Dartmouth Medical School (DMS) is the medical school of Dartmouth College, located in Hanover, New Hampshire, in the United States. The fourth-oldest medical school in the United States, Dartmouth Medical School was founded in 1797 by New England physician Nathan Smith and grew steadily over the course of the 19th century. In the early 1900s, it was forced to cease granting the Doctor of Medicine (M.D.) degree. After further problems in the 1950s, the clinical M.D. program was reinstated and the school returned to national prominence for its academics and research. Several milestones in medical care and research have taken place at DMS, including the first clinical X-ray (1896), the first intensive care unit in the United States (1955), and the Brattleboro rat (1961).

Today, Dartmouth Medical School continues to grant the M.D. and Doctor of Philosophy (Ph.D) degrees, as well as a Master of Public Health (MPH) and Master of Science (M.S.) degrees. The school has a student body of about 620 students and more than 2,300 faculty members and researchers. As part of the Dartmouth-Hitchcock Medical Center, DMS organizes research through over a dozen research centers and institutes, receiving more than US$100 million in grants annually. DMS is one of seven Ivy League medical schools and is ranked as a "top medical school" by U.S. News & World Report for both primary care and biomedical research.

History

Foundation and early years

Dartmouth Medical School was founded in 1797 as the fourth medical school in the United States, following the University of Pennsylvania School of Medicine (founded 1765), the medical school of King's College (now Columbia University) (1767), and Harvard Medical School (1782). The founder was Nathan Smith, a Harvard University-educated physician from Cornish, New Hampshire. Noting the death of medical professionals in the rural Connecticut River Upper Valley area, Smith petitioned the Board of Trustees of Dartmouth College in August 1796 to fund the establishment of a medical school to train more physicians for the region. Though Dartmouth College as a whole was financially strapped, the Board approved the request, and Smith began lecturing on November 22, 1797.
For much of its early life, Dartmouth Medical School consisted only of Nathan Smith and a small class of students, operating in borrowed space at Dartmouth College. Students of Smith were educated as apprentices, and received a Bachelor of Medicine degree upon graduation. Like Dartmouth College as a whole, DMS had continual funding shortages. As time passed, however, the popularity of both the medical instruction and the basic sciences taught at the school drew undergraduates and training physicians alike. Soliciting funds from the state of New Hampshire, Smith was able to obtain medical equipment and, by 1811, a dedicated physical plant for the school.
Smith acted as the sole administrator and instructor of the medical school until 1810, when a second faculty member was hired. Smith also revamped the curriculum, allowing the school to begin offering the Doctor of Medicine (M.D.) degree in 1812. Smith ultimately left DMS in 1816, founding three additional schools of medicine at Yale University, Bowdoin College, and the University of Vermont.

Expansion and difficulties

Smith's departure provided for a period of expansion, both among the faculty and the student body. Former students of Nathan Smith's replaced him on the faculty, drawing medical professionals in the northeast such as Oliver Wendell Holmes, Sr. to join them. The first hospital at Dartmouth Medical School was founded by DMS alumnus Dixi Crosby in 1838, who used it to integrate academic instruction with hands-on patient care. In 1870, Carlton Pennington Frost, DMS '57, replaced Crosby as Dean of the school. Under Frost, the curriculum sustained another revamping, this time into a four-year program that included clinical and academic training. Frost also presided over the establishment of Mary Hitchcock Memorial Hospital in 1893, built to replace Crosby's defunct hospital.

The Dartmouth Medical School campus, from 1915 or earlier.

In 1908, The Carnegie Foundation for the Advancement of Teaching conducted a survey of medical education institutions in the United States. At the time, the discipline emphasized "bedside teaching" and providing students experience with a broad variety of illnesses and patients. Dartmouth Medical School's rural location was deemed too remote for proper clinical training, and the school was advised to stop offering the Doctor of Medicine degree and only provide pre-clinical instruction. The class of 1914 was the last (until 1974) to receive the Doctor of Medicine degree; subsequent classes of students attended DMS for two years before transferring to other medical schools. The drop of clinical instruction worsened the school's problems by driving away talented faculty members.
After World War II, the tide of the medical discipline had shifted towards research. Although Dartmouth Medical School was well-regarded for preparing students for clinical education at other institutions, its faculty was criticized for its apparent disinterest in research. The school was also criticized for using Dartmouth College's undergraduate program as a feeder school. Based on these criticisms, DMS was placed on "confidential probation" in 1956 by the Association of American Medical Colleges and the Council on Medical Education.

From the "refounding" to present

Mary Hitchcock Memorial Hospital (right), circa 1915.

At the time of the probation, Dartmouth College had already anticipated the medical school's plight, amassing capital to fund a revitalization of the school. In 1956, the trustees of the College formally agreed to a "refounding" of Dartmouth Medical School's academic offerings, physical facilities, and faculty. S. Marsh Tenney, DMS class of 1944, was appointed to carry out this task. Tenney more than doubled the size of the faculty and the student body, added several new departments, and oversaw the construction of five new campus buildings by 1964.

