Johns Hopkins: A Canadian medical school?

CMAJ | JULY 4, 2017 | VOLUME 189 | ISSUE 26 E893 Q uestions about the special role Canadians play globally have new resonance as we observe the strikingly different leadership styles of Justin Trudeau and Donald Trump. William Osler, first chief of medicine at Johns Hopkins Hospital in Baltimore, was Canadian. Turns out, there were plenty of Canadians in early leadership roles at Hopkins. Shortly before his death in 1919, Osler remarked upon how “well and gently” his equally influential American cofounders had accepted the “Canadian personality” during the institution’s early development.1 There were also whispered criticisms, however, that too many Canadians were calling the shots at the new and important medical university.1 The innovative and idiosyncratic teaching methods in medicine and nursing that constituted the Hopkins model were emulated by medical and nursing schools across North America. To what extent did a distinctly Canadian influence exert itself in terms of institutional dynamics, teaching or research? I am currently exploring this question using archival collections and published works. Here, I highlight three important dimensions for investigation: the perception, selection and selfidentification of Canadians in key leadership roles at Johns Hopkins during its first 50 years (1889–1939). Various factors explain why the Johns Hopkins medical model evolved as it did. Central was the principle that hospitals were instruments of nursing and medical education, and that the latter required bedside instruction and laboratory experience. This vision incorporated multiple European and British traditions in new ways, and the university’s trustees had ample resources to execute it (despite later shortfalls), which attracted talented faculty.2 John Shaw Billings, hired to design the visionary teaching hospital, acknowledged that its success would not depend on his architectural choices, but on the careful selection of “proper and suitable persons” — Billings specified six men and one or two women — “to be the soul and motive power of the institution.”3 The early leaders at Johns Hopkins were charged with institutionalizing state-of-the-art therapeutics, curricula and research, and they handpicked individuals for admission and promotion.4 The influence of individual personalities and collective identities are also important HUMANITIES | MEDICINE AND SOCIETY