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Dean Wilbur's Report to the Trustees on Union with UC [27]

In 1910 there was considerable discussion between the authorities of the two universities as to a possible union of the Medical Departments. A conference was held between the Trustees, the Regents and the University Presidents at which the problem was discussed. Following this conference, a tentative proposition was presented by Stanford to the University of California for consideration. It apparently did not meet favorable reception on the part of the University of California and nothing further was heard of it officially until recently.

The Carnegie Foundation and others interested in Medical Education have urged, at various times, the apparent desirability of the two Universities combining their Medical Schools into one. In October, 1913, the wisdom of such a plan was orally suggested by the Dean of the University of California to the Dean of the Stanford Medical School. Following this conversation, a proposition was presented by me for discussion and consideration. No answer was made to these suggestions until March, 1914. The President of Stanford University had urged in December that an effort be made to bring the Medical Schools together. Committees were appointed by the Board of Trustees and by the Regents of the University of California These committees have the general principles of the subject still under discussion. The points, which are up for decision at present, can best be indicated by quoting from a letter written to the Dean of the University of California Medical School on March 11 1914 as follows: (Emphasis added.)

It would, I think, facilitate definite action of some sort in regard to the possible union of the Medical Schools of our two Universities to ask for prompt consideration by the authorities of both institutions of the following points:

1. Is it desirable that the Universities should unite their resources in Medicine into one large Medical School under common management rather than continue the support and development of two good schools?

2. If the first is settled in the affirmative, would the following be an acceptable plan for the management and control of the one School?

A.. -- The administration to be in the hands of a Board of Managers of nine members constituted as follows:

  • Two regents
  • Two trustees
  • The Presidents of the two Universities
  • Three members chosen by the above

B. -- A Dean, the best available man regardless of locality, to be selected by the Board of Managers.

C. -- A Faculty administration committee to be selected by the Board of Managers.

The Universities to continue their present financial support until endowments make the School independent financially.

All funds to be administered by the Board of Managers.

3. Is it desirable, if one school is decided upon, that all departments of this school be gotten together and that the courses given in Palo Alto and Berkeley which form part of the curriculum of Medicine be concentrated in San Francisco.

It would be more feasible at the present time for both Universities to give instruction leading to the degree of A. B. and covering the first year in Medicine, but an ultimate plan could include the combination of all work together in San Francisco.

If the University authorities agree to the above premises, then I think that the detailed plan submitted by me to you at a previous time should be at once carefully considered. Until the above principles are decided upon, the less time spent upon details, the better. I do not agree with you that it is necessary to call in an outside man or men to settle upon a plan provided the Universities decide that it is desirable to unite their forces in Medicine. Certainly we should not call in anyone until we have exhausted all reasonable means of bringing about a mutually satisfactory arrangement.

I will send a copy of this letter to the President of the University and to the Committee of the Trustees in the hope that it will bring about prompt and conclusive action as far as the above enumerated items are concerned.

The position taken by Stanford has been to thoroughly analyze the question of a union and to favor it, should it prove to be the proper solution financially and educationally of the Medical situation in San Francisco. The following extracts from letters written to the President, I think, illustrate the point of view of the Medical Faculty: (Emphasis added.)

The ambition of the Medical Faculty has been to develop a small medical school of high quality to do the character of work done previously by the Johns Hopkins Medical School without falling into their error of overcrowding their facilities by large classes.

Convinced that the small teaching unit is the best particularly under the Stanford scheme and of the desirability of "setting standards" so often insisted upon by Chancellor Jordan when the buildings of Cooper Medical College were remodeled, provision was made for classes of only twenty-five students each. We assume that since the State University has begun medical education that it will continue to develop it, but that it can never limit the numbers or be independent of certain political and community influences that will necessarily hamper the real progress of medical education.

It is striking in this connection that the Rockefeller Foundation, in its efforts to set certain medical standards that seem to it desirable, has recently made gifts to the medical schools of two private institutions, Johns Hopkins of Baltimore, Maryland, and Washington University of St. Louis, Missouri, instead of to the State Universities of the State in which these schools are located or the more prominent State Universities elsewhere.

