The origin of the full-time faculty system. Implications for clinical research
W. B. Fye
Cardiology Department, Marshfield Clinic, WI 54449-5777.
Clinical research has long been viewed as a fragile pursuit requiring
special nurturing. The full-time clinical faculty system was introduced in
the early 20th century to provide a milieu that would foster clinical
investigation. This article, based on extensive archival research, will
show that the main goal of the architects of the full-time system was to
stimulate research by removing the incentive for medical professors to
devote their main energy to practice. The plan was developed by preclinical
scientists at The Johns Hopkins Medical School (Baltimore, Md) and was
inaugurated there in 1913 with the financial assistance of the Rockefeller
General Education Board. As other medical schools adopted traditional
academic criteria for appointment and advancement, there were additional
incentives for faculty members to undertake research. In the 1920s, the
General Education Board yielded to pressure to liberalize its definition of
full time and began to support medical schools that implemented what came
to be known as the "geographic full-time plan." Increased government
support and other factors encouraged the expansion of full-time plans and
led to an impressive increase in the output of research. Today, growing
pressure on full-time clinical faculty members to generate income from
practice for themselves and their institutions threatens the future of
clinical research in this country.
