For more than 90 years, the Department of Medicine at IU School of Medicine has had a rich heritage that has influenced the field of academic medicine throughout the world. IU School of Medicine was established in 1903 with Allison Maxwell, MD, being named the first dean for the University. From 1911 until 1913, Charles P. Emerson, MD, was the first chairman of the Department of Medicine and succeeded Maxwell as dean. Under Emerson’s leadership, several buildings still in use on the IU School of Medicine – Indianapolis campus were dedicated, including Long Hospital (now Long Hall), Riley Hospital for Children at IU Health, Coleman Hospital (now Coleman Hall) and Ball Residence.
During this time, there were very few full-time faculty within the Department of Medicine. Clinical training and patient care was the part-time responsibility of local internists, pediatricians and surgeons; no true clinical research laboratories existed on campus. In 1918, there were four medicine residents, one of whom was James O. Ritchey, MD, who became chairman of the department in 1932. During his time as chair, Ritchey moved the department into an important and influential role in both medical student education and the training of post-graduate internists. The Clinical Building, now Fesler Hall, was built in 1937 and the Laboratory Sciences Building was received from the Indiana State Board of Health.
In 1950, Robert J. Rohn, MD, joined the department as part-time faculty to spearhead the establishment of a hematology research laboratory. Three years later, Charles Fisch, MD, became the founding director of the Robert M. Moore Heart Clinic, later known as the Krannert Institute of Cardiology. The process of hemodialysis was introduced by department faculty into the clinical setting in 1954.
After Ritchey’s retirement in 1956, William M. Kirby, MD, was appointed as chairman of the department by Dean John Van Nuys, accepting a $22,000 annual salary with an operational budget of $141,800. During his short appointment, Kirby named Roy H. Behnke, MD, as chief of medicine at the VA, ultimately leading to a joint educational program between the VA and University Hospitals to train house staff and medical students.
In 1958, John B. Hickam, MD, was recruited from Duke University to head the department. It was then that the department began to see tremendous growth, excelling in medical academics and education. Medical student lectures were moved from Emerson Hall to the new Medical Sciences Building, subsequently named for Dean Van Nuys, and the entire medical school program was brought together at the Medical Center campus. Remodeling of the old medical school building was completed and renamed Emerson Hall; Phase I of University Hospital was occupied; the Indiana statewide medical education system was instituted by incorporating first- and, later, second-year students at eight campus locations.
In addition to establishing a centralized department, Hickam was instrumental in fostering various research initiatives and, by introducing the General Practice Preceptorship and integrating the VA, City Hospital and University hospitals, he played a significant role in revising the medical school’s curriculum. In his tenure, the department grew from less than 10 full-time faculty members to approximately 70. Grant funding was almost non-existent when Hickam assumed the role as chair; but by 1970, grant funding for the department totaled nearly $2.3 million.
The department’s 10 divisions were not formally established as they are today, but recruitment efforts led by Hickam resulted in the following: Philip A Christansen, MD, established the first training program in the state of Indiana for gastroenterology in 1958. This was also the first division to be organized across the three campus hospitals. William Deiss, Jr., MD, spearheaded the division of endocrinology the same year and was succeeded by C. Conrad Johnston, Jr., MD. In 1961, Charles Fisch, MD, became the director of the cardiology division; and in 1967, Arthur C. White, MD, was recruited to create an infectious disease division and Stuart A. Kleit created the nephrology division. When Hickam came to Indiana from Duke University, he brought Joseph C. Ross, MD, with him, who later became the director of the pulmonary disease division and pulmonary laboratory.
Hickam played a vital role in the progressive nature of the University until his untimely death in 1970. Walter J. Daly, MD, then assumed the role of chairman until he became dean of the school in 1983. Shortly after becoming chairman, he appointed David Challoner as assistant chairman to administer the house staff program. Joseph Mamlin, MD, who has been a part of the faculty since 1968, became chief of medicine at Marion County General Hospital, now Eskenazi Health, in 1971.
