||COLUMBIAS MEDICAL SCHOOL WAS ALREADY A VENERABLE institution when, at age 161, it joined with Presbyterian Hospital to form what has become one of the most respected and well-known medical centers in the world.
The history of the College of Physicians & Surgeons is complex. Columbias medical school dates back to 1767 when 13-year-old Columbia University then Kings College formed a medical faculty. Some historians, mostly those with Columbia loyalties, call Columbias medical school the nations first. What is now the University of Pennsylvania started offering a few medical lectures in 1765, giving Penn the chronological bragging rights to the first title. (Columbia supporters argue that the courses did not constitute a full faculty.) Columbia claims rights to granting the first M.D. degree in the Colonies, in 1770. From there the history gets murky. Kings College closed during the Revolutionary War and reopened in 1784 as Columbia College. It struggled for years to reestablish its medical school and successfully reorganized a medical faculty only when the state legislature moved to establish another school. Columbias medical school struggled, though, and a rival private school, the College of Physicians & Surgeons, opened in 1807. Samuel Bard, who became dean of the reorganized Columbia medical school in 1791, became president of P&S in 1811. P&S absorbed the Columbia medical faculty in 1813, and the New York state legislature approved the merger in 1814. P&S operated as an independent medical school until it formed a nominal connection with Columbia in 1860 and became a part of Columbia officially in 1891 as the College of Physicians & Surgeons of Columbia University.
Much of P&S history at CPMC is reflected in this issues descriptions of people, events, and contributions. Below are summaries of the legacies of the deans who led the medical school in the 75 years since CPMC opened and the dean who laid the groundwork for the medical center.
The Lambert Legacy
Samuel W. Lamberts deanship ended before Columbia-Presbyterian opened in 1928 but he was instrumental in the development of the alliance that paved the way for the medical center.
Dr. Lambert, an 1885 graduate of P&S, had been associated with Columbia since 1891. He and other progressive P&S colleagues called the Young Turks held radical views on medical education. When he became dean in 1904, he required students to fulfill terms of daily service in hospital wards, an expanded use of hospitals for medical education. The need for clinical instruction exceeded the number of opportunities available, and he recognized the importance of a close and permanent affiliation with a general hospital.
Dr. Lamberts predecessor as dean, Dr. James McLane, became president of Roosevelt Hospital after his deanship, but a rift between Dr. McLane and Dr. Lambert and a rift between Dr. McLane and Columbia President Nicholas Butler prevented Columbia from expanding its clinical program through Roosevelt Hospital. This was despite efforts of prominent Columbia trustees, Roosevelt Hospital trustees, and medical staff members who favored the affiliation.
One of those Roosevelt trustees was Edward S. Harkness, who resigned from the Roosevelt board and joined the Presbyterian Hospital trustees. At the same time, Columbia approached St. Lukes and Presbyterian hospitals to discuss affiliation. Mr. Harkness offered to build a new surgical pavilion and laboratory and provide money to support the affiliation. Presbyterian accepted Columbias offer, but it took another 10 years of planning to select a site, incorporate other partners interested in joining the medical center, and construct the facilities.
The agreement P&S and Presbyterian reached in 1911 underwent revision and almost ended without completion of a medical center. Negotiations broke off several times. Columbia considered combining its medical school with Cornells and the combination of New York and Presbyterian hospitals was discussed. After World War I, the site of the medical center at 168th Street and Broadway was selected. William Darrach, who became dean in 1919, wrote a Memorandum on the School of Medicine almost immediately after taking office as dean. This memorandum, which became the basis for the revised agreement between P&S and Presbyterian in 1921, emphasizes the three themes of teaching, research, and patient care as the proper business of the medical school for which a complete geographic and functional union with the university hospital and full-time clinical departments were necessary.
Dr. Darrach had been dean of P&S for only two years at the CPMC location when he resigned but his efforts provided the foundation for the medical center. He is credited with smoothing the transition of P&S as an isolated academic institution to a partner in a new and complex venture with far-reaching implications for medical education and patient care.
Willard C. Rappleye
Dean and Vice President, 1930-1958
The longest-serving dean of P&S during the medical centers history was, by far, Willard Rappleye. Dr. Rappleye, a Harvard medical graduate, rose through the ranks of medical school administration by teaching and holding positions at the University of California, Yale, and Harvard. He was 38 years old when he was named dean of P&S. His 28 years as dean marked a time of growth and progress in education, medical practice, hospital administration, and research. He was a national leader in academic medicine.
Because his deanship was so long, his accomplishments are many. He studied the idea of national voluntary prepaid health insurance, was involved in the development of residencies and fellowships for specialty training, created new departments, and developed a post-M.D. degree called the doctor of medical science (M.S.D.) degree. He also organized a program of student aid.