In the 1960s, due to a national shortage of physicians and government incentives for schools that increased their class sizes, Dartmouth Medical School graduates began to experience difficulty in trying to transfer to other medical school to complete their final two years of medical school as other medical schools had increased their class size and could not accommodate transfer students. In the meantime, Mary Hitchcock Memorial Hospital had grown to be a 400-bed medical center, and Dartmouth Medical School had established a partnership with a 224-bed Veterans Administration Hospital in White River Junction, Vermont. The Doctor of Medicine program, now possible with the expanded local medical centers, was reinstated by a vote of the trustees in 1968. The admission of M.D. candidates resumed in 1970. Initially, the medical school curriculum was three years in length, unlike most medical schools, but it later was increased to the usual four years in 1979.

A cooperative program with Brown Medical School began in 1981 where students received training at both medical schools. Fifteen to twenty students were selected for the program, which combined the first two years of basic science coursework at Dartmouth with the final two years of clinical coursework at Brown. The program balanced Dartmouth's greater basic science facilities than Brown, but fewer clinical facilities than available at the urban setting of Brown, which is located in Providence, Rhode Island. Graduates of the program received M.D. degrees from Brown. The program will be discontinued in 2010.

In 1991, the Dartmouth-Hitchcock Medical Center was established on a campus in Lebanon, New Hampshire. The three-year project, completed at the cost of $228 million, served as a replacement for the Mary Hitchcock Memorial Hospital, which was partially demolished in the early 1990s. A new curriculum was introduced in 1996 entitled "New Directions." The curriculum, still in place today, seeks to promote small classes, reduce the amount of lectures, and offer students extensive interactive experience with patients.

Campus

The Dana Biomedical Library

Dartmouth Medical School has facilities on the campus of Dartmouth College, which is situated in the rural, Upper Valley town of Hanover, New Hampshire as well as at Dartmouth-Hitchcock Medical Center (DHMC).

The medical school facilities at Dartmouth College sits in a complex on the north side of Dartmouth's campus and includes academic, administrative, research, and presentation facilities. DMS is served by two libraries, the Dana Biomedical Library and the Matthews-Fuller Health Sciences Library, which together offer 240,000 volumes. DMS does not offer on-campus housing; off-campus housing is available through Dartmouth College. The Class of 1978 Life Sciences Center is expected to be completed in May 2010 at the cost of $92 million.

The Dartmouth-Hitchcock Medical Center, centered in nearby Lebanon, New Hampshire, is the umbrella medical organization of which Dartmouth Medical School is a constituent part. Mary Hitchcock Memorial Hospital, DHMC's 396-bed inpatient facility, acts as the medical school's teaching hospital and "primary teaching site". DHMC's other constituent elements include the Dartmouth-Hitchcock Clinic (a network of physicians in Vermont and New Hampshire) and a Veterans Affairs Medical Center in White River Junction, Vermont. In total, DHMC serves an area with a population of 1.6 million.
In addition to on-campus instruction in Hanover and Lebanon, third- and fourth-year M.D. students may choose from 75 regional sites for their required clerkships. Most clerkship facilities are located in central New England, although students are also able to clerk at sites in Alaska, California, New Mexico, and Florida.

Academics

Dartmouth Medical School offers the four-year Doctor of Medicine (M.D.) degree and the Doctor of Philosophy (Ph.D) degree in certain fields. In addition, the school offers two joint-degree programs: the combination M.D./Ph.D., for which the Ph.D. can be obtained from any doctoral program at Dartmouth, and the combination M.D./Master of Business Administration (MBA), offered in conjunction with the Tuck School of Business. The Dartmouth Institute for Health Policy and Clinical Practice, one of a number of DMS research institutes, offers its own degree programs in evaluative clinical sciences, including a Master of Public Health (MPH), a Master of Science (M.S.), a Ph.D., post-doctoral fellowships, several joint-degree programs, and a residency program for preventive medicine. Mary Hitchcock Memorial Hospital also offers residencies and fellowships which are administered by Dartmouth Medical School faculty.

The curriculum for the Doctor of Medicine degree spans four years, combining required courses with electives. First-year students learn human anatomy and basic biomedical science in classes offered by the basic science departments, while beginning a two-year course of study in clinical studies. Second-year students study pathophysiology and take courses from almost every clinical and basic science department in the school. In their third year, M.D. candidates are required to participate in six eight-week Medical clerkships with area medical institutions, covering both ambulatory clinics and hospitals. The final year is spent on additional clerkships, the designation of an area of focus, and preparation for a post-graduation residency. In addition to imparting medical and clinical knowledge, the M.D. program is designed to teach "interpersonal and communications skills", "professionalism", and other practical skills for a medical career.