Research within the Department of Medicine continued to grow. A Specialized Center for Research (SCOR) in Hypertension was established by James T. Higgins, MD, in 1971 – the first of four established by the National Institute of Health (NIH). The Rheumatology Division was formed in 1975 under Kenneth D. Brandts, MD; the Diabetes Research and Training Center was funded in 1977 and was one of five such centers across the nation; and Ronald Hoffman, MD, succeeded Rohn as director of the Hematology/Oncology Division. One of the most notable research projects within this decade occurred in 1976 when Lawrence H. Einhorn, MD, presented the findings of his research on testicular cancer. The first patient was treated with new techniques established by Einhorn two years prior and now, the “Einhorn Regimen” is he standard protocol for the treatment of testicular cancer in the United States and beyond with a 95 percent cure rate.
The department’s practice plan, University medical Diagnostic Associates, was incorporated in 1971. This evolved from an executive physical program set up by Hickam for Sam Regenstrief’s Design and Manufacturing Corporation (D&M). Under Daly’s leadership, the department faculty grew from approximately 70 full-time faculty to 130, the house staff and fellows from 95 to 140, and research funding grew to approximately $8.1 million. Also during Daly’s term, Philip Snodgress, MD, succeeded Behnke as chief of medicine at the VA in 1983 and Richard E. Brashear, MD, replaced Ross as head of the Pulmonary Division.
When Daly became dean of the school in 1983, August M. Watanabe, MD, became chairman. The department continued to grow and excel with new research and clinical services. The Bone Marrow Transplant Unit was established in 1984; a cardiac transplantation program was established within the Department and Surgery, the Alcohol Research Center was funded, and the Division of Clinical Pharmacology was created in 1986. One year later, the Walther Oncology Center was established, as well as the Specialized Center of Research in Osteoarthritis. In partnership with the Department of Surgery, the liver transplantation program was formed in 1988, and in the same year, biostatistics formally became a separate division. Several changes in division chiefs occurred during this time: Lawrence Lumeng, MD, followed Christiansen in the Division of Gastroenterology in 1984; in 1988, T. Dwight McKinney, MD, succeeded Kleit in the Division of Nephrology; Robert B. Jones, MD, replaced White in the Division of Infectious Disease; and William J. Martin II, MD, became director of the Pulmonary Division. Fisch retired as director of cardiology in 1990 and was followed by David R. Hathway, MD.
Two major health care entities were incorporated into the school in order to sustain a referral base necessary for teaching and research: University Health Care, Inc. in 1986 focused on primary care, and Indiana University Health care Associates, Inc. in 1987 for managed care. The department underwent a major review and reconstruction in 1986 with the establishment of a finance area and its first chief operating officer, Charles F. Fox, Jr. At the same time, Watanabe organized associate chairs for post-graduate medical education, undergraduate medical education and clinical affairs.
An agreement between the Department of Medicine at IU School of Medicine and Moi University in Eldoret, Kenya was signed in 1990 to establish teaching programs and elective rotations for medical students and house staff. By 1990, both department faculty, and residents and fellows, had grown to approximately 200 individuals each.
After Watanabe’s departure from the School of Medicine, D. Craig Brater, MD, was appointed chairman and remains as such to this day. Since his appointment, there have been substantial changes in the junior core curriculum as well as the house staff program. A joint venture with the Indiana Regional Cancer Center and Community Hospitals of Indianapolis to establish and autologous bone marrow transplant unit began in 1991. In that same year, a lung transplant program was established. Outreach clinics were established by both University Health Care and Wishard Memorial Hospital to be better deliver primary health care to the community. Seed funding was also secured for both cancer research and cancer treatment buildings, and to build a nursing home/chronic care facility as part of Wishard Memorial Hospital. In terms of funding, the department continued to grow with $24.9 million in research grants by 1992.
Since its inception, the Department of Medicine at IU School of Medicine has grown exponentially and has trained approximately 75 percent of internists practicing in Indiana. The success of the department at an international level represents the cumulative efforts of a faculty dedicated to the tripartite mission of the department.