Under Dr. Rappleye, medical education came to be viewed as a lifelong endeavor of continuing education instead of the time-limited pursuit of all medical knowledge.
During World War II, Dr. Rappleye was part of the national planning for the training and distribution of physicians and he served as an adviser to the Selective Service. Accelerated schedules began, and P&S admitted students every nine months instead of annually. P&S graduated two classes of physicians in 1943, one in March and one in December.
As Dr. Rappleye recruited top-notch scientists and department chairs, the caliber of Columbias medical research enterprise soared. P&S developed into a world-renowned center for biochemical research, announcing one breakthrough after another in nuclear medicine, cardiovascular research, virology, and immunology. During his time as dean, Dickinson Richards23 and André Cournand won the Nobel Prize in 1956 for their body of work in cardiac catheterization.
H. Houston Merritt
Dean and Vice President, 1958-1970
After serving as acting dean from 1958 to 1959, H. Houston Merritt became dean of the Faculty of Medicine. He rose to the position from inside the school, where he had been professor and chairman of neurology and director of neurological services at the Neurological Institute since 1948.
He earned international acclaim for research in anticonvulsant therapy, which produced, among other things, the use of Dilantin for treatment of epilepsy. Under his leadership, the Neurological Institute became a renowned center for neuroradiology and for pioneering treatment of a number of disorders first described there. He wrote A Textbook of Neurology, published in 1955, which remains one of the fields leading textbooks. The 10th edition of the textbook, now called Merritts Neurology, was published in 2000.
Dr. Merritt was instrumental in creating the Parkinsons Disease Foundation in 1957, which moved to the new William Black Research Building when it opened in 1965.
Paul A. Marks
Dean and Vice President, 1970-1973
A 1949 P&S graduate who completed housestaff training and a fellowship at Columbia-Presbyterian, Dr. Paul Marks returned to P&S in 1955 as instructor in medicine and researcher of mechanisms of protein synthesis in cells. He was professor and chairman of the Department of Human Genetics and Development when he was named dean of the Faculty of Medicine and vice president in charge of medical affairs, all while continuing his productive research career.
He is credited with reorganizing the administrative structure to create a modern team of professionally trained personnel. His efforts to expand external support for teaching and research made P&S one of the largest private academic centers for biomedical research in the country. He is remembered for extensively recruiting P&S scientists and teachers.
In 1973, Dr. Marks gave up the deans title when the deanship and vice presidency were separated. Dr. Marks continued as vice president for health sciences, a new position. He also became director of the Cancer Research Center, which he and other faculty members organized in 1972. The cancer center became a prestigious National Cancer Institute-designated comprehensive cancer center shortly after its creation and has developed into todays influential Herbert Irving Comprehensive Cancer Center.
Donald F. Tapley
While Paul Marks continued as vice president for health sciences, Don Tapley became acting dean and a nationwide search began for a dean. A year later, Dr. Tapley was named to the position. A professor of medicine, he had been on the P&S faculty since 1956.
His first research paper was published while he was in his second year of medical school at the University of Chicago. Further scholarship and his academic record earned him an internship and residency at CPMC with Dr. Robert Loeb. His work with Dr. Loeb and other distinguished teachers gave him an appreciation for teaching that he took into his 15 years as director of the medical clerkship program and that translated later into his priorities as dean of P&S. As associate dean for faculty affairs from 1970 to 1973, he worked closely with Dr. Marks to emphasize the importance of teaching by encouraging and rewarding outstanding teaching ability.
He would want to be remembered for maintaining standards of excellence for P&S, partly by recruiting many of todays faculty, center directors, and department chairs. He established guidelines for academic excellence and became the authority on criteria for promotion. He also introduced titles and procedures that allowed non-physicians to receive appointments in clinical departments. He also maintained excellence by ushering in a new era of fund raising and setting the precedent for the dean to be the medical schools chief fund-raiser. During Dr. Tapleys tenure as dean, the P&S endowment grew from $78 million to more than $160 million, and federal funding for research doubled. His fund-raising role continued after he left the deans position.
When he died at CPMC of cardiac arrest in December 1999, he was serving as Alumni Professor of Medicine and senior deputy vice president for the Health Sciences.
Henrik H. Bendixen
Vice President and Dean, 1984-1989
The vice presidency and deanship came together again when Henrik Bendixen became dean of the Faculty of Medicine and vice president for health sciences in 1984. A faculty member since 1973, he was professor and chairman of anesthesiology before moving into the deans office.
