Chapter XVI. 1st and 2nd Annual Sessions Medical Dept, University of the Pacific 1859 - 1860
Opening Ceremony Medical Department, University of the Pacific
At eight o'clock on the evening of Thursday May the 5th a large and intelligent concourse of persons convened to witness the ceremony attendant on the formal opening of the Medical Department of the University of the Pacific. At a little after the hour the Board of Trustees and Faculty of Medicine entered and took seats on either side of the stage. The exercises were opened with prayer after which the Honorable George Barstow, Professor of Medical Jurisprudence, delivered a Salutory Address to the Board of Trustees of which the following are the fervent introductory passages:  
My colleagues have confided to me, on this occasion, the agreeable duty of giving formal expression of our thanks to you, that in this great state, so recently called into existence by the power of the American people in their triumphant progress, you have seen fit to establish an institution of learning.
We thank you that in this, the chief city of that new world which American enterprise has built upon the shore of the Pacific ocean, at once a witness and a monument to the irresistible energy of Freedom - that here in San Francisco you have, with wise forethought, established the Medical Department of the University of the Pacific.
The President of the Board, Reverend Briggs, was unable to attend the Ceremony and the responsibility to deliver a response to Professor Barstow's eloquent salutation fell at the last moment upon the Reverend Jesse T. Peck. He rose to the occasion with an impromptu peroration of which the following is the remarkably insightful passage he addressed directly to the Faculty of the Medical Department: 
But, gentlemen, to you belongs not merely the credit of maturing and bringing forward the plan, but also that of making the sacrifices and performing the labor of its inauguration; and I need not tell you that these sacrifices and exertions must be of no ordinary kind. No institution can raise and gain an elevated rank without a struggle. Every truly great idea must battle for its place amid the selfish ambition and the fierce antagonisms of this frenzied age; and no one of us here can claim the prophetic gift in so high a degree as to venture to indicate the conflict you are destined to pass in the development of your favorite scheme. We doubt not you will maintain your position with becoming energy and with high professional ability; and I have no hesitancy in pledging to you, on the part of the Board, a firm and hearty cooperation. Other similar institutions will doubtless arise, each fulfilling its peculiar claims to the public consideration and patronage; but as the Medical Department of the University of the Pacific will inevitably be the oldest school of medicine and surgery on the Pacific Coast, let us resolve that it shall be the best.
Now Professor Barstow returned to the podium to deliver an eloquent and wide ranging Introductory Address dealing with the intellectual and moral obligations of the physician, and the importance of education to the future of the nation. The reporter from the Alta California who covered the proceedings described his discourse as a masterly effort that throughout its delivery riveted the attention of the audience.
The Reverend Mr. Cutler, a clergyman not associated with the University of the Pacific, gave the final address of the evening. Speaking for the community at large he welcomed the inauguration of the Medical Department as adding another force to the great cause of education and mental culture on the Pacific coast where "a new society has come into being and is in the process of crystalization." 
All honor, then, to the zeal and enterprise of those men who have founded this Department of the University of the Pacific. It should bear the name of Cooper, written on its very front. By its success and stability as an institution for the promotion of surgery and medicine - the first established on the Pacific ocean - it will carry down to posterity the names of Cooper, and Morison, and Rowell, and Cole, and Carman, and Barstow; names already honorably associated with learning, ability and skill in their professions; and the deep satisfaction will be theirs, of here planting a seed, the leaf of whose tree shall be for the physical healing of this and generations to come.
We shall leave the last commentary on this memorable occasion to the reporter from Alta California who wrote: 
Thus was duly inaugurated the first Medical College on the shores of the Pacific. May it go forth "with healing on its wings," and be the means not only of alleviating the distresses of suffering humanity at home, but elevating and improving the character of our educational institutions abroad.
First Annual Session of the Medical Department
May to September 1859
Twelve students  were matriculated during the First Session, a respectable beginning for a pioneer medical school on the educational frontier of the country. The question of finding a room for the lectures and of constructing a medical school building had already been discussed in Faculty meetings, reflecting the desire of the Professors to establish the School's independence from any individual's practice or facilities. At the outset, no other suitable accommodations having been secured by the Room Committee, lecture sessions were held in the top story of Cooper's Infirmary. Dean Cole felt that these modest, rent-free quarters were beneath the dignity of the first and only medical school on the Pacific coast and continued to urge the renting of a separate and more conspicuous site. In fact, for a time, he paid the rent out of his own pocket for a part of Union Hall, but it was not many months before classes were moved back to the top floor of the Infirmary. There they remained until three years later when other arrangements were finally made.  
The Lecture Plan for the year was worked out at a Faculty Meeting on 2 April 1859. According to later commentary by Cooper, the Professors were most conscientious in the performance of their duties and rarely if ever missed a class. Cooper himself carried a heavy teaching load with a one-hour lecture at three p. m. on Monday, Tuesday, Thursday and Friday, and a two-hour clinical session on Wednesday and Saturday at two o'clock. As mentioned, students in American medical schools often requested a professor to permit them to publish a lecture which pleased them. Also, Introductory and Valedictory Lectures were commonly published by the school. Under the circumstances we are surprised to find that none of Cooper's lectures were ever published.
