The most gruesome diploma in history was issued in 1782. It read:

"These may certify that Israel Keith Esq, has diligently attended an entire course of my Anatomical Lectures & Demonstrations; together with Physiological & Surgical disertations at the dissecting Theatre in the American Hospital, Boston: whereby he has had an opportunity of acquiring an accurate knowledge in the structure of the human body. John Warren, M.D. March 28, 1872."

At the top of the medical certificate was a likeness of the balding, bearded Dr. Warren. At either side was a grotesque dangling skeleton. At the bottom was a drawing of a surgeon, performing some sort of abdominal dissection upon a corpse with instruments faintly similar to oyster knives. The slashed end of a hemp rope dangled from the edge of the table. The other end of the rope was still fastened in a noose about the corpse's neck.

This was the first diploma awarded by the man who had sold the Boston Medical Society on the idea of anatomical dissection as a practical teaching method. Warren became the first professor of the Harvard Medical School the following year.

Respectability of diplomas has not been the only change down through 166 years of the Medical School's constantly expanding and sometimes turbulent existence. The school is now larger, its staff is more experienced, its equipment is of higher quality, and its problems more numerous than ever.

The present physical plant of Harvard Medical looks like M.I.T. set up on a small hill. Heavy Greek architecture and columns feature the massive, U-shaped external view. In the center is the Administration Building, Building A, which houses the Dean's Offices of the Medical School and the School of Dental Medicine, the Alumni Office, the Office of Graduate Courses, the Business Office, the joint library of the Medical School and the School of Public Health, and the Warren Museum, which has, among other displays, large tanks full of specimens of human hands.

Well-Stocked Libraries

The joint library is on the second floor, and contains nearly 100,000 volumes, plus 205,000 pamphlets and 900 periodicals. The 4000-volumes, 1500-pamphlet School of Dental Medicine library is further down Longwood Avenue. In addition, the other buildings hold well-stocked departmental libraries.

The remaining buildings are denoted merely by letter. Building B holds the Department of Anatomy, Histology, and Embryology. Opposite is Building C, containing the Departments of Physiology, Physical Chemistry, Biochemistry, and Experimental Surgery. Building D is occupied by the Departments of Bacteriology, Biophysics, Pathology, Preventive Medicine, and the laboratories of the Department of Medicine (internal). Finally, Building E houses Pharmacology, Legal Medicine, and Comparative Pathology and Tropical Medicine. The vast, almost monastic interiors of the buildings smell like a cross between a hospital and a chemistry laboratory--essentially what they are.

But as impressive as their own physical plant is, its administration is even more proud of the extent of the Medical School's hospital affiliation.

The very essence of the teaching method in the Medical School is clinical diagnosis. The student spends his first-year-and-a-half on normal required courses at the School. But the last two-and-a-half years he puts more and more of his time into working in hospitals in the clinical facilities at the School's disposal.

During this period the student is graded largely on his hospital and diagnosis efficiency. He works as part of the hospital team. The work he does and the diagnosis he makes are carefully checked by someone over him, who is checked in turn.

Although this is certainly not an unusual method of medical instruction, Harvard Medical students have an almost unrivalled opportunity to secure a well-organized clinical experience and knowledge of disease. A large number of cases in four major hospitals are available for student work--Massachusetts General, Boston City, Peter Bent Brigham, and Beth Israel. In addition, cases are used for teaching in nine specialist hospitals.

An active service is maintained to aid graduates in securing suitable hospital appointments as interns. These affiliated hospitals make about 100 such appointments each year.

These affiliations and appointments are two of the most desirable aspects of the Medical School, and a primary reason why it has to turn down nine out of every ten applicants. Harvard College annually gains the highest number of admissions, averaging between 30 and 40. The remainder are scattered about the country, although the Medical School seems to be following the unintentional College trend of taking a higher and higher percentage from the New England area.