E-drug: Re: Adm org of universities of medicin and pharmacy (cont'd)
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Dear Ms Brunneton,
Allow me to comment on the schools of medicine in the US, with a few words about
The Netherlands..
In the US, the schools of medicine are either private institutions or
institutions of the individual states (there are 50 states, each with its own
ideas about how to do things), and typically, though not universally, the
state-sponsored medical schools are parts of that state's university system.
So, in California, where I live most of the time, there is the University of
California, which is an arm of the government of the State of California; the
University has seven campuses -- Berkeley, Los Angeles, San Diego, Riverside,
Irvine, Santa Cruz, and Davis. There are schools of medicine at San Francisco
(UCSF), Los Angeles (UCLA), San Diego (UCSD), Irvine (UCI), and Davis (UCD). I
cannot recall if there is also one at Riverside. The University of California
has been very successful at raising private funds for its independent endowment,
quite apart from the moneys that it receives annually from the State
Legislature. The private funds give the University system a great measure of
independence. Similar independence, because of private donations to endowment
funds, is found in other big state university systems -- Wisconsin, Texas,
Nebraska, Kansas, to name a few. It is one of the many aspects of the genius of
the federal system of 50 quasi-independent states in the US, and their
willingness to accept, and abilities to raise, private moneys to help support
the state university systems, including the medical, pharmacy, dental, and
nursing schools. There is a Department of Education in the US Government, but
it has little or no role in these big university systems, which are really
creatures of the individual states plus the private endowments that support many
aspects of their work. The National Institutes of Health, which is the biggest
single supporter of biomedical research worldwide, is part of the US
Government's Department of Health and Human Services, but it enjoys a
considerably degree of autonomy because of long-running Congressional support of
biomedical research and resistance to seeing it either politicized or
bureaucratized.
Wholly private schools, e.g., Harvard, Johns Hopkins, University of
Pennsylvania, Yale, University of Chicago, Rockefeller, Mt Sinai, Columbia, have
managed to grow in both facilities and faculty by raising private funds. They
are, of course, major recipients of research and training grant support from the
National Institutes of Health and other granting agencies, but the organization
of the grant review system is such as to prevent the granting system from being
an arm of bureaucratic control, except to assure that the schools operate in
harmony with the national government's policies in respect to pollution, equal
opportunity under the law, and so forth.
One could point to many inequities and problems in this vast and diverse system,
which numbers well over 100 schools of medicine, but in its great diversity,
aided and abetted by the diversity of sources of supporting funds for both
operations and endowment, it is a dynamic and vital force in biomedical research
and education.
In The Netherlands, where I serve as part-time professor of
pharmaco-epidemiology at Maastricht University, the universities and schools of
the various health professions are all creatures of the national government, via
the Ministry of Education. There have been some attempts to emulate the
American schemes of raising private money, but for the most part such efforts
are rejected on the basis of "who wants to give money to the Ministry of
Education? We already pay taxes."
Part of the impetus to private giving to either private or state medical schools
in the US is the deductibility of such gifts from individual Federal income
tax. Another is the willingness of the schools to put the names of large donors
on, e.g., buildings, rooms within buildings, professorships, etc. A great deal
of ingenuity has been invested in devising ways to stimulate private giving to
both state and private schools. For example, J.P. Morgan has his name in a
prominent place on one of the main buildings of the Harvard Medical School, for
having donated the funds needed to construct those buildings back in the first
decade of this century. In contrast, John Urquhart has his name on a small
brass plaque aside 426 Vanderbilt Hall, which is the single student living
quarters at Harvard Medical School; 426 Vanderbilt was my room during the first
3-1/2 years of my studies there, until I married. About 15 years ago, my wife
and I donated the funds necessary to renovate the room.
John Urquhart, MD, FRCP(Edin)
Palo Alto, California
Maastricht, Netherlands
urquhart@ix.netcom.com
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