Johns Hopkins University School of Medicine

The Johns Hopkins University School of Medicine, located in Baltimore, Maryland, USA, is a highly regarded medical school and biomedical research institute in the United States. Located in East Baltimore, it is affiliated with Johns Hopkins Hospital, its major teaching hospital, as well as several other community sites, including the Johns Hopkins Bayview Medical Center. The East Baltimore campus of Johns Hopkins University is home to the School of Medicine, the Bloomberg School of Public Health, and the School of Nursing. The campus comprises several city blocks, radiating outwards from the Billings building of the Johns Hopkins Hospital and its trademark dome.

The Johns Hopkins University School of Medicine has served as the model for most American medical schools since its founding in 1893 , and has been home to many "firsts"; it was the first medical school to require its students to have an undergraduate degree. It was also the first graduate-level medical school to admit women on an equal basis as men. Mary Elizabeth Garrett, head of the Women's Medical School Fund, was a driving force behind both of these 'firsts'.

History

Before Hopkins

At the end of the 19th century, American medical education was in chaos; most medical schools were little more than trade schools, established primarily to turn a profit, often accepting high school graduates who would have had trouble getting into a liberal arts college. After two, at most three, years of attending typically repetitious lectures by part-time teachers, students were free to apprentice themselves to older doctors or simply hang out a shingle, even if they had never laid a hand on a patient.

The founding of Hopkins

With the opening of The Johns Hopkins Hospital in 1889, followed four years later by The Johns Hopkins University School of Medicine, a new era in medical education began, marked by rigid entrance requirements for entering students, a vastly upgraded medical school curriculum with emphasis on the scientific method, the incorporation of bedside teaching and laboratory research as part of the instruction, and integration of the School of Medicine with the Hospital through joint appointments. The new model also created standardized advanced training in specialized fields of medicine with the creation of the first house staff fellowships and post graduate internships.

To wage this revolution, Hopkins recruited four impressive young physicians, William H. Welch, William Osler, William Stewart Halsted, and Howard Kelly - the so-called Big Four - by offering them rare and tempting research opportunities. The basic scientists and later the clinicians were free to do research by having a full-time salary, a departure from the tradition of employing part-time local practitioners to teach classes.

Another innovation assured higher quality applicants: rigid entrance examinations after prerequisite college education, heavy on basic science -- chemistry, physics, biology -- and rigid entrance examinations, were expected of all students who ventured into a Hopkins medical school classroom.

Classes were small and involved hands-on training with patients, a departure from the old lecture format. From the start, talented women were permitted to enroll, breaking a prohibition that many older schools held for decades. Medical research by both faculty and students was fostered as part of the educational process and as integral to patient care. The "clinician-scientist" became a Hopkins hallmark.

Study was rigorous and lasted four years, including unprecedented hours of bedside learning at the side of experts, original research projects guided by respected clinicians, and extensive laboratory training. Then came postgraduate education in the Hospital for interns and residents, an innovation that became the model for the postgraduate clinical education of the 20th century. Hopkins' "products" soon were in demand across the country.

The Flexner Report

The Hopkins reforms in American medical education were pushed further after 1910, when the Carnegie Foundation asked educator Abraham Flexner to survey the 150 medical schools then operating in the United States and Canada. The Flexner Report found only five that were adequate, and Flexner held up Hopkins as the model.

"The influence of this new foundation can hardly be overstated," Flexner wrote. "It has finally cleared up the problem of standards and ideas and its graduates have gone forth in small bands to found new institutions or to reconstruct old ones."

In fact, Washington University School of Medicine, Vanderbilt University School of Medicine, the University of Iowa College of Medicine, Duke University School of Medicine, and the University of Rochester Medical Center, as well as Peking Union Medical School patterned their medical schools directly after Hopkins; Duke went so far as to hire all but one of its first chairmen and chiefs of service from the Hopkins faculty.

In turn, Johns Hopkins had modeled itself largely after German universities, where medical science was highly valued and laboratories were well equipped. Few facilities like this were available in the United States in the late 19th century, but slowly, with Hopkins in the vanguard, the belief spread that medicine would not advance unless doctors were firmly grounded in basic science and applied research methods to the study of disease.

Delays

It was perhaps fortunate that the opening of The Johns Hopkins Hospital was delayed for 13 years after the opening of the University in 1876. These years gave Daniel Coit Gilman, the University's first president, a chance to get a program of postgraduate education well established.

The delay also gave William H. Welch, the first professor at the School of Medicine, time to get Pathology up and running before the wards opened. The emphasis on research was well established before a single patient was admitted. The bacteriologic era came into full bloom during those years, as well. Robert Koch discovered the tuberculosis organism in 1881, launching a new awareness of the role of germs in disease, which strongly influenced the practice of medicine.

The School of Medicine opened four years after the Hospital and, in retrospect, this gap, too, was an advantage, for it gave the innovative residency system time to get firmly established. When the first medical students came along, they could easily be incorporated into the wards. One other great benefit emerged from the delays: William Osler had the time he needed to write his classic textbook, The Principles and Practice of Medicine.

