If Federal matching could be available for medical and dental educational facilities, including the teaching hospitals and dental clinics, this would go far to insure the completion of our medical center on schedule and it would permit the Hill-Burton funds to be used where they are needed in the improvement of community hospitals throughout the State of Kentucky. The provision of such funds would also accelerate our development. According to our present schedule we cannot contract for the dental school facility until 1960, when, presumably, sufficient Federal funds will become available to match State moneys to permit us to enter into a contract. The delay factor introduces risks for this phase of the development, in that costs may rise during the intervening period and contracts for the dental clinic cannot be let until a new administration is in office, at which time it is possible that the political climate or economy of the State would result in the indefinite postponement of this phase of our development. Our financial plan is so tight that I believe we will find the money allocated for equipment inadequate, and Federal matching funds could be very helpful, perhaps, in enabling us to equip properly our new medical center. I hope that Congress will take action to make funds available. I believe that such money is of great importance and should carry a high priority, particularly so now that we are in the sputnik era. If I can assist in any way, do not hesitate to call upon me. Yours very truly, WILLIAM R. WILLARD, M. D., Vice President. P. S. Since dictating this letter your recent memoranda, Nos. 9 and 10, arrived. You asked that we indicate the additional number of students that will be accommodated as a result of the development of our facilities. We are planning for a class of 75 medical students, 50 dental, and 60 to 100 nursing students. On a supplementary page we have tabulated the potential enrollment of the various kinds of students after our medical center is fully developed. The figures indicate that about 1,000 students in full-time residence and about 1,000 part-time students might be enrolled in any given year. Since this is a new center, these figures represent an increment over existing resources. One point covered in the letter but not emphasized is our need for Federal matching funds for the construction of hospital and patient care facilities. The inclusion of hospital beds has not been indicated in any previous proposals that I am aware of, except in the Hill-Burton program. In my opinion, it would be desirable either to supplement the Hill-Burton program, or to include patient care facilities for teaching centers in any proposed legislation. WILLIAM R. WILLARD, M. D. University of Kentucky Medical Center projected enrollment in the education programs at full development Medical students (75 per class) Interns, residents, and clinical fellows. Postgraduate medical education (part-time) Dental students (50 per class). Dental interns and residents__ Postgraduate dental education (part-time or short-term) Nursing: Collegiate program (70 per class). Supplementary program In-service training Extension enrollment_ Graduate program__. Anciliary programs: Dental hygiene_. Occupational therapy. Laboratory technology Clinical psychology Total_ Obviously, many of these figures represent crude estimates, we have been saying that at full development we can anticipate at least 1,000 students of all kinds in full-time residence, and another 1,000 students enrolled for short-term or part-time postgraduate education. STATEMENT OF NEED OF THE UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE FOR NEW FACILITIES, JANUARY 17, 1958 1. The present medical school (basic science) building was constructed in 1892. An annex was added in 1935. In 1950 a small, very old building immediately adjacent was remodeled and joined to the annex; this houses research activities exclusively. Even in 1937, a survey team reported that our facilities were inadequate. In December 1954, a second survey team reported that: "The present medical school building does not provide proper and adequate space for current and planned activities. In all instances, most efficient use of the space available is seriously handicapped by the many difficulties which are an inherent part of such antiquated building." It recommended: "There should be vigorous pursuit of plans for total replacement of the current facilities." 2. The present necessity of sharing of laboratories and lecture rooms by different departments (and with the dental school) imposes great difficulties in scheduling and has resulted in making it next to impossible to institute curricular changes which are desired by the faculty to keep pace with modern trends in medical education. 3. The research programs of the school have grown so rapidly in recent years that every available square foot of space is being utilized. It has become necessary to move for storage articles of equipment, reserve books, etc., to a building nearby which the university has leased, in order to free space for research purposes. Even that has not freed nearly enough even to approach the demands for it. The building is almost literally "bulging at the seams." One result has been that one department has been unable to offer a fellowship to an individual who is available and for which there are funds on hand, for the simple reason that we can find no place for him to work. Another more serious effect is that it has made it so far impossible for us to obtain the services of a qualified chairman of the department of anatomy. Several candidates who have been interviewed have not been interested-invariably on the single basis that they could see no possibility that we could provide adequate space for the needs of the department. An application is being prepared for a research building for the basic sciences. However, we have no assurance that this will be approved, and even if it is it will still not permit the development of adequate laboratories, classrooms, or library facilities in the present building because of its antiquated structure. 