Medical School Convocation

The systems approach, more commonly associated with computer technology than with humanity, was projected as an answer to educational, as well as societal, problems at a convocation October 2 commemorating inauguration of a new three-year M.D. program at the Dartmouth Medical School.

President Kemeny, the keynote speaker, said man's capacity to understand the implications of complex contemporary systems, whether they be the city, the industrial corporation or the university, is extremely limited, and he urged the American academic community to come up with new "analytical tools."

He suggested that social scientists, mathematicians and computer specialists join in a "think tank" concentration on fundamental research to analyze and predict the behavior of such complex systems. He pointed out that past knowledge had generated excellent means for handling relatively simple systems, but that complex systems of major social systems not only confound by their complexity, but often respond to efforts at improvement in ways that are the reverse of the intended.

President Kemeny said, "We need a brand new professional. I would call him a social analyst. I am talking about men who specialize in being expert on complex systems as opposed to being expert in psychology, sociology, government or economics, who combine the knowledge of the social sciences with mathematics and knowledge of the computer capable of attack on complex systems wherever they arise."

In a similar vein, William D. Carey, former assistant director of the Bureau of the Budget, who is with the management consulting firm of Arthur D. Little, Inc., said some form of "social accounting" should be substituted for what he called "the sancrosanct" Gross National Product.

He said the nation needs "some chart of our progress, or lack of it, over the spectrum of housing, nutrition, unemployment, health care, recreation, environmental quality, transportation, crime and poverty."

Mr. Carey, in reporting that the U. S. Gross National Product would rise $270 billion in current prices within five years, to $1.2 trillion by 1975, said that neither social scientists nor government experts had devised a means to measure how such an increase should be spent to meet national social priorities or even how to set such priorities.

Dr. Carleton B. Chapman, dean of the Dartmouth Medical School, referring to the new three-year M.D. program, said, "The establishment of a new medical school, whether de novo or on the foundations of an old one, itself represents a policy decision in the public interest and implies the recognition of certain priorities. This, in effect, is what Dartmouth is about at the present time. In theory, it ought not be difficult. Medical education serves a system, and its primary obligation is to provide training for enough people to man that system effectively."

Citing the awakening in recent years among medical schools of their responsibility to help deliver health services, Dr. Chapman said, "Medical schools over the country are increasingly involved in all sorts of programs, most of them experimental, that are designed to provide some sort of answer to some aspect of the nation's health care problem.... One thing is emerging with dramatic force: problems of this sort are not, by their very nature, handled very effectively by the medical schools alone. They are problems that rightly belong to the university as a whole. And few, if any, American universities are themselves structured to meet such a need."

Other convocation speakers were Dr. Roger O. Egeberg, Assistant Secretary for Health and Scientific Affairs, Department of Health, Education and Welfare; Dr. John S. Toll, President of the State University of New York at Stony Brook; Dr. James G. Wyngaarden, professor and chairman of the Department of Medicine at the Duke University Medical Center; and James M. Cox, Avalon Professor in the Humanities and Professor of English at Dartmouth College.

Resumption of the M.D. program is a milestone in the history of the Dartmouth Medical School, the nation's fourth oldest, founded in 1797. The full M.D. program was discontinued at Dartmouth in 1914 when it was recognized that the clinical teaching resources then available were insufficient to the training demands of new medical knowledge. Since then Dartmouth has concentrated on providing a superior two-year program in the basic sciences with its graduates transferring to quality M.D. schools to complete their studies.

Key to the three-year M.D. program at the Dartmouth Medical School is shortening of the curriculum by compression of material and adoption of an 11-month academic year. Acknowledging that the standard M.D. curriculum is geared to a bygone era when a majority of M.D. graduates immediately went into general practice, Dartmouth has cut away from the traditional curriculum much that is considered after careful study to be non-essential.