I think that I express the feeling of the Medical Faculty in regard to the proposed union with the University of California in the following:

We have been willing and have proposed an association provided it would maintain our present standards and permit of growth enough to handle the necessarily enlarged classes. This would in no way reduce the responsibilities or present expenses of Stanford and would, we feel, not really advance medical education unless someone came promptly forward with four or five million dollars to endow the new medical school founded on the resources of the two now in existence. To merely crowd in more students, introduce politics and divide management would be no real advance. We wish to be convinced that we will do a real service to Medical education by giving up our present strong position and ideals. It would be far better for us to handle small classes in true Stanford fashion than to be immersed into a large institution struggling to care for large numbers of students with a meager budget.

If, with increasing endowment and hospital facilities, it becomes feasible and desirable to educate larger classes, arrangements for such purpose can readily be made without handicapping existing work or crowding existing buildings and hospitals. Stanford is at present in good position for growth, first into a complete unit for small classes and then later into additional units of like strength and size. The day of large medical classes taught for the most part by lectures is gone, and with its disappearance there has been an abrupt increase in the expense of medical education.

If the plan limiting the upper classes of Medicine to twenty-five students each is continued, Stanford can estimate about what the expenses are to be including the number of hospital beds required.

In case of a union, there are three possible plans.

1. The present Stanford site to be chosen and made the basis for the new and greatly enlarged school.

2. The Parnassus Avenue site of the University of California to serve as the nucleus.

3. Both present sites to be abandoned and land to be purchased near the new San Francisco Hospital and a complete plant to be erected there.

Plan No. 1 is the most economical as far as new construction is concerned and the best one also for the care of all classes of patients. Assuming then its selection as the site for the combined schools and that only the strictly clinical years are to be taught there, the problem is about as follows:

Stanford now has 18 students in the Sophomore class in Medicine and the University of California has 45 students. In 1914-15, the Junior class of the combined school would probably total at least 65 students. Our present facilities could be made to do double work and be used for two sections of 25 each. We would have to expect classes of 75 within a very few years. Naturally while there might be some saving of expense from the larger classes, Stanford would inevitably have to pay the half of the education of all students so that its expense would be greater than with its own classes of 25 each. No limit could readily be set to the number of medical students by the University of California while Stanford could do as Johns Hopkins has done and refuse admission beyond a certain maximum. In other words, there would be no saving to Stanford in a union but only increased responsibility and increased expense. The question then should be, is one large medical unit so desirable that Stanford should increase its responsibility and its expense along medical lines to bring it about? As indicated previously, unless a gift of $3,000,000, or more is given to the combined school it would, to maintain Stanford standards, be placed in a precarious financial position.

The principal objection to a union from the standpoint of Stanford University is based upon the financial side of the question. It is not necessary to discuss the details of the expense required for additional buildings, for the duplication of work, the increase in hospital facilities and the increase in the Instructing Staff to take care of the teaching of numerous small sections, to show that without considerable endowment, a union of the Medical Schools would be a larger burden upon Stanford University. If Stanford desired only to put in a limited amount of money, it could not demand equal representation in the management. If it did not care to go beyond a certain amount and had equal representation, it might interfere greatly with the combined Medical School.

Both Universities are so established that they could not make the sacrifice of their present sites and facilities and disturb the work given at Berkeley and on the Stanford campus without having independent funds bringing in at least $ 100,.000 to $150,000 per year available for the united schools. It is unfortunate that while the Hooper endowment may be of great service to Medicine on this Coast eventually, at present the speculative features of the endowment make it more of a liability than an asset in making financial plans for a united school.

That there would be some advantages in uniting the schools provided funds were available is apparent. Without such funds, there is certainly great advantage to Stanford remaining in its present independent position. It is probable that this question will soon be permanently settled and that some recognized expert will be asked by the University authorities to review the situation and give Stanford an opinion as to the wisest and most economical course to pursue.

