Something Challenging
The gray-haired man with the boyish features put his fingertips together in front of him, carefully matching right to left. "I am 57," he said. "If J wanted to do something new and challenging, this was the time to do it." That is why Robert McCollum left Yale after 31 years and came to Hanover, exchanging the chair of Yale's department of epidemiology and public health for the deanship of the Dartmouth Medical School. McCollum, who played a leading role in the research that led to the vaccine for poliomyelitis, is now studying hepatitis, though that work has been shelved temporarily while he settles into his new administrative position. The Texas-born doctor is soft-spoken and selfeffacing, and his staff" already credits him with a lift in office morale.
He explained why he chose Dartmouth: "This medical school is old by age, good by reputation, and evolving toward a new image and a new mission. And it's unique in its rural setting."
McCollum went on to point out the advantages of Dartmouth's location: "The focus of modern medicine tends to be the large, urban medical center. It's hard if you have been trained in the climate of a metropolitan hospital to imagine a rural hospital could be as exciting. It's true that we don't have the concentration of patients, the complications, or the variety of illnesses that they do in the city; and to some, this diminishes our value as a teaching and training place. But I don't see it that way. We have an abundance of medical and health problems, not the same as those in the city, but nonetheless real and important in medical education developmental problems and pediatric-care problems, problems with an aging population. They run the spectrum, but the mix is'different. The location of Dartmouth's medical school serves to introduce students to these problems, and it should attract people to practice away from urban centers. I feel very positive about it."
Not that a Dartmouth medical education need be totally rural, McCollum explained. "Part of our uniqueness is the combined Dartmouth/Brown plan. When the new four-year program gets fully underway year after next, each entering class will consist of 85 students, all of whom will be here for the first and second years of study. In the third and fourth years, about 20 of them will go to Brown for their clinical work two years of urban experience in Providence. We hope this link will lead to enriching faculry and student exchanges and some joint work in urban/rural comparative research as well. It should also enhance our teaching in the clinical years."
Asked about his first four months as dean, McCollum said frankly, "Rough! The toughest problem he has inherited is the tangled state of relations among the Hitchcock Hospital, the Hitchcock Clinic, the Medical School, and the V. A. Hospital as the group evolves slowly, and sometimes painfully, toward a unified Dartmouth-Hitchcock Medical Center. "The basic decisions were made last year, and it was my understanding that by the time I got here differences would have been resolved and worked out, lamented McCollum. "But they're bogged down in the hands of the lawyers, who are trying to work out the details of what is still only a group understanding about fiscal relationships and governance." A major hitch, said McCollum, is the question of the location of the Hitchcock Clinic's new family practice facility. His understanding is that some clinic members are currently inclined toward a location on Route 120, the main road from Hanover to Lebanon. "If that were to happen," he said, "it would not be an effective part of the center. The happiest outcome as I see it would be a plan allowing for the clinic to remain entire and well-integrated into the medical center on site. We're also hoping to see it evolve into a not-for-profit foundation intimately involved not only in the academic programs and development but also in providing some of the financial support of the Medical School what President McLaughlin calls 'academic reinvestment.'"
On the bright side of his first four months was the unexpected and welcome gift of $500,000 from the Foster McGaws in honor of Mrs. McGaw's son James Vail '5O, the third Vail to have been memorialized by the generosity of the McGaws. The money will be used to initiate a medicalstudent loan fund that will cushion the effect of governmental cuts in graduate student loans. McCollum is enthusiastic about the new fund, which will, he said, provide loans at much better rates than the old governmental programs written at commercial bank rates of 18 or 19 per cent.
McCollum worries that medical school expense may be part of the reason behind falling enrollments across the country. "The postwar baby boom has peaked, of course, and fewer young people fall into the age range for entering medical students," he explained, "but the decrease goes beyond that. We don't know exactly why. Perhaps the glory of medicine is less than it once was. Perhaps fewer people can afford to become doctors. Next year, tuition at Dartmouth is going to be around SI 1,500 a year, and what with living expenses, the average single medical student can expect to spend at least S 16,500 annually. Given inflation and interest on loans, the total bill might well come to SBO,OOO for those entering this year. I can't imagine that that's not a deterrent."
Recruited from Yale. Robert McCollum joinsthe Nathan Smith succession as medical dean.