As vice president and dean, he brought P&S and the rest of the Health Sciences into the information age, supporting the creation of the Center for Medical Informatics (now a P&S department) and establishing the computer infrastructure that has evolved into a ubiquitous educational, clinical, research, and administrative resource. He is also credited with saving the School of Nursing and developing the Robert Wood Johnson curriculum reform proposal at P&S. The curriculum proposal best demonstrates his pioneering commitment to the information resources relied upon so heavily today. He insisted that the 10 or so groups working on the proposal transmit text to him via the campus computer network. When that request proved too ambitious, he lowered his expectations and accepted diskettes instead.
Vice President and Dean, 1989-1999
Herbert Pardes joined the P&S faculty in 1984 as professor and chairman of psychiatry (and director of the New York State Psychiatric Insti-tute) after serving as director of the National Institute of Mental Health at the NIH. He was a national figure in psychiatry and mental health administration who became a national figure in academic medicine while serving as vice president and dean.
He accomplished major changes in the education of physicians, enhanced clinical and basic science research, and assumed a national role as an advocate for education, health care reimbursement reform, and support of biomedical research. During his tenure, the first buildings in the Audubon Biomedical Science and Technology Park opened at Columbia-Presbyterian.
Like Dr. Tapley, Dr. Pardes was a gifted and tireless fund-raiser. He was especially successful in attracting private funding for mental health research. Endowment and research resources nearly tripled, and he exceeded his goal of endowing 100 chairs for the Health Sciences and pushing the endowment toward $1 billion.
He initiated a $300 million capital refurbishment program, recruited leadership in almost every department, and gained for the Health Sciences Division more autonomy within Columbia University. Income from clinical trials and intellectual property soared under his leadership.
On Jan. 1, 2000, he became president and CEO of New York-Presbyterian Hospital, the new hospital created by the merger of Presbyterian Hospital and New York Hospital on Dec. 31, 1997.
||Thomas Q. Morris and David Hirsh
Interim Deans, 2000-2001
For the first time, P&S had two individuals sharing the responsibilities of acting dean. Two long-time faculty members, Tom Morris and David Hirsh, served as interim deans from early 2000 to early 2001.
Tom Morris58, Alumni Professor of Clinical Medicine and a member of the deans office since 1994 (top photo), served as interim dean for clinical and educational affairs. David Hirsh, the Robert Wood Johnson Jr. Professor and Chairman of Biochemistry and Molecular Biophysics, was interim dean for research.
Dr. Hirsh and Dr. Morris worked together to maintain momentum while Columbia conducted a nationwide search for a successor to Herb Pardes. When Eric Kandel won the 2000 Nobel Prize, Drs. Hirsh and Morris led the campus and university celebrations of the first Nobel given to an active P&S faculty member since 1956.
Gerald D. Fischbach
Executive Vice President and Dean, 2001
The legacy of the deanship of Gerald Fischbach is still being scripted. Dr. Fischbach was director of the NIHs National Institute of Neurological Disorders and Stroke when he was approached for the job of vice president and dean. Dr. Fischbach joined Columbia in February 2001, becoming the first person recruited from outside Columbia to be dean since Willard Rappleye was recruited from Harvard in 1930. The title of dean expanded; Dr. Fischbachs full title now is executive vice president for health and biomedical sciences, dean of the Faculty of Health Sciences, and dean of the Faculty of Medicine.
Soon after moving into the deans office, Dr. Fischbach launched a far-reaching strategic planning process that resulted in a plan unveiled in October 2002 that will allow the Health Sciences to manage change, set priorities, and strive for excellence in all arenas. The process included an evaluation of existing space and a search for new, more flexible space that will allow expansion, driven by academic imperatives outlined in the strategic plan.
Some of the strategic plans suggestions have been implemented. Others are long-range goals. Still others require resources that Columbia hopes to raise in a capital campaign. The plan covers all missions of Columbia Health Sciences and the Columbia-Presbyterian Medical Center: education, research, patient care, and community service. The planning process, which involved more than 300 members of the Health Sciences and medical center community, provided an opportunity for Columbia Health Sciences not only to identify needs and contemplate solutions, but also to reaffirm the strengths of the medical center.
Dr. Fischbach, like deans before him, emphasizes the value of teaching. He announced at the 2003 P&S commencement the creation of an academy of teaching named for Glenda Garvey69, recipient of the 2003 Teacher of the Year award and a multiple-year winner of the honor.
Dr. Fischbach also has strengthened the already strong neurological sciences through recruitment of faculty and development of interdisciplinary centers. Columbias New York Science, Technology, and Academic Research Integrated Imaging Center, funded by New York state, is a centerpiece of the expanding interdisciplinary movement in the neurosciences.