One hundred fifty years ago, a small group of visionary Nashville physicians had an aspirational goal — to create a school of medicine to train physicians to better meet the South’s health care needs.
Looking across today’s bustling environs of Vanderbilt University School of Medicine (VUSM), it’s hard to envision the early years of the institution that today is one of the country’s top-ranked medical schools, with a stated mission of catalyzing the advancement of impactful discovery, servant leadership and lifelong learning.
A modest beginning
In the mid-19th century, medical education in the United States was in its infancy. As was the case at Vanderbilt, medical schools were often founded by groups of physicians who paid themselves for their lectures and demonstrations with students’ fees. Most balanced caring for patients in their private practices with their teaching obligations.
VUSM welcomed its first class in fall 1874, operating initially as a shared program with the University of Nashville’s existing medical department. The two institutions shared space at the Nashville Medical College Hospital on Market Street (now Second Avenue) in downtown Nashville.
In 1875, Vanderbilt University (VU) — founded two years earlier through a generous grant from Commodore Cornelius Vanderbilt — awarded its first degree, a Doctor of Medicine degree, to Henry William Morgan. The future head of Vanderbilt’s Dental Department joined 60 of his peers in accepting this honor.
Establishing a singular presence
Under the leadership of VU Chancellor James H. Kirkland, the University of Nashville Medical School and Vanderbilt Medical School separated in 1895. “The Comet” — VU’s first yearbook — documented this momentous occasion:
“Vanderbilt University has taken another stride forward, and the medical profession of the South is especially in her debt. We are proud to record the fact that Vanderbilt has reorganized and taken full control of her Medical Department. It will be conducted on a high plane and in keeping with the most progressive ideas in medical education.”
A medical school facility — described as the “most complete of its kind in the South” — was constructed on the corner of Fifth and Elm streets in downtown Nashville. It included consultation and exam rooms, an apothecary, laboratories, surgical and medical demonstration rooms and more.
William L. Dudley, professor of Chemistry in the College of Arts and Sciences, was appointed medical dean, and admission requirements were raised to require a high school diploma. The course of study was lengthened to three years, and basic sciences laboratory work was added. In 1898, the quality of VUSM’s medical education was again upgraded as instruction increased to four years.
Driven by lessons learned from the Civil War, a nursing training program was established in 1908 overseen by the hospital superintendent. This became the School of Nursing in 1926.
These efforts to provide an exemplary medical education were praised in the 1910 publication of the landmark “Flexner Report,” a Carnegie Foundation-funded evaluation of medical training institutions. The report stated Vanderbilt was best suited among Tennessee medical colleges to deliver a course of study. The report noted, however, that the school could use more laboratories, equipment and faculty.
The onset of World War I in 1914 meant medical school enrollment throughout the country declined significantly as faculty and students entered military service. The Student Army Training Corps was also established on campus, transforming Vanderbilt into a military post.
“I can only say that wherever one went in the service, one saw Vanderbilt men. On this side in every camp, at the port of debarkation, on the transports, on the firing line, in the hospitals, and even back in the quiet zones of the S.O.S., eating their hearts out to get up to the front,” said Lt. Col. W.D. Haggard in a February 1919 address to the Vanderbilt Club of Nashville.
The same year, spurred by the “Flexner Report,” Kirkland negotiated a $4 million grant from the General Education Board, an organization supporting higher education and medical schools bankrolled by philanthropists.
The newly appointed Medical School Dean Canby Robinson, MD, decided the top priority should be relocating all training, laboratory and patient care facilities to conjoin the Vanderbilt University campus. A remarkable amount of determination resulted in an additional $3 million raised to fund the effort, an extraordinary feat in the postwar South.
A unified campus
Under Robinson’s leadership, the medical school made the transformational relocation from downtown Nashville to what was then known as the West Campus along 21st Avenue. On Sept. 15, 1925, the facility housing the Medical School, Vanderbilt University Hospital (VUH), outpatient clinics, laboratory space and medical library opened. This building, including the ornate School of Medicine entry arch facing the current day John E. Chapman Quadrangle, remains at the heart of Medical Center North.
Robinson increased the number of full-time educators and clinical faculty, recruiting nationally known trailblazers to serve in leadership roles. He established three departments — medicine, surgery, and obstetrics and gynecology — as well as three specialized laboratories — physiological, infectious diseases and chemical.
