So Much to Learn, So Little Time
At Dallas’ Southwestern Medical School, one of the nation’s best research institutions, students not only have to master an exploding body of scientific knowledge—they also must learn to deal with social problems and a changing marketplace. No wonder becoming a doctor is harder than ever.
(Page 3 of 4)
The first Southwestern closed its doors in 1915 after a brief affiliation with Southern Methodist University. That hardly mattered, since Baylor Medical College was located in Dallas in those years, but Baylor’s move to Houston in 1943 threatened to leave the city without a medical school. Civic leaders and former Baylor dean E. H. Cary formed a foundation that started a new medical school in Dallas in the same year that Baylor departed. Both the foundation and the medical school bore the resurrected Southwestern name. But the new Southwestern, like its remote ancestor, could not survive long as a private, unaffiliated institution. Not until the post-war years did Cary find the right adoptive parent for the orphan school. The University of Texas system was ready to expand to meet the demands of a doctor shortage in a growing state. The system had only one medical school, at Galveston, and UT was looking for a venue suitable for another. At the time, Southwestern didn’t have a lot to show for itself, but it did have a large parcel of land that had been donated by local scion Karl Hoblitzelle and the support of the Southwestern Medical Foundation, a charitable arm of the local business establishment. That was more than other cities—principally, San Antonio and El Paso—had to offer, but it still took some clever politicking by Cary to get his little school adopted into the UT family. He first cozied up to the board of regents. Then, knowing that Dallas was—and always would be—unpopular with rural members of the Legislature, he helped push through a law authorizing a second UT medical school. He also persuaded lawmakers to hand over the decision of where to locate it to the House of Delegates of the Texas Medical Association. As historian John Chapman notes in his 1976 history of Southwestern, the strategy was simple: “if the Dallas delegation to the Legislature was not the strongest or most in�uential, its delegation to the Texas Medical Association was both powerful and well-respected.”
In 1949 Cary’s school officially became part of the UT system under the name Southwestern Medical School of the University of Texas. In becoming a member of the UT family, the school’s overseers had to give up its land and other assets to the system, as well as a great deal of control—including an agreement that 90 percent of the students would be resident Texans. But the school would remain small, obscure, and without much of a distinctive character for another couple of decades. The building of its new campus on Harry Hines Boulevard was steady but painstakingly slow, as was assembling a faculty. Though Southwestern had been adopted by a large, wealthy state university, years would pass before it would lose its identity crisis over being an orphan.
Big Science would provide that identity. The school was gaining its firm footing just as the biomedical wave was building up. Research was an arena where an upstart school lacking in pedigree could make a quick reputation for itself. Southwestern couldn’t hope to catch up with the Harvards and the Johns Hopkinses of the medical academic world according to the traditionally accepted measures—size and quality of the student population, teacher-pupil ratio, budget, and physical plant. If the school couldn’t compete for students, however, it could build a national reputation by competing for faculty. A few notable experiments, discoveries, papers, or awards by individual faculty members could instantly leapfrog the school over the competition.
By the seventies Southwestern was in position to go after the top professor-researchers. Funding, once a hand-to-mouth matter, now seemed to be rushing in from all directions. The school was finally getting large payouts from UT’s share of the Permanent University Fund. A bounty of federal research grants was available from Washington. Most important, annual donations from local benefactors began to top seven figures. In a two-year period, for example, two Texas Instruments executives, Erik Jonsson and Cecil Green, gave the school a combined $4.6 million to help fund teaching chairs and building projects. With other donations, Southwestern was able at last to finish much of the master plan it had commissioned in the sixties. An odd collection of buildings next to Parkland Memorial Hospital began to grow at astounding speed: During the decade, the Fred F. Florence Bioinformation Center, the Tom and Lula Gooch Auditorium, the Cecil H. and Ida Green Science Building, the Eugene McDermott Academic Administration Building, the Philip R. Jonsson Basic Sciences Research Center, and assorted necessities such as a large parking garage were erected. By 1976 the number of students, including postgraduates, passed one thousand; the next year, Southwestern graduated its 3,000th doctor.
Meanwhile, the faculty was beginning to attract notice in the world of medical academe. In 1978 two Southwestern doctors were published in the prestigious New England Journal of Medicine; the next year saw the first Southwestern faculty member named to the National Academy of Sciences. Such modest acclaim might seem trivial compared with the yearly accomplishments of the faculties of the nation’s top medical schools, but at Southwestern, it was an indication that the school’s recruiting policies were working.