4. The University of Kentucky is about to construct a completely new medical school "from scratch." It is estimated that the cost, with that of a university hospital, will be approximately $25 million. It is expected to be open for the first freshman class in 1960. It is not difficult to imagine the psychological effect on a young applicant when he compares its beautiful new building with the ancient structure occupied by its sister school. Other factors are likely to be of secondary importance to an impressionable youth in choosing his medical school. This is a cause of very considerable worry to us. 5. Because our teaching hospitals are located 2 blocks away from the medical school building we would locate a new building adjacent to them, to conserve time and increase efficiency. Although it is possible that the present building could then be remodeled so that 1 or perhaps 2 departments could then remain here, the isolation resulting therefrom would be extremely undesirable in view of our constant efforts to promote more interdepartmental cooperation in our instructional program. There are many other uses to which the building could be put with relatively simple changes, e. g., student housing. 6. It is our intention to plan a new structure to accommodate up to 124 students per freshman class, if necessary. J. MURRAY KINSMAN, 1 M. D., Dean, University of Louisville, School of Medicine. THE JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE, Dr. WARD DARLEY, Evanston, Ill. DEAR DR. DARLEY: In response to your recent memorandum, I am submitting a statement relative to our need for funds for modernization and expansion of existing medical teaching facilities. You may use the whole or parts of this statement in any way you see fit. The Johns Hopkins School of Medicine was established some 60 years ago. Some of its present buildings were built before the beginning of this century, and most of them are more than 40 years old. During the past few years, our endowment income has decreased in relationship to current operating expenses of the school of medicine so that year after year we are faced with an operating deficit. While one new building has been built in the past few years and construction is just beginning on another, in general, our physical facilities for medical teaching badly need either replacing or modernization. It appears that the only likely source of funds for this purpose, or, at least, a substantial portion of them, is the Federal Government. I trust that the Association of American Medical Colleges will take all feasible steps to bring this situation, which is similar to that existing in many medical schools, to the attention of the appropriate congressional and executive committees. Specifically, we estimate that our immediate needs for modernization are $2,520,000, and that our needs for new construction for teaching purposes are $2 million. These represent only our immediate and urgent needs; longer range plans call for larger sums. At the present time, we have no plans for enlarging our student body. THOMAS B. TURNER, M. D., TUFTS UNIVERSITY SCHOOL OF MEDICINE, Dr. WARD DARLEY, Association of American Medical Colleges, DEAR DR. DARLEY: Tufts University School of Medicine and School of Dental Medicine are very much interested in Federal construction funds. The pressing needs of the school of dental medicine have been presented to the American Association of Dental Schools. The needs of the medical school are urgent. We cannot have a department of microbiology until we have space to house its members, both in offices and laboratories. The student laboratory is inadequate. For the same reasons, we cannot have a division of biophysics. The medical library is inadequate; many days, there is not a seat to be had. The available stack space will be completely exhausted in 2 years. There is no lecture hall that will accommodate more than one class. The number of graduate students that can be accepted is limited in all departments, and zero in some, because of inadequate laboratory space. Were these deficiencies to be met, the size of the medical-school classes could be increased by 5 to 10 percent. It is hard to estimate the cost of this program until it is determined whether a new dental clinic is to be built. If such is built, and if it also includes the laboratory for preclinical technique, this would free 2 floors in the medicaldental building, as well as some 1,500 square feet of research laboratory space. or a total of 21,500 square feet. With remodeling, this could take care of medical-school needs, except for library and auditorium, for the next 10 years. The estimated cost might be $500,000. A like amount would be required for expansion of the library and an auditorium. If no dental clinic is built, and if the needs of the medical school must be met by new construction, the cost would be $2 million or more. These, of course, are my own very rough estimates, but, I hope, may be of some use to you in presenting the needs of the medical schools of this country. Sincerely yours, J. M. HAYMAN, Jr., M. D., Dean. Dr. WARD DARLEY, UNIVERSITY OF MICHIGAN MEDICAL SCHOOL, Executive Director, Association of American Medical Colleges, DEAR DR. DARLEY: We have just completed plans for the second unit of our medical-science building, and expected the legislature to make a commitment to us this year. We have done likewise for a pediatrics hospital and for a chronic-illness hospital. However, our legislature has become most economicminded, and, obviously, is not going to give favorable consideration to our requests at this time. It is doubtful, also, that we shall be favored in respect to these capital outlays for the next several years, judging the present attitude of the legislature and the financial situation of the State. If we could obtain matching funds, however, this would be a tremendous inducement to our legislature. May I, therefore, list the following: 1. 2d unit, medical-science building, cost--. 2. Pediatrics hospital, cost--. 