{"id":13195,"date":"2017-11-29T11:00:05","date_gmt":"2017-11-29T16:00:05","guid":{"rendered":"http:\/\/circulatingnow.nlm.nih.gov\/?p=13195"},"modified":"2024-10-21T11:00:15","modified_gmt":"2024-10-21T15:00:15","slug":"michael-debakey-and-the-education-of-american-surgeons","status":"publish","type":"post","link":"https:\/\/circulatingnow.nlm.nih.gov\/2017\/11\/29\/michael-debakey-and-the-education-of-american-surgeons\/","title":{"rendered":"Michael DeBakey and the Education of American Surgeons"},"content":{"rendered":"

By Justin Barr ~<\/em><\/p>\n

\"A<\/a>
Michael E. DeBakey, ca. 1942
NLM #101413427<\/em><\/a><\/figcaption><\/figure>\n

Michael DeBakey came to Houston in 1948 as the new chairman of the Department of Surgery at Baylor College of Medicine.\u00a0 Upon arriving, he discovered that \u201cmost of the physicians doing surgical procedures [there] were not qualified, they did extremely poor quality surgery.\u201d\u00a0 He recalled one particular episode when a general practitioner tried to perform a complicated operation called a Whipple Procedure for pancreatic cancer and mangled it so badly the patient died.\u00a0 On numerous occasions, DeBakey had to step in to the operating room to help the local surgeons through their cases.\u00a0 Disgusted with the state of surgery in Houston, DeBakey set about to improve it.<\/p>\n

Rather than exceptional, this scenario was representative of the state of American surgery in the 1940s and 1950s.\u00a0 In the early 20th century, most surgeons trained by a combination of apprenticeship and post-graduate courses.\u00a0 This model worked well enough when operations were rare and relatively simple, like appendectomies and draining abscesses.\u00a0 As the 20th century progressed, medicine and surgery changed to encompass new technologies and therapies.\u00a0 Everything from penicillin to blood transfusions to X-rays led to a dramatic increase in both the number and complexity of operations.\u00a0 The old educational model no longer sufficed.\u00a0 Producing competent surgeons required a new system called residencies:\u00a0 formal, 4-year, post-medical school, regimented experiences.<\/p>\n

DeBakey himself did not complete a formal residency.\u00a0 He graduated from Tulane Medical school and then spent one year working as an intern at Charity Hospital with senior surgeon Alton Ochsner.\u00a0 Ochsner recognized the talented young man, took him under his wing, and mentored him.\u00a0 DeBakey later sought further education in Europe, a common pathway for those few doctors who aspired to work as university professors.<\/p>\n

\"Sixteen <\/a>
Michael DeBakey with Rene Leriche and surgical colleagues at the Leriche Clinic in Strasbourg, France, ca. 1935 Profiles in Science, Courtesy Katrin DeBakey <\/div> <\/div> <\/div>
\"The <\/a>
The Clinic of Professor Rene Leriche, April 1938 <\/div> <\/div> <\/div> <\/div> <\/div>\n

After practicing as a surgeon with Ochsner in New Orleans and serving in the US Army during World War II, DeBakey was hired to chair the department of surgery at Baylor in Houston, where he instituted a number of reforms.<\/p>\n

First, he created a residency, and here the connections he made with surgical leaders while in the military proved helpful. \u00a0\u201cI called some of my\u2026friends on the American Board of Surgery and told them I wanted to start a residency program and get it approved,\u201d recalled DeBakey.\u00a0 \u201cThey gave me temporary approval so that I would start the program.\u201d\u00a0 With this head start, he created a training program utilizing multiple Houston hospitals.<\/p>\n

Second, he began restricting operations to physicians who were certified, either through the American College of Surgeons or the American Board of Surgery.\u00a0 By 1950, both organizations insisted on the completion of residency program, thereby eliminating the previous generation of apprentice-trained general practitioners.\u00a0 Thus, DeBakey ensured Houston patients had trained surgeons operating, with correspondingly improved outcomes.<\/p>\n

\"A<\/a>
Affiliation of Hospitals Benefits All, 1949
MS C 582 box3, folder 13<\/em><\/a><\/figcaption><\/figure>\n

While these changes affected local circumstances in Houston, DeBakey also worked to improve surgical education on a national scale through his efforts to improve the VA system.\u00a0 While still in the Army, he helped shepherd the affiliation of VA hospitals with academic medical centers.\u00a0 DeBakey implemented this model locally, too, ensuring the Houston Naval Hospital became the regional VA center and incorporating it into Baylor.\u00a0 This symbiotic relationship provided universities with an expansive patient population to help train young doctors while availing VA facilities of the expertise of America\u2019s leading clinicians.\u00a0 In arranging this alliance, DeBakey helped created thousands of residency positions where American surgeons could train, elevating the profession and practice of surgery.<\/p>\n

 <\/p>\n

Justin Barr, M.D., Ph.D., is a Resident in the Department of Surgery at\u00a0Duke University Medical Center. He was a Michael E. DeBakey Fellow in the history of medicine at the NLM in 2017. For more on this subject read his article “The Education of American Surgeons and the Rise of Surgical Residencies, 1930-1960<\/a>” in the <\/span><\/em>Journal of the History of Medicine and Allied Sciences<\/span>.<\/span><\/em><\/p>\n

Quotes in this post come from an oral history interview of Michael E. DeBakey by Charles Morrissey on December 17, 1988, in the Michael E. DeBakey Papers <\/span>at NLM; MS C 582 box9, folder 7<\/a>.<\/em><\/p>\n

We invite interested individuals to learn more about the\u00a0Michael E. DeBakey Fellowship<\/a> program and about the new group of 2018 Fellows<\/a>, which was announced November 28, 2017.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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