In 1925, he recruited Barney Brooks, MD, from Washington University to be the first professor of Surgery and chair of the Department of Surgery. He wrote Brooks of his confidence: “I have not a shadow of a doubt regarding your fitness, ability and strength to do your full measure in getting the new school underway.” 1
In a 1933 letter, Brooks praised the new facility: “I never fully realized the advantages of all activities of a university medical school being conducted within a single ‘building’ until I came to Nashville. I have stated a great many times that if Dr. Canby Robinson never made any other contribution than his planning of the Vanderbilt University School of Medicine, he could still be considered as one of the great contributors to medical education.”2
Collaborations flourish
The cohesive campus was a catalyst for research and clinical collaborations that led to transformational advances in the provision of innovative, safe patient care throughout the country.
For example, Vanderbilt surgeon Alfred Blalock, MD, and his research and laboratory assistant Vivien Thomas conducted research that later led to the groundbreaking development of the Blalock-Thomas-Taussig shunt. This was used for infants born with the cardiac defect tetralogy of Fallot.
A process for culturing vaccines in chicken embryos and fertilized eggs was developed by Ernest William Goodpasture, MD, a Vanderbilt pathologist. His work, which began in the 1930s, revolutionized vaccine development.
In 1962, Mildred Stahlman, MD, professor of Pediatrics and Pathology, Microbiology and Immunology, established the nation’s first newborn intensive care unit to use monitored respiratory therapy in babies born with damaged lungs at VUH.
Wartime contributions
Medical schools in the U.S. played a remarkable role during World War II, and VUSM was no exception. The draft pulled students and faculty to the battlefield, and more than 4,500 Vanderbilt University alumni were recorded as serving in every branch of service and theater of operation.
The demand for medical professionals to care for battlefield wounded and to provide domestic health care pushed Vanderbilt to offer accelerated degrees year-round, often graduating multiple classes each year.
Growth of facilities and programs
The years immediately following World War II were a time for rebuilding. VUSM and VUMC achieved several facility expansions fueled by federal grants; an increased emphasis on advanced basic science research; and continuing clinical subspecialization.
In the 1960s through the 1980s, larger, more specialized spaces were needed for growing patient populations, advanced investigations, medical student education, and new and expanded clinical and academic departments. Many of the facilities on the Main Campus today were added during this period, including the Learned Laboratories, the Round Wing, the Joe and Howard Werthan Building and Rudolph A. Light Hall.
New hospitals and clinics
In 1970, the patients of the Junior League of Nashville Home for Crippled Children, established in the 1920s, had been transferred to Vanderbilt. After years of building support within the community and university, David Karzon, MD, later chair of the Department of Pediatrics, led efforts to establish the Children’s Regional Medical Center, to be housed within VUH.
A new adult hospital, with space dedicated on three floors for pediatric patients, opened to great fanfare on the Main Campus in 1980. In 1985, the Psychiatric Hospital at Vanderbilt — initially for children and adolescents — was completed.
The Vanderbilt Clinic, an expansive space for outpatient specialty clinics, was opened in 1988, and new medical research buildings on the Main Campus were constructed in 1989 and 1994. In 1993, the Vanderbilt Stallworth Rehabilitation Hospital was dedicated, and in 1994 the Annette and Irwin Eskind Biomedical Library opened.
In 1999, local businessman and philanthropist Monroe Carell Jr. began a fundraising campaign for a new, freestanding children’s hospital. In 2004, an eight-floor, 206-bed pediatric hospital, named in Carell’s honor, opened. When the ongoing expansion is complete, Monroe Carell Jr. Children’s Hospital at Vanderbilt will have 401 beds and more than 1 million square feet on the Main Campus, plus 30 off-site and affiliated locations.
In 2009, Vanderbilt Health began a steady expansion of outpatient, specialty clinics, and today there are more than 180 outpatient clinic locations and more than 400 specialty clinics.
VUMC has steadily grown to five regional campuses with seven hospitals — including three regional hospitals — and more than 1,700 licensed inpatient beds. The medical clinical staff has grown to exceed 4,900.
VUMC is now one of the largest health care systems in the Mid-South, and its extensive medical specialties and subspecialties provide abundant and unparalleled training opportunities for VUSM students.
New leadership
In October 2008, Jeff Balser, MD, PhD, then associate vice chancellor for Research for VUMC, was named VUSM’s 11th dean. Balser was also named vice chancellor for Health Affairs in 2009. In 2016, he was named President and CEO of VUMC, while continuing to serve as dean.
