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(November 1, 2001, Gazette)

Friday, Oct. 19, 10 a.m.
Address to convocation by Dr. Ian Rusted

Dr. Ian Rusted and Chancellor John Crosbie. Dr. Ian Rusted and Chancellor John Crosbie.

Mr. Chancellor, your honour, honourable minister, Mr. Chairman of the Board of Regents, Mr. President, Mr. President of the Alumni Association, members of the Board of Regents, members of Senate and faculty, members of the graduating class, distinguished guests, ladies and gentlemen. That formal salutation includes certain individuals who played significant roles in the founding of our medical school and Health Sciences Centre. The three essential groups initially were this university, the Newfoundland Medical Association and government, particularly the federal and provincial health departments. The federal department was the main source of the Health Resources Fund, recommended by the Hall Royal Commission in 1964. Without that fund this province could not have afforded a medical school and Health Sciences Centre. It is a noteworthy coincidence that the chancellor, the chair of our Board of Regents and our visitor (His Honour, the Lieutenant Governor) were among those who played significant roles 30 plus years ago – and subsequently. I wish time permitted me to identify others who made important contributions.

The most important participants today are, of course, the new graduates – to whom I offer my congratulations. I fear that I may be diluting the quality of their convocation: surely none of them took 63 years to move from the status of new student to recipient of a first MUN degree! In spite of that, I venture to emphasize something you have already practiced: when you undertake major tasks, be sure to do your homework well – and seek the best advice and help available. I shall try to give one or two examples.

But first, let me remind you about some aspects of Newfoundland in the 1950s. When I returned to Newfoundland in late 1952, there was no thought in my mind of a medical school. There were only 144 doctors in the entire province at the time of Confederation – caring for a population of 350,000. (Now there are 1,000 doctors for just over 500,000.) There were only a handful of specialists, the largest group being those looking after 1,000 people with tuberculosis. There was only one doctor in each cottage hospital – except Gander, where there were two. The Trans Canada Highway was not yet in existence.

Obviously, cottage hospitals deserved a great deal of attention and I had made a commitment to help. This had been agreed upon only two months after Confederation, while I was at McGill and the Royal Victoria Hospital. Dr. Leonard Miller, deputy minister of health, arranged for me to visit his counterparts in Ottawa and develop the following three-part plan.

I would do no private practice for two years but would receive a modest federal grant so that I could: First, visit cottage hospitals, seeing patients in consultation and recommending improvements. Second, develop continuing education programs for physicians – with the help of visiting guest speakers from Canada, the U.S.A. and the U.K. – without fees! Third, function as director of medical education at the General Hospital. For many years two “housemen” or internes had obtained one or two years experience there before starting their own practice. These numbers had increased to six or eight after World War Two.

First, cottage hospitals: I returned to our new province on Oct. 1, 1952, with my Danish-born wife and small family. A month later, I made my first visit to Botwood and Gander, both with war-time hospitals. Doctors Jim Paton and Hugh Twomey welcomed me warmly and together we saw many of their more worrisome patients and discussed possible improvements. At their suggestion, the doctors in the wide area (from Terra Nova to Springdale and Buchans) were invited to join us in Botwood at the end of my second visit – and I spoke on some of the most interesting patients we had seen at Gander and Botwood. This proved to be the start of the Central Newfoundland Medical Society. Similar sessions were later held at Come-by-Chance Hospital, or Clarenville, and in Western Newfoundland – usually Corner Brook. There were, of course, many other ways in which we were able to help.

Second, time does not permit details of our continuing medical education programs, which included twice-yearly refresher courses with three to five visiting professors from centres across Canada, the U.S.A. and the U.K. — without fees!

Our plan of formal postgraduate lectures and teaching rounds, based mainly at the General Hospital, came to be recognized by national bodies and, within a few years, we had a total of about 50 nationally approved positions: 22 for rotating internships and 25 for residents in major specialties. However, most of the best of these left at the end of their training – stating they were unlikely to return because facilities and equipment were increasingly inadequate. This had a significant influence on the decision by several of us to seek improvements, such as a medical library, or Academy of Medicine – or even a medical school some day!

I had begun, in 1958, collecting information about medical school costs from B.C. and Saskatchewan (two of the newest medical schools in Canada then) and from Manitoba and other sources.

By 1963, this combination of positive and negative influences led me to submit a 10-page brief to the minister of health, Dr. James McGrath. It recommended three courses of action: First, improved bursaries for pre-med students at MUN, and during medical school; second, formal steps to examine the possibility of a medical school; and third, examine the future role of the General Hospital in view of the new Children’s Hospital being planned and the expansion of other hospitals.