***

Critical Correspondence in Regard to Union of the Medical Schools of Stanford University and University of California [28]

On 19 April 1914, the Dean of the University of California Medical School, Dr. Herbert Moffitt, asked your Dean (Dr. R. L. Wilbur) for a prompt answer upon certain phases of the proposed union of the Schools and the following correspondence ensued:

20 April 1914

Dear Dr. Moffitt:

Following your verbal request of today, I presented to the Special Committee on Medicine the proposition outlined by you. The Committee did not feel that it could give a definite answer by ten o'clock tomorrow morning, since a meeting of the Trustees had been called for Friday of this week and they would have to wait until that meeting to come to a decision. I am enclosing herewith a copy of a letter written to Mr. Hopkins, President of the Trustees, in which I am presenting your statement. If this does not meet with your approval in any particular, please communicate with me at once as I wish to have it authoritatively brought before the Trustees at this coming meeting.

Very truly Yours,

(Signed) R. L. Wilbur

20 April 1914

Mr. Timothy Hopkins, President

Board of Trustees, Stanford University

510 Nevada Bank Bldg. San Francisco

Dear Sir:

The Dean of the University of California Medical Department, Dr. Herbert C. Moffitt, asked me this morning to obtain if possible from the Medical Committee or the Special Committee of the Stanford Board of Trustees, a definite answer on the union of the Medical Schools before ten o'clock Tuesday morning, 21 April 1914. Dr. Moffitt wished to make at that time a report to the Committee of the Regents of the University of California. He wished to obtain a statement as to the attitude of the authorities of Stanford University on certain propositions concerning medical education which have been up for discussion. This was in order to bring about prompt and final action through a joint meeting of the Board of Trustees and the Regents should it seem likely that a union of the Medical Schools could be brought about.

When I informed him that Stanford was waiting until Professor Welch of Johns Hopkins could come west before making a decision, he stated that he did not see how they could keep their building and other plans in abeyance so long nor did he see how Professor Welch could contribute materially to the decision on the essential points upon which decision must be reached.

The proposition advanced, as I understand it, by the Regents through Dr. Moffitt is as follows: They consider it desirable for the two Universities to unite their interests in Medicine either upon the Parnassus Avenue site - the present site of the University of California Medical School - or in the Mission near the new San Francisco Hospital on the adjoining land now owned by the Catholic Church. This land the Archbishop is willing to sell at a reasonable figure, considerably less than $ 200,000. It is part of the plan of the University of California to construct a private pavilion, since they see the opportunity in this way of producing income for the care of teaching patients. The present site of the Stanford University Medical School will not be an acceptable site for a joint school.

If Stanford goes into a union, it will not be asked to contribute more than the amount now being spent for medical education including Physiology, Anatomy, Embryology, etc. The Regents of the University of California realize that there will have to be an increasing amount put into medical education with an increasing number of medical students, but will not ask Stanford to share it with them. The Board of Managers is to be constituted of five regents and three Trustees or upon some similar basis. Future representation will depend upon the amounts actually put in by the two institutions. With the majority of Regents upon the Board, it apparently will not be necessary to have a constitutional amendment in order to permit joint control of funds by the Regents and the Stanford Trustees. The University of California states that its present budget for Medicine is about $200,000. This includes apparently the hospital expenses and the Hooper Foundation.

I trust that you will be able to get a definite answer to this proposition at the earliest possible date. I judge though that it cannot come up before the meeting of the Board of Trustees on Friday. If I can give you any further information, please command me.

Very truly yours,

(Signed) R. L. Wilbur

San Francisco, 24 April 1914

Doctor R. L. Wilbur, Dean

Stanford Medical School

Sacramento & Webster Streets

San Francisco

Dear Doctor Wilbur:

Following your suggestion in your note of April 20th, it has seemed to me wise to amplify certain paragraphs of your communication to Mr. Hopkins. It is the earnest wish of the Committee of the Regents to bring about a union of the medical departments of the two Universities. Members of the Committee feel that such a concentration of forces would be of tremendous importance to the cause of medical education on the entire Pacific Coast and they stand willing to make all reasonable concessions to effect it. They would not wish to seem hasty and to urge an immediate decision on the ground of the necessity of developing at once the plans of the University Hospital. They would be perfectly willing to await the arrival of Doctor Welch provided certain fundamental propositions can be accepted.

The Committee feels that the authority of the State is invested in the Board of Regents and cannot be transferred to others and that the State will be called upon in future to put more money into Medicine and that the majority control of the Board of Management of the united school must rest with the Board of Regents. As you say in your note "The Board of Managers is to be constituted of five Regents and three Trustees or upon some similar plan."