Early in the First Session of the Medical Department, Dean Cole journeyed to Santa Clara and made a progress report to the Board of Trustees of the University. According to the following excerpt from the Minutes, the Board took the occasion of his visit to establish the procedure for awarding the M. D. degree: 
Santa Clara, 7 June 859
Dr. R. Beverly Cole was invited to take a seat with the Board and at their request made an interesting statement of the condition and prospects of the Medical Department. Dr. Peck then offered the following resolution and preamble which were adopted;
First - That upon the recommendation from the Faculty of the Medical Department certifying the proper qualifications in character and acquirements, this board will issue its mandamus for the graduation of candidates to the degree of Doctor of Medicine; and the same order shall be observed in conferring the Honorary title of Doctor of Medicine.
Resolved second - That the Diplomas of graduates in this Department shall be signed by the President of the University and Professors of the Medical Department and sealed with the Medical seal of the University.
From the standpoint of the internal affairs of the Medical Department, the first Annual Session went very smoothly. Two of the twelve matriculated students had previously taken a full course of lectures elsewhere and were therefore awarded the M. D. degree at the close of the Session on 13 September 1859. These two graduates, the first to receive the M. D. degree west of the Mississippi Valley, were:
- Alfred Atkinson
- Charles E. A. Hertel.
The Board of Trustees were gratified by the performance of the new Department, as briefly recorded in the Minutes of 13 September 1859: 
The Medical Department has just closed its first session under auspicious circumstances. The Faculty matriculated thirteen students of whom two received the degree of M. D. The Department appears to be in a flourishing condition.
Petition for Access to the San Francisco City and Count Hospital
We have already pointed out the need for a medical school to have access to a sizeable, well-managed hospital for clinical teaching. The forward-looking Cooper was, of course, eager to make such an arrangement as soon as possible and to that end submitted the following petition to the San Francisco Board of Supervisors early in 1860: 
Date: (Early 1860)
To the Board of Supervisors, City and County of San Francisco:
We the undersigned members of the Faculty of the Medical Department of the University of the Pacific, having established in this city the above institution as a permanent College of Medicine and Surgery, are desirous of throwing around it all those aids which are the bulwarks of medical education everywhere, and among which clinical teaching occupies the first place. We would therefore respectfully represent to your Honorable Board that you have it in your power to do much towards encouraging and furthering the interests of this College without any expense or inconvenience to the Commonwealth which you represent, but on the other hand the high estimation in which we hold clinical advantages to students of a Medical College are such as to induce us to make a proposition to you at once advantageous to yourselves and constituents as property holders and citizens.
We propose as follows: that our faculty (who are practitioners as well as teachers) will give all the necessary attention as visiting physicians and surgeons to the City and County Hospital free of charge provided we can have the privilege of delivering clinical lectures to the pupils of our Medical College in the Hospital. This, as your intelligence and experience must enable you to know, is almost universally done in large cities in which there are Charity Hospitals and Colleges of Medicine.
We will further propose and agree to appoint two of our most competent graduates of each year as resident physicians and surgeons and will hold ourselves individually and collectively responsible for the faithful performance of the duties of the same at a salary each of five hundred dollars per annum with board and lodging in the Hospital.
In making this proposition as may readily be seen, we have no pecuniary advantages to gain, our sole motive being the advancement of our College of which the honor as well as our own reputations are hereby pledged for the faithful discharge of our duties to the sick poor if our proposition be accepted. Besides the acceptance of this proposition would save the City and County of San Francisco the sum of thirty-eight hundred dollars a year.
With this guarantee in favor of the patients of the Hospital, associated with the fact that the interests of the whole community will be subserved in the acceptance of our proposition, we trust that your Honorable Board will not hesitate to take a step so well calculated to promote the cause of medical education on this coast as well as to save the expenditure of a large amount of money each year to the City and County you represent. The latter consideration is rendered the more worthy of mention when it is remembered that the City and County of San Francisco have constantly to support an immense number of indigent sick from all parts of the State while none of their paupers are supported by other counties.
The change which is hereby proposed by us is by no means new, but is exactly similar to that which has long been adopted by the Board of "Ten Governors" of New York City in the management of Bellevue Hospital and those of Blackwell's and Randall's Islands, as well as by the Commissioners of Emigration of the State of New York in the Hospitals which are under their control. Experience has there long since indicated that propriety of this system as by far the most economical, whilst at the same time, there is secured by it every attention to the unfortunate poor who are compelled to resort to such institutions.
E. S. Cooper, M. D.
and other undersigned Faculty)
In the above letter Cooper made a persuasive case for converting the City and County institution into a Teaching Hospital by delegating responsibility for medical care to the Faculty of the Medical Department of the University of the Pacific. Cooper's proposition also included the establishment of a rudimentary graduate training program by the assignment of two graduates each year to the Hospital Staff as Residents to serve under the supervision of the Faculty. However, as is usually the case in public hospitals, local physicians were already serving in salaried positions as Hospital Staff, and the Board of Supervisors were reluctant to replace them. We shall later see how Cooper decided to cope with the political realities of this situation.