Premier Joey Smallwood’s response is well known: yes to bursaries for pre-med and med students and (later) free tuition and “salaries” for all, briefly.

Of course there were difficulties. Time does not permit a review of the many commissions and other studies that ultimately overcame opposition to a medical school and Health Sciences Centre. Our Newfoundlanders’ inferiority complex was much stronger then – and included some physicians who felt that it was impossible for Newfoundland to even think of having a medical school – not merely because of the cost, but also because there would not be enough qualified students in the province. Also, it was argued, we were already finding it difficult to attract ordinary doctors, so how could we expect professors to come here?

The facts are good students are accepted each year. They have come from all over Newfoundland and Labrador selected from 200 applying each year. New Brunswick and PEI purchase 12 additional places and, as a national medical school, we accept a small number from elsewhere. That national status was part of the secret of getting an extra $10 million from the some of the special reserve portion of the Health Resources Fund.

I will now give an example of faculty recruiting experience.

Even before I officially became dean of medicine on Sept. 1, 1967, I began to appoint international advisory committees, each with six to eight members, to recommend candidates for each of the eight major chairs — e.g. surgery, medicine, pediatrics, pathology and (something new) family medicine. Where possible, these committees met at international conferences and prepared a long list of candidates, from which a short list was distilled. This gave us about 50 advisers, mostly from across Canada, the U.S.A. and the U.K. – all unpaid!

You can see why I stressed the importance of doing your homework and seeking good advice!

(I was in Toronto to attend two advisory committee meetings when I met one of their professors who greeted me warmly but immediately asked, incredulously, “Is it really true that you have agreed to try and develop a medical school in Newfoundland? Do you really, seriously, think that someone – like me – will give up a secure appointment here, with a lovely home in the best part of Toronto and with children in the best schools in Canada and go to a new med school – not yet built – in Newfoundland?” I made the obvious reply – that we would not expect, or want, anyone who felt as he did to join us, but Memorial University was a good, rapidly-growing university and we were confident we would find first-class faculty members who would recognize this opportunity to do something unique and worthwhile – not only for Newfoundlanders.)

About six weeks later, the advisory committee chaired by the dean of medicine at the University of Toronto (formerly their professor and head of pediatrics) with a committee that included Dr. Charles Janeway (after whom our children’s hospital was named) narrowed their long list to Dr. John Darte, head of a department at Toronto’s Hospital for Sick Children and the only pediatrician in Canada who was also a specialist in cancer treatment. Dr. Darte and his wife visited Newfoundland a few weeks later – and accepted the appointment.

Three weeks later, the dean of medicine at McGill University phoned Toronto to ask for the name of their best candidate for the chair of pediatrics at McGill – and received the answer that their best candidate had already agreed to go to Memorial University!

Dr. Darte and eight other senior faculty members arrived in September 1968, just one year after my appointment. They included Dr. Albert Cox (who later succeeded me as dean and later still as vice-president) and a series of other appointees, including several on the local scene and others who returned to the province. This enabled us to admit our first class of medical students in September 1969. A record achievement! These examples – and the hundreds of applications from good students – helped to dispel some of the negativity about our province, here and elsewhere. (Dr. Cox resisted three later efforts by UBC to have him return as their dean of medicine.)

Dr. Kenneth B. Roberts, the first appointment after my own, as associate dean, visited medical schools with me in the U.S.A. in late 1967. (One of his former graduate students at the London Hospital Medical College, Dr. William Marshall, had moved to the New York University Medical Centre in 1966. During our visit, he agreed to join our faculty, effective Sept. 1, 1968.) The dean and vice-president of New York University Medical Centre, Dr. Lewis Thomas, agreed to become a member of our advisory committee on pathology. Dr. Thomas became so enthusiastic about our novel approaches that he became a candidate for the position, visited St John’s with his wife, agreed to come – and resigned his positions at NYU. However, this was the period of the Vietnam war stresses – recalled by many during the recent New York crisis. Dr. Thomas was invited to a series of meetings with the mayor of New York, the governor of New York State and, finally, the president of the United States. These powerful individuals – and many others – persuaded him that if he were to leave the United States the impact would be extremely serious – encouraging even more individuals to leave for Canada. Dr. Thomas later became president and CEO of Memorial Sloan-Kettering Cancer Institute in New York. However, he maintained a friendly interest in our development and was present at the formal opening of the HSC in 1978, at which time he received a honorary degree.

I will end this address with a sentence from his convocation address: “Don’t be satisfied with the status quo if you seriously think it can – and should — be improved.... we have plenty of