Our history reminds us that the road to scientific discovery often isn’t straightforward. While we have come a long way, we still have much farther to go.
Sarah Alger, Paul S. Russell, MD
Museum of Medical History and Innovation director
Mass General’s educational mission encompasses not only trainees and faculty, but also patients, scholars and the community.
The Paul S. Russell, MD Museum of Medical History and Innovation, which opened in 2012 for the hospital’s 200th anniversary, is the only freestanding hospital museum in the United States. The Russell Museum aims to inform and inspire patients and their families, students from grade eight through college and visiting health professionals and tourists from the world over. As its name suggests, the museum features artifacts and stories from the hospital’s more than two centuries of history, as well as modern innovations. Current visitor favorites include an iron lung, a laparoscopy trainer and a cell sorter.
Programming – paused during the COVID-19 pandemic – included medical simulation sessions run by the MGH Learning Lab. The museum’s monthly evening public lecture series features experts in research, clinical care and medical history. Museum exhibits draw largely from the MGH Archives and Special Collections.
The Archives — broadly defined as documents that serve as official records of the institution — span about a quarter mile of shelf space. The Special Collections — art and artifacts of historical significance — number about 2,000. The hospital’s archivist fields queries from employees and scholars worldwide. The Archives’ most frequently consulted collections are those about the 1846 ether demonstration and the social work service established in 1906 – the first in a U.S. hospital.
For more information about the Archives’ holdings or about donating materials, visit russellmuseum.org/archives.
Education at Massachusetts General Hospital: A Brief History
In their circular letter to notable Bostonians, appealing for funds to establish a general hospital, MGH co-founders John Collins Warren and James Jackson note the need for educational facilities: “…[I]t is necessary to have a medical school in New England. All the materials necessary to form this school exist among us. Wealth, abundantly sufficient, can be devoted to the purpose, without any individuals feeling the smallest privation of any, even of the luxuries of life. Everyone is liable to suffer from the want of such a school; everyone may derive, directly or indirectly, the greatest benefits from its establishment.” Serving as the first and largest teaching hospital of Harvard Medical School, Mass General has helped shape medical education for more than two centuries.
Unlike the highly codified medical education system in place in the United States today, Harvard Medical School students of the 1840s bought tickets to lectures held in classroom and hospital settings, including the first successful public demonstration of surgical ether anesthesia. In order to graduate, students had to prove that they attended each required lecture at least twice and that they had studied with a “competent physician” for at least three years. The medical school curriculum was revamped along lines recognizable today in 1869.
Physicians-in-training – today known as “residents,” then referred to as “house pupils” – are first lodged on the hospital grounds. Quoting from former MGH librarian Grace W. Myers’ History of Massachusetts General Hospital, A Continuation: 1872-1900, “If the condition of a patient in a ward became unsatisfactory during the night, the nurse had to go to the house pupils’ sleeping room and call the one assigned to duty on her ward.” A nurse (Miss Elizabeth Robinson Scoville) of 1878, recalls the close quarters: “A dim twilight reigned in the room, and in summer each bed was shrouded in mosquito netting…. If a stumble was made it roused all the sleepers.” The MGH now hosts about 1,500 medical-surgical residents and fellows for training across specialties. Some of the most senior physician faculty still wear the “short” white coat historically worn by medical students and first year-resident “interns” to symbolize that even experienced faculty are always learning at Mass General. All physician faculty have appointments with Harvard Medical School.
Based on the principles of Florence Nightingale, Mass General opens what is to become the oldest continuously operating school of nursing in the United States: the Boston Training School for Nurses, renamed the Massachusetts General Hospital Training School for Nurses in 1896, and then, the Massachusetts General Hospital School of Nursing. The MGH School of Nursing graduates its last diploma school class in 1981.
Attention to health and nutrition was present from the MGH’s earliest days. Mass General inaugurated its first program in dietetics in 1910. Early courses were brief affairs, expanding to six-, eight-, nine- and 10-month courses as the program grew in popularity, settling on a one-year program by 1934.
Mass General internist Richard Cabot works with pathologist James Homer Wright to adopt a teaching format different from the time period’s long lectures: discussions of “actual cases of disease.” These diagnostic conferences are then published as Case Records of the Massachusetts General Hospital in the New England Journal of Medicine and continue to be renowned and emulated the world over.
Taking its first students in 1941 and graduating its last class in 1967, the Massachusetts General Hospital School of Medical Illustration was a short but influential chapter in the hospital’s history. The field of medical illustration — depicting tissues and cells at the microscopic level, human anatomy and surgical procedures — has existed for centuries but made great advances in the early 20th century. Mass General’s school was the third in the country, evolving the field from an assortment of self-taught practitioners to a profession with specialized training.
From former hospital director Nathanial Faxon’s The Massachusetts General Hospital: 1935-1955: “On January 1, 1944, the ‘9-9-9 Plan’ for resident training in hospitals during World War II, promulgated by the Office of Procurement and Assignment, became effective. This plan was arranged to provide resident and intern service in hospitals and to supply to the armed services a large number of partially trained medical officers, needed to fill the lower grades, and a smaller group of officers competent to fill the more exacting positions in all the specialties. The physician faculty, instead of deploring the shrinkage in size and lessened experience of the house staff, adopted as their watchword ‘Let us do the best we can with what we’ve got.’ This was the spirit of the entire Hospital. At the Medical School, all students except the few unfit for active service went on active duty in the Army or Navy on July 1.”