3. Chronic-illness hospital, including facilities for rehabilitation, cost--- Total_____. $9, 000, 000 9, 000, 000 8, 000, 000 26, 000, 000 I hope that you may use these requests in your approach to Congress. A. C. FURSTENBERG, Dean. UNIVERSITY OF MINNESOTA, THE MEDICAL SCHOOL, Minneapolis, March 22, 1958. Dr. WARD DARLEY, Executive Director, Association of American Medical Colleges, DEAR DR. DARLEY: This letter is in response to your recent memorandum requesting information about the needs of the various medical schools for instructional facilities. At the University of Minnesota Medical School, our needs relate principally to a biological-medical library and to instructional facilities for the basic-science departments. Our needs in the clinical departments are less acute, since these facilities are newer. The following is a list of needs which we foresee in the next 3 to 5 years: A. Biological medical library: This is a longfelt need on our campus, for at the present time our biological-medical library is part of our main library, located a considerable distance away from the medical-school area. A biological-medical library which would fully meet our needs would cost $1.5 million. We have at the present time $832,000 from legislative appropriation for this purpose, and we are making current plans for a building to cost this amount, realizing that it will not be completely adequate. This leaves a balance of $668,000 necessary to build a library which we would consider entirely adequate. B. Basic-science teaching facilities: Teaching facilities in our basic-science departments are more than 40 years old and are badly in need of remodeling. In addition, expansion of these facilities is required in order to accommodate the larger classes which we will be accepting (vide infra). Estimated cost of rehabilitation and expansion of these facilities is $1,248,000 (including $120,000 for the school of dentistry). The university administration has agreed to request $860,000 of this amount from the 1959 legislature, which would leave a balance of $388,000 necessary for the completion of basic-science teaching facilities. The extent to which the legislature will meet this request is, of course, problematic. C. Rehabilitation and expansion of lecture rooms: Two lecture rooms currently used for classes in the junior and senior years are in need of rehabilitation and expansion to accommodate the larger classes. Total cost is estimated at $150,000. The source of these funds is not in sight. D. Office space for clinical departments: Currently, several clinical departments are operating under very crowded conditions with regard to their office space. This situation will become worse when the clinical departments have to increase their staffs to accommodate the larger classes that they will be responsible for, beginning 2 years hence. Estimated needs here are $100,000, and, again, no source is apparent at present. The foregoing needs total $1,306,000, and are based on the assumption that the Legislature of the State of Minnesota will appropriate $860,000 in 1959. Should such an appropriation fail to materialize, our needs will, of course, be even greater. In the past, our basic freshman enrollment has been 125 students. This is being increased to 140 students in the freshman class entering in the fall of 1958, and, further, to 150 students in the freshman class entering in the fall of 1959. Thus, we have already committed ourselves to larger classes, and we are assuming that we will be able to complete the expansion of our physical facilities to accommodate them. Although I cannot assign a precise proportion, I estimate that, roughly, half of the above-mentioned funds needed would be used for rehabilitation and the other half for expansion. The foregoing estimates are based on the further assumption that during the next 3 to 5 years there will be no fundamental changes in concepts or philosophy of education at this institution. In other words, these estimates do not include the needs which might arise should curricular changes or other experimental educational programs be introduced. Finally, one additional need should be mentioned. At the present time, we have no satisfactory facilities for student-lounge purposes. We have an area which probably could be converted to such use for approximately $50,000. I hope that this information is what you need for your purposes. Please let me know if you would like any further details. I do hope that you and your colleagues will be successful in your representations. With best personal regards. Sincerely yours, ROBERT B. HOWARD, M. D., Associate Dean. DARTMOUTH MEDICAL SCHOOL, Hanover, N. H., January 21, 1958. Dr. WARD DARLEY, Executive Director, Association of American Medical Colleges, Evanston, Ill. DEAR DR. DARLEY: With regard to your memorandum No. 9, which concerns Federal constructive funds for medical and dental schools, I may answer the following for the needs of Dartmouth Medical School: (1) Our immediate and urgent need is for a modern facility to house adequately the research and teaching activities of the medical school. To this end plans are completed for a new medical-science building estimated at a little over $3 million. A great request totaling $1 million has been filed under the Federal health-research-facilities program. We are in process of raising the $1 million needed to match the Federal grant and the other $1 million to finance the cost of the instructional portion of the building. When completed, this new building will allow the medical school to double its enrollment, i. e. we will go to 50 students per class. (2) A much needed addition which we anticipate as the second stage in physical-facilities development, will be an adjoining library and auditorium to the medical science building. Estimates on this structure, are in the neighborhood of $1 million. In summary, our school's stake in any Federal construction funds which might become available would amount to needs of approximately $2 millionthis includes the cost of teaching facilities in the new medical science building and the auditorium and library to be constructed adjoining. Our enrollment with these new buildings could be doubled. It was a pleasure to see you in Washington the other day. I am sorry there was not a free moment to talk at greater length. Regards, S. M. TENNEY, M. D. |