The availability of different sites seems of secondary importance and will be discussed later. The Committee feels, however, that the present site of Lane Hospital does not admit of suitable future expansion. Certain minor corrections of your note may here be in order. It is part of the future plan of the University of California to build a private pavilion in connection with the (County) Hospital, but the chief aim of this private department will not be to provide funds for the maintenance of the teaching hospital. The budget for the support of medicine this coming year is $ 157,000. This does not include the hospital earnings or the income of the Hooper foundation.

Trusting that this note may be transmitted with your communication to Mr. Hopkins and to the Trustees of Stanford University, I remain,

Very truly yours,

Herbert C. Moffitt, Dean

Medical School , University of California

24 April 1914

Dr. R. L. Wilbur, Dean

Stanford Medical School

Sacramento & Webster Streets

San Francisco

Dear Sir:

The Board of Trustees has considered the correspondence which has recently passed between yourself and Dr. Herbert C. Moffitt, Dean of the University of California Medical School, relative to a proposed consolidation of the medical schools of the respective universities.

The Board has requested me as President to transmit to you the following resolution so as to enable you to reply to Dr. Moffitt's letter:

Resolved: that in the opinion of the Board of Trustees of Stanford University the trusts which they are administering do not permit their turning over either property or income to be managed and disbursed by any institution in which they do not have at least an equal voice, and that they consider it impossible to formulate any plan for the union of the medical schools of the two universities on any other basis.

Yours truly,

(Signed) Timothy Hopkins

President.

P. S. The letters referred to above are those of yourself of the 20th to me as President and Dean Moffitt's letter to you of April 24th.

25 April 1914

Dr. Herbert C. Moffitt, Dean

Medical Department, University of California

2d & Parnassus Avenues, San Francisco

Dear Dr. Moffitt:

Please find enclosed copy of a letter received this day from Mr. Timothy Hopkins, President of the Board of Trustees of Stanford University, in reference to the proposed union of the Medical Schools of the two Universities. You will note by it that the Board does not see its way clear to enter into a union upon the basis which you have stated in your letter of April 24th is considered by the University of California authorities as fundamental. I refer to the majority control of the Board of Management of a united school resting with the Board of Regents of the University of California.

I judge therefore that this permanently settles the question of uniting the two Medical Schools. The trusts of the two institutions apparently do not permit a satisfactory arrangement to be made. I wish to express my appreciation of the spirit in which you personally have considered this whole question and to congratulate you upon the forward steps which you have made in medical education. I trust that there will be no difficulty in securing close cooperation of the two Medical Schools in the advancement of higher medical standards upon the Pacific Coast and wish to assure you of my willingness to assist you in all efforts along those lines.

Very sincerely yours,

(Signed) R. L. Wilbur

On 12 May 1914 the California Regents addressed the following conciliatory response to the Stanford Trustees: [29]

After careful consideration of all that has hitherto transpired (the California Regents) voted to express officially to the Stanford Trustees their deep desire that an amalgamation be consummated of the work in medicine of the two schools. They are convinced that the welfare of medical education will be so much advanced by such a merger that the opportunity of united effort in this field by the two universities ought not to be lost. The Regents, therefore, in earnest hope of the realization of a plan of so much moment to the community, would request your Board to suggest a basis on which in your opinion such a merger in medical education may be brought about.

This proposal by the Regents, so consistent with the Pritchett stratagem which called for making every effort to absorb the Stanford school within the State system, forced the Stanford Trustees to at last put to rest the persistent notion of a truncated and subordinate medical school for Stanford. At their regular meeting held on 29 May 1914 the Trustees were firm and final in their decision: [30]

Resolved, that this Board of Trustees, after full deliberation, is reluctantly convinced that no basis of merger of the said two medical schools can be formulated, or exists, which is compatible with the legal powers and duties of either university; and further that, if such merger could be formed, it would cause no material saving in expense to either university, and that the interests of each university and of the public will be best served by the maintenance of the two separate schools, each pursuing its own methods and standards and so far as possible supplementing each other.

This resolution signaled the end of the medical school controversy - and by this action the Trustees preserved a full program of medical education as an integral part of Stanford University.

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