“During 1950, arrangements were consummated with the Massachusetts College of Pharmacy to institute a Pharmacy Internship Program. Upon completion of the two-year program, one year of academic instruction and one year of internship, the intern would be granted a Master of Science in Pharmacy degree, from the college, and receive a diploma from the hospital,” Faxon noted in his hospital history. In the early 1960s, internships were replaced with a residency program.
Frank Austen, MD, quoted reflecting on his experience treating polio patients in Something in the Ether, “In July, as I was about to go on holiday, Walter Bauer said that he would like me not to go on holiday at that time but to start admitting polio patients along with Jan Kochweser, another resident. We were both first-month assistant residents. Within two weeks, the volume of patients became so great that Bauer and the hospital made two additional decisions. The first was that no private doctor would be allowed to write orders on polio patients; all orders had to be made by Austen and Kochweser, because they were the ones developing on-the-job experience with the disease and they were in direct touch with Louis Weinstein, the acknowledged regional expert.”
MGH is awarded degree-granting authority by the Commonwealth of Massachusetts. In 1980, the MGH Institute of Health Professions opens, admitting its first master’s students in physical therapy and social work. Certificate and degree-granting programs are now consolidated in the MGH Institute’s School of Nursing, School of Health and Rehabilitation Sciences, and the School of Healthcare Leadership — which also now offers advanced degrees in the science of learning through its Health Professions Education program.
The Department of Psychiatry founds the Psychiatry Academy, providing international leadership in education and dissemination of best practices in mental health. Today, the Psychiatry Academy distributes more than 100,000 pieces of educational content each year and includes members from 127 countries.
The Youth Scholars, STEM and Senior STEM programs are established by the Mass General Hospital Center for Community Health Improvement (CCHI). The CCHI Youth Programs open doors of opportunity and empower young people from Boston, Revere and Chelsea to overcome racial and social injustices. In total, these programs serve more than 1,000 students each year to create a sense of belonging, promote academic achievement and develop the leadership skills needed for students to thrive in school, excel in the workforce and transform the world.
From as early as third through eighth grade, CCHI STEM and Senior STEM clubs aim to spark an interest in science, technology, engineering and math through partnerships with the Boys and Girls Clubs of Boston. From ninth to 12th grade, the emphasis of the Youth Scholars program shifts to educational attainment and college preparation with programming held on the MGH campus. Throughout the college years, the alumni program provides academic coaching as well as the social and emotional support students need to thrive in college and beyond.
Mass General ranks consistently as one of the top employers of the Boston Mayor’s Summer Jobs program, providing meaningful summer employment to more than 100 young people per year.
The MGH Learning Laboratory is established to support simulation-based education as a new field of practice and study, expanding opportunities for MGH trainees and staff to engage in routine deliberate and reflective practice for expert performance. The lab provides a central infrastructure to support educational units and teaching fellows across campus and builds on a longstanding collaboration with community partners including the Center for Medical Simulation, a pioneering educational center founded by the anesthesia departments of the Harvard-affiliated hospitals in 1993. Since that time, MGH educators and faculty have played a leading role in developing simulation training locally, nationally and worldwide.
The Lunder-Dineen Health Education Alliance of Maine is established with a gift to Mass General from The Lunder Foundation of Portland, Maine, designed to extend Mass General educational expertise to Maine residents and health care professionals.
The MGH and the IHP establish the first interprofessional dedicated education unit in the U.S. Through active observation, this innovative model assists IHP students in recognizing interprofessional collaboration and practice delivered by direct care clinicians. As these students assume roles in health care post-graduation, this education is essential in delivering exemplary team-based clinical care to our patients and families.
The MGH embarks on a multi-year strategic planning process that includes a focus on teaching and education. Resulting recommendations will lead to appointment of an Executive Director for Teaching and Education (2015) and a Chief Learning Officer (2018) to support the education mission across professions.
Mass General teams create and disseminate best-evidence treatment protocols for the COVID-19 pandemic, rapidly training each other and guiding the local, national and international community. Harvard Medical School students’ clinical rotations were paused, and eligible students were able to graduate two months early to begin active COVID-19 patient care, and students who could not begin clinical duties immediately organized non-clinical COVID-19 response teams, such as the Harvard Medical School COVID-19 Student Response Team.
Building on years of leadership work to advance post-graduate clinical nursing education, the MGH Nurse Residency Program is awarded Accreditation with Distinction by the American Nurses Credentialing Center. The nurse training program is the first nurse residency in the city of Boston to achieve this credential, and the first in the nation to receive distinction under the newest accreditation standards. In 2021, an institutional committee was formed to explore an Advanced Practice Fellowship designed to advance specialty training for nurse practitioners.
In support of the short- and long-term educational needs articulated as part of the hospital’s strategic planning process, MGH received a transformational $50 million gift from The Lunder Foundation of Portland, Maine that aims to reinvent health care education for the 21st century and ensure the highest quality care for every patient. This commitment — one of the largest ever to support education across the health professions — will enhance the training of providers in all roles now and into the future by funding three linked, interdependent initiatives: the Peter L. Slavin, MD Academy for Applied Learning in Health Care; the Lunder Learning Hospital; and the MGH Learning Endowment.