Remsen and Vail Medical Sciences Buildings

Dartmouth Medical School also offers the Doctor of Philosophy degree to train students as biomedical researchers and scientists. The Ph.D. is available in six fields offered by the basic science departments: pharmacology and toxicology, molecular and cell biology, immunology, molecular pathogenesis, systems biology, and experimental and molecular medicine. Research and teaching positions at DMS and its centers and institutes are available to Ph.D. candidates.

Organization and research

Like the undergraduate portion of Dartmouth College, Dartmouth Medical School operates on a quarter system. As part of the larger institution, DMS is ultimately administered by Dartmouth's President and Board of Trustees. The school is directly managed by a Dean who is advised by a fourteen-member Board of Overseers. As of the 2007-2008 academic year, the school operates on a budget of $214.3 million.
Besides research conducted within the infrastructure of academic departments, research at DMS and DHMC is also organized around over a dozen research centers and institutes. The centers cover various medical subjects such as neuroscience, oncology (Norris Cotton Cancer Center), psychiatry, and pediatrics. Funded research at Dartmouth Medical School amounted to $123 million during the 2006-2007 academic year; the school claims to be in the top 10% of American medical schools in terms of "basic science research funding on a per faculty member basis."

Admissions and rankings

3 Rope Ferry Road is the location of Dartmouth Medical School's Office of Admissions.

In the fall of 2007, 68 students enrolled in the Doctor of Medicine program from an applicant pool of 5,310, with the Office of Admissions offering an acceptance rate of 7 percent. Applicants from the previous year had an average score in the numerically graded sections of Medical College Admission Test (MCAT) of 30.7, and an average undergraduate grade point average (GPA) of 3.7. Applicants to the M.D. program are expected to have a background in chemistry, biology, physics, and calculus, and are required to have at least three years of undergraduate education.
Dartmouth Medical School is accredited by the Liaison Council on Medical Education. None of the residencies programs of Mary Hitchcock Medical Center, which are administered by Dartmouth Medical School faculty, are on probation by the Accreditation Council for Graduate Medical Education.

For 2009, Dartmouth Medical School was ranked by U.S. News & World Report as 13th on the "Top Medical Schools - Primary Care" list and 31st on the "Top Medical Schools - Research" list. The magazine also ranked the Dartmouth-Hitchcock Medical Center on its "America's Best Hospitals" lists for gynecology (#34), cancer (#36), and digestive disorders (#50).

People

Student profile and student life

Dr. C. Everett Koop, Dartmouth class of 1937, currently serves as a Senior Scholar of the C. Everett Koop Institute at Dartmouth Medical School.

Dartmouth Medical School's enrollment as of October 2007 totaled 621 students: 315 M.D. candidates and 305 graduate students. 34 students elected to pursue the dual degree program, seeking both the M.D. and Ph.D. degrees. In addition to the student body, over 350 resident physicians and research fellows were on campus as of July 2007. The student population is split approximately evenly between men and women, while about 25 percent of the student body is made up of international or minority students. From an average class size of 75, over 60 undergraduate institutions and most of the U.S. states are represented. According to The Princeton Review, the small class size at DMS helps to establish "a strong sense of community and collaborative spirit". The school offers about a dozen community service, recreational, professional, and other student groups.

Faculty

As of November 2007, Dartmouth Medical School employs a staff of 2,315 faculty and researchers: 766 full-time faculty, 1,301 part-time faculty and non-faculty instructors, and 248 research positions. The ratio of full-time, on-site faculty to students is given by the school as 2:1. Notable current faculty include Stuart Gitlow, former Surgeon General of the United States C. Everett Koop, palliative care physician Ira Byock, former astronaut and Democratic politician Jay C. Buckey, psychoanalyst Peter A. Olsson, and biochemist William T. Wickner. Notable former faculty include biochemist Mahlon Hoagland and pathologist and geneticist Kurt Benirschke.

John C. Lilly, an experimenter into the nature of consciousness, studied at Dartmouth Medical School from 1938-1940.

Alumni

As of September 2006, Dartmouth Medical School claims 4,010 living graduates active in medicine around the world. DMS cites its required clerkships as a mechanism for allowing students to make connections and obtain real-world experience. Fourth-year students are prepared for residency with counseling classes; recent graduates have most commonly taken their residencies at Dartmouth Medical School itself, the Harvard Medical School, the Tufts University School of Medicine, and Brown Medical School.
Alumni of Dartmouth Medical School who have become notable medical practitioners and researchers include physician and Freethinker Charles Knowlton, consciousness researcher John C. Lilly, physician Robert O. Blood, ophthalmologist and epidemiologist John D. Bullock, and attending physician at the United States Capitol John Francis Eisold. Alumni in other fields include U.S. Representatives Richard S. Molony and Robert Burns, Governor of New Hampshire Noah Martin, and television personality Ian Smith.