For more than two decades, Balser, along with VUSM’s and VUMC’s leadership, has led the charge to bring personalized medicine from the research setting to the bedside, integrating advances in biomedical informatics, discovery science and precision genomics while training future generations of leaders in medicine.
Redefined medical training
Medical education at the School of Medicine underwent a seismic shift in 2013, with the creation of Curriculum 2.0, a first-of-its-kind academic model that transformed the traditional two-year preclinical program.
The model is composed of a 13-month preclinical curriculum; clerkship rotations in the second year; clinical experiences and electives based on career interests in the third and fourth years; and student research across four years. Medical schools around the country have followed Vanderbilt’s lead and adopted Curriculum 2.0’s structure.
To better support Curriculum 2.0, Eskind Biomedical Library underwent a $12.9 million renovation and reopened in July 2018 as the Annette and Irwin Eskind Family Biomedical Library and Learning Center, creating a new learning home for medical students. The project was supported by a visionary $6 million gift to Vanderbilt University from the Eskind family.
Delivering care to neighbors in need
In 2005, the Shade Tree Clinic, a community-based health clinic run by Vanderbilt medical and nursing students, was established to provide care to medically underserved Middle Tennessee residents. The clinic has grown from a walk-in clinic in a double-wide trailer to a comprehensive medical home for more than 400 patients.
Participating in the Shade Tree clinical experience offers medical and nursing students the unique opportunity to be responsible for a continuum of patients’ needs while learning the fundamentals of health care delivery. The experience is rewarding for everyone involved and represents the best of VUSM’s mission to train future leaders in health care.
Building a legacy of distinction
Today, VUSM ranks among the nation’s top National Institutes of Health grant recipients, with more than $527.7 million in NIH grant funding. VUSM has an estimated $900 million in total annual research awards supported by government, foundation and industry sponsors.
VUSM currently has 2,798 full-time faculty members. To date, 37 faculty members have been elected to the National Academy of Medicine; 10 have been elected as members of the National Academy of Sciences; and one faculty member has been elected as a member of the National Academy of Engineering. Election to a national academy is one of the highest professional honors for scientists, engineers and health professionals.
The School of Medicine has a current enrollment of 392 students, with a composition of 52% female and 48% male. VUSM offers three doctoral degrees and eight master’s degrees in specialties such as public health, medical physics and genetic counseling. A range of dual degree programs allows medical students to complete their Doctor of Medicine degree along with a graduate degree in another specialty to broaden their expertise and career path.
VUMC houses one of the nation’s most distinguished graduate medical education programs with more than 1,200 residents and fellows training in more than 200 accredited specialties.
Of note, VUMC has led key discoveries delivering vaccines and treatments for COVID-19. It has leveraged its BioVU DNA resource to establish the Alliance for Genomic Discovery with nine pharma and biotech partners, creating the nation’s largest whole-genome DNA repository linked to electronic health records for both academic and commercial use.
Recognized as the nation’s academic leader in health information technology, the NIH Data and Research Support Center for the All of Us Research Program is based at VUMC. The All of Us Research Program is asking 1 million volunteers to share health and lifestyle information with the goal of accelerating research and medical breakthroughs.
Vanderbilt’s Department of Biomedical Informatics (DBMI) is one of the largest academic departments of biomedical informatics in the country, with more than 140 faculty members and an exceptional graduate training program. DBMI’s portfolio of research and development projects includes work in clinical, computational and translational informatics; bioinformatics; pharmacogenomics; systems biology; personalized medicine and more.
Many advancements developed at Vanderbilt, including an enterprise-wide electronic health record, clinical communication and decision support tools, and population-scale research resources, have been adopted by hospitals, health systems and research institutions across the nation.
Much more to come
Upon its sesquicentennial, it is easy to see how VUSM graduates have long been transformational ripples throughout the United States health care community and beyond. Ripples of innovation, excellence and compassion emanating from a single pebble drop, the awarding of the first medical degree by Vanderbilt University.
Here’s to many more extraordinary milestones in the centuries ahead.
1 Communication to Brooks, July 24, 1925, Box III-27, History of Medicine Collections, Vanderbilt University.
2Communication to Arthur Kendall, Dec. 16, 1933, Box II-38, History of Medicine Collections, Vanderbilt University.
