Throughout the first three decades of the Chicago Medical School (CMS), the college operated dispensaries, or free outpatient clinics, which helped prepare students for interacting with patients. The 1924–1925 course bulletin describes dispensary practice as, “First, to the patient, to provide the best possible treatment; second, to science, the instruction of medical students and the advancement of medical knowledge; third, to the community, to aid in the prevention of disease and to aid social service activities.”
Dispensaries began in England and spread westward throughout most cities of the United States from the late 18th century through the 1940s. These healthcare facilities were operated by settlement houses, religious organizations, companies and municipal entities; they were very common among medical schools. Dispensaries were an efficient and cost-effective outlet to ensure the clinical training outlined for medical education in the influential 1910 Flexner Report, which was aimed at improving the quality of medical services throughout the United States, called for stricter standards in medical education, and ultimately pushed one in three medical colleges to close their doors.
The practice of outpatient care has evolved through the decades. Treatment received by patients at a dispensary in the very early days of the 20th century often involved a long wait in an uncomfortable space, a minimal exam and a prescription to be filled at the dispensary’s internal pharmacy. As more diagnostic tests became available during this period, the bulletins noted growing laboratory capabilities and tools, such as X-rays in 1928, in CMS dispensaries.
At CMS, coursework in the dispensary was generally undertaken by third- and fourth-year clerkships in medicine, surgery, gynecology, pediatrics and dermatology. According to the 1930–1931 CMS bulletin, faculty gave “careful instruction on history-taking, physical examination, diagnosis and treatment, and the formality of approaching the patient.” Students also had training at area hospitals.
In 1947, clinical training via the dispensary ceased at CMS. The bulletin cites deeper ties to Cook County Hospital, as well as the new clinical site of Mt. Sinai Hospital, whose affiliation would be a critical piece toward the full accreditation of CMS by the American Medical Association in the following year.
Kelly Reiss is director of the Rosalind Franklin University Archives and the Feet First Exhibition.