The Southwestern recruiting gospel was the brainchild of Donald Seldin, the chairman of internal medicine. The one advantage that Southwestern had over high-prestige schools like Harvard was that it wasn’t encumbered by tradition. At the established schools, young professors had to wait their turn. At Southwestern, though, professors could make a name for themselves immediately and in a big way. Armed with increasing amounts of funding, Seldin and others set about identifying and wooing the rising stars of biomedical research.
Seldin started out by recruiting his own students. He made the brightest students his protégés, sent them off to continue their studies at the top medical institutions in the East, and at the appropriate time, talked them into returning to Southwestern as professors and researchers. Then he encouraged them to spread the word about Southwestern to other scientists they met along their academic career paths.
One of the first and, as it would turn out, most notable of Seldin’s returnees was Joseph Goldstein, who had graduated from Southwestern in 1966 with plans to become a neurosurgeon. Seldin persuaded the brilliant young scientist to pursue genetics at Massachusetts General Hospital in Boston and then coaxed him into returning to Southwestern to teach and do research in the discipline. When Goldstein came back to Dallas, he brought with him fellow geneticist Michael Brown. “It sounded to me like a Bible school,” Brown would tell the Wall Street Journal in 1994. “But Joe kept telling about this wonderful Dr. Seldin and how he had already begun building a team better than Massachusetts General.” In 1977 Goldstein was named to head a new basic-science department.
Goldstein and Brown took full advantage of the academic atmosphere Seldin had championed at Southwestern: In 1985 their ongoing work on the genetic control of cholesterol metabolism in the body was awarded the Nobel prize for medicine—the first in the school’s history. Almost overnight, Southwestern became a viable option for young researchers weary of the morass of tradition and bureaucracy at other schools. And Southwestern had the money to suit their needs: State funding had jumped to more than $60 million, allowing the school to expand its space to more than 2 million square feet. More importantly, the Nobel at last gave the school’s leaders something tangible to show to the city’s new generation of philanthropists to get them to open their checkbooks. When oil and real estate crashed in the mid-eighties and state funding dipped by 13 percent, Southwestern had to get more private money. “We knew we were dealing with very smart, careful philanthropy,” says president Wildenthal. “We had to craft very specific proposals for donors.”
The sales pitches have centered on Southwestern’s commitment to biomedical excellence. Scientists were the school’s stars—Brown and Goldstein in genetics and molecular biology; Johann Deisenhofer, whose work in photosynthesis brought Southwestern its second Nobel, in 1988; and Alfred Gilman, who won the third Nobel, in 1994, for work in cellular communications.
The pitch to canny, science-minded donors like Ross Perot was the opportunity to have their names on research projects and educational programs that were on the cutting edge of scientific inquiry. Donors could match their interests to Southwestern’s research programs. Perot, for example, had long expressed a deep interest in ensuring that the school continue competing for and winning Nobel prizes. So, after a year of discussion, the persnickety billionaire agreed to fund the school’s M.D.-Ph.D. program. Big civic names like Aston, Zale, McDermott, and Jonsson adorn the center’s array of clinics and specialized educational centers. The list of its “lifetime benefactors” (donors who have given more than $l million cumulatively) reads like a who’s who of North Texas’ wealthy and powerful—among them Perot, Moncrief, Seay, and Simmons.
For all its achievements and high local profile, however, Southwestern continues to be routinely excluded from rankings of top medical schools such as U.S. News and World Report ’s annual scoresheet, largely because its student-to-faculty ratio remains relatively high and its mandated Texas-resident student base prevents it from recruiting the best and brightest students nationwide. The mean MCAT (Medical College Admissions Test, the entrance exam for medical schools) scores of its students are the highest among the state’s public medical schools at 31.7, compared with UT’s branches in San Antonio, 29.1; Galveston, 27.5; and Houston, 27.1. But the all-important figure still lags behind, say, the mean score of Harvard Medical School’s class of 2000, which is 33.8. Southwestern’s reputation in the research community is secure: A study tracking how often the published work of faculty members in all disciplines was cited by other authors between 1981 and 1994 placed Southwestern among the eight most-cited faculties in the country, a group that included Yale, Harvard, and Stanford. But outside the research community, Southwestern remains, to some extent, the little orphan who still isn’t taken quite seriously by those who look first at pedigree.
My Library