Rankings

For years, Hopkins has been a top medical school in the amount of competitive research grants awarded by the National Institutes of Health. It is consistently ranked as one of the top two medical schools in research according to US News.

Curriculum

Today, a newly revised curriculum integrates basic science education and clinical instruction with community-based learning. Education in medical history, ethics, even literature informs and expands the learning experience. Throughout the curriculum, the emphasis is on small-group and seminar learning, with private practitioners playing an expanded role. Students engage face-to-face, work shoulder-to-shoulder with many of the world's leading physicians, scientists and medical educators. According to Hopkins leaders, "the line between learning and teaching disappears into a continuum of discovery."

Notable Past and Present Faculty

• John Jacob Abel - Pharmacologist
• Peter Agre - Molecular biologist, Nobel laureate
• John Shaw Billings - Civil War surgeon, pioneering leader in hygiene
• Alfred Blalock - Developed field of cardiac surgery
• Max Brödel - Acclaimed medical illustrator
• William R. Brody - Radiologist, President of Johns Hopkins University
• John Cameron - Hepatobiliary surgeon
• Ben Carson - Pediatric Neurosurgeon
• Curt I Civin - Oncologist
• Denton Cooley - Cardiovascular surgeon
• Harvey Cushing - Father of modern neurosurgery
• Walter Dandy - Neurosurgeon
• Elliot Fishman - Radiologist
• Carol Greider - Molecular biologist
• William Halsted - Father of modern surgery
• A. McGehee Harvey - Internist
• John Eager Howard - Endocrinologist
• Kay Redfield Jamison - Psychologist and Psychiaty professor
• Howard Kelly - Gynecologist
• Paul Ladenson - Thyroidologist
• Irene H. Maumenee - Geneticist, Ophthalmologist
• Paul McHugh - Psychiatrist
• Victor McKusick - Developed field of medical genetics
• Adolf Meyer - Psychiatrist
• Russell Morgan - Radiologist
• Daniel Nathans - Molecular biologist, Nobel laureate
• William Osler - Father of modern medicine
• Edwards Park - Pediatrician
• Dorothy Reed - Pathologist
• William Rienhoff - Surgeon
• Florence Sabin - Anatomist
• Hamilton O. Smith - Microbiologist, Nobel laureate
• Solomon H. Snyder - Neuroscientist
• Helen Taussig - Pediatric cardiologist
• Vivien Thomas - Developed Blalock-Taussig Shunt
• Bert Vogelstein - Molecular oncologist
• Patrick Walsh - Urologist
• William H. Welch - Pathologist
• David B. Weishampel - Paleontologist, author of The Dinosauria 2004
• Elias Zerhouni - Radiologist, Director of NIH

Nobel laureates

• Peter Agre - Nobel Prize in Chemistry, 2003
• Richard Axel - Nobel Prize in Medicine, 2004
• Joseph Erlanger - Nobel Prize in Medicine, 1944
• Andrew Fire - Nobel Prize in Medicine, 2006
• Herbert Spencer Gasser - Nobel Prize in Physiology, 1944
• Paul Greengard - Nobel Prize in Medicine, 2000
• Haldan Keffer Hartline - Nobel Prize in Medicine, 1967
• Thomas Hunt Morgan - Nobel Prize in Medicine, 1933
• Daniel Nathans - Nobel Prize in Medicine, 1978
• Martin Rodbell - Nobel Prize in Medicine, 1994
• Francis Peyton Rous - Nobel Prize in Medicine, 1966
• Hamilton O. Smith - Nobel Prize in Medicine, 1978
• Torsten Wiesel - Nobel Prize in Medicine, 1981
• George Hoyt Whipple - Nobel Prize in Medicine, 1934

In popular culture

• In the Fox television program House, MD, Dr. Gregory House is a world-famous diagnostician who was expelled from Hopkins Med. Neurologist Dr. Eric Foreman also attended Hopkins.
• In the TV drama Grey's Anatomy, Preston Burke is a cardiothoracic surgeon who graduated first in his class from Hopkins Med.
• In The Simpsons, Julius Hibbert is a family physician who graduated from Hopkins Med.
• Dr Hannibal Lecter, from The Silence of the Lambs and other books, completed his residency training at Hopkins Hospital
• In the Book series of Alex Cross by James Patterson , the main character ALEX went to Hopkins Med.
• In The West Wing, President Bartlet's middle daughter Ellie was a student at Hopkins Med.
• Johns Hopkins is mentioned many times in Tom Clancy's novels: Jack Ryan's wife, Cathy, is an ophthalmology professor there.

Milestones

• In 1991, scientists working at JHUSM identified aquaporin, a protein that controls passage of water into and out of red blood cells and kidney cells, spawning research that now seems likely to impact treatment of brain swelling and certain lung and kidney diseases. This discovery garnered a Nobel Prize in 2003 for the principal scientist.
• In 1969-70, scientists working at JHUSM discovered restriction enzymes, the "biochemical scissors," and showed that they cut DNA at specific nucleotide sequences and could be used to analyze DNA, thus giving birth to the entirely new field of genetic engineering. The discoverers were awarded the Nobel Prize in 1978 for their achievement.