give each one of its students the best possible training in its specialty. Consequently, any hindrance to the achievement of these goals must be regarded as the most serious and basic problem a school can face.

It is this type of problem which confronts the School of Public Health today.

The excellence of any school depends directly on the quality of its professors, and a school which wishes to improve itself attempts to bring the best available men onto its faculty. Tenure appointments, which assure a man of a continuing academic position, are the means normally used by a school to give its best men the security which will attach them firmly to the school and to their teaching and research in the school. However, due to lack of funds the School of Public Health is at present unable to offer new leaders in the field anything more than short term professional appointment. This condition leads to an unstable faculty which is extremely unhealthy for the academic life of the school. Since the minimum cost of a tenure appointment is set by the University at $400,000, this is indeed a difficult problem with which to deal. Dean John C. Snyder of the Public Health School estimates that $2.5 million would be the minimum amount with which "we could stabilize the school and proceed on a sound basis."

"Bricks and Mortar"

The second type of problem which an institution must face is of a physical nature. It is probably true that "bricks and mortar" can never solve completely the difficulties of an educational institution, but there is no doubt that the graduate schools face serious physical inadequacies.

All three of the University's medical schools are involved in the worst way with the consequences of the growth and development of the past few decades. It is indeed regrettable that an institution cannot build once and be done with it. One might even settle for being able to build and feel that needs had been taken care of for just one decade. However, the general rule appears to be that you build and need to build again as soon as you move into your new buildings.

Perennial Problems

The Medical School has been plagued by this problem ever since its birth in 1782 in the basement of Harvard Hall. From that era up to the present day the School's history has been one of constant moving from one building to the next. In 1883, the School moved to 688 Boylston Street which "was expected to be the home for medicine for generations." Seventeen years later, it was ready to move to its present location just off Huntington Avenue.

When it finally did enter its present location in 1906, all problems seemed to be at an end. With five enormous granite buildings and the clinical resources of Boston's hospitals nearby,, there seemed no doubt that the Medical School had stopped growing.

This was partly true, for the days of moving from building to building were definitely over. But the School was quick to grow within its new structure over the next fifty years. The student body increased by 80 percent. New methods changed the techniques of medicine beyond many expert's wildest dreams, and these methods brought about a need for new types of equipment and special types of buildings. Most of all, time took its inevitable toll on the buildings.

Today there is a tremendous need for constant temperature rooms, special dark rooms, animal houses, refrigeration rooms, laboratory space, and renovations dictated by fifty year's wear and tear on the physical plant. The most convenient way to achieve many of these new requirements appears to be by the costly process of mezzanining (putting a floor between the already existing floors and ceilings).

Expensive Needs

But this is an enormously expensive project. Such an operation was made on several floors in Building D in the years 1952 to 1956 with funds from the Joseph A. DeLamar Bequest of 1919, made available by special vote of the Corporation. The total cost of these renovations came to $1.1 million and they did not begin to deal adequately with the problem of the School's need for additional space. Even if adequate space had been created, the need for new wiring and plumbing throughout the entire system of buildings is indeed a pressing one, and one which will involve a large expenditure of money.

Inadequate Library

There is also great call for several additional buildings in the School's physical set-up to remedy two of its most acute problems. Firstly, the existing Medical School library, housed in the main administration building, is woefully inadequate as it stands today. It is jammed to the bursting point. Many of the books which belong in it must be housed in Widener, and many others, periodicals and other similar publications, are stored away in boxes where they are virtually inaccessable. The School's administration also hopes that if a new library is built it will be a research library, rather than a purely "book library" as it is now.

Above the present library is the Warren Museum which also suffers from the same overcrowding seen in the library. The museum is designed to provide exhibit cases for the display of many of the instruments and techniques discussed in class. As it stands now the cases are heaped to overflowing with a mass of instruments. Lighting facilities are very poor, and the skylights have been blackened so that very little daylight can enter. If this museum were renovated, it could better serve its purpose of giving students an historical and visual perspective of the field which they are studying.

Another important construction need is for new animal quarters. The last such building, completed in 1945, was out-grown the day the animals moved in, and with the large-scale utilization of animals in medicine today, adequate housing for the School's animals becomes more important than ever.

Public Health Wants

The problem of inadequate facilities extends from the Medical School into the School of Public Health, where the problem is probably more acute than any place else at Harvard. Various divisions of the School are temporarily boarded outside the School because of a lack of space. Although the previously mentioned problem of faculty salaries is given priority over all other considerations, Dean Snyder does not deemphasize the School's physical requirements.

"The classrooms, laboratories and offices of the school are crowded and inadequate. It has been necessary to put several activities of the Faculty and Staff in buildings not owned by the School: for example, space is rented from the Peter Bent Brigham Hospital for cancer control and statistical offices; the department of Industrial Hygiene conducts its air cleaning research for the Atomic Energy Commission in rented quarters several blocks from the school; the Department of Tropical Public Health occupies space in the Medical School; and the Department of Sanitary Engineering is located in the Division of Engineering and Applied Sciences in Cambridge."

To remedy this acute problem, the School has proposed a new wing to be constructed adjacent to the main building at 55 Shattuck Street. It would have seven floors and would, hopefully, provide the necessary housing for the School's various activities. However, the construction, equipping and maintenance of such a building would cost approximately four million dollars, a sum not easily come by, especially in such a small graduate school (the School of Public Health has only about 160 students).

Expansion

It is important to remember that these plans make no mention of the third main problem: expansion. The School merely wants to make a home for what it has at the present time. It is content to remain small and train a small corps of "experts," but to do this job in the best possible manner the School needs to have the proper facilities, in which they are sadly deficient at the present time.

Although the problem of increased enrollment is not present in the School of Public Health, it is a major question in the Dental School, and, as a result, in the Medical School. The average graduating class in the Dental School comprises only about thirteen or fourteen men, and according to Dean Roy O. Greep this figure is too small: "The School must look forward to an increase in its graduate enrollment at some time in the future." Dean Greep feels that the Harvard system of dental instruction--in which the oral diseases are looked at not from a purely dental standpoint, but from the consideration of their relation to the entire human organism has proved its worth beyond all doubt and that the Dental School could increase its present enrollment without lowering the existing high standards of instruction.

However, the present arrangement is such a compact student-faculty unit that any increase in enrollment, however small it might be, would be very expensive. Because of this, Dean Greep explained that when the School did expand it would do so "all at once." He guessed that the enrollment would increase along the order of magnitude of "two times its present enrollment."

Integrated Problems

Since the dental students study in the Medical School for their first two years, any Dental School expansion would have to be integrated with the Medical School's plan. Dean Greep feels, however, that there is "a greater need for increasing the amount of dentists than of doctors" and that the need for dentists is "becoming acute." But there is obviously a serious block then to the expansion of the Dental School: the fact that there is no room at the present time in the Medical School for any more students in the first two years.

Expansion for the Dental School would therefore imply, in addition to added staff and equipment, new construction to accommodate the needs of an appreciably larger amount of students. This might possibly correspond to an increase in Medical School enrollment, but at the present time the Medical School is more concerned with bringing itself up to date than with expansion, so it would appear that growth in the Dental School will not take place in the near future.

One aspect of the Dental School's planning for the future shows every sign of coming into realization over the next five or six years. A new program of post-graduate study, designed to produce a small group of clinical scholars, has been set up in collaboration with the Mass. General Hospital, the Children's Medical Center and the Forsyth Dental Infirmary. Many of them will be heading for higher academic posts in education and will become the leading researchers in the field of dentistry.

Housing Troubles

At the present time, one man has embarked upon a course of post-graduate study, and Dean Greep hopes to see this figure rise gradually over the next few years to about ten. These men will work with a professor who is engaged in some area of research fundamental to dentistry, will work in the School's teaching program, and will handle advanced clinical cases within general dentistry of a specialized field thereof.

The last problem which the graduate schools must cope with is that of housing for its students, and in many ways this is the most significant one with which they must concern themselves. The Dental School is largely free from the housing problem because of its very small size, but the Medical School and the School of Public Health are very much entangled in its many different aspects.

The School of Public Health has about one-third of its students which come each year from foreign countries. Since there is no school dormitory of any sort these people must look for apartments in the neighborhood of the School. These students form their impression of the United5Old man and dentist-to-be in the Dental School clinic. The School's facilities are perfect for its present enrollment, but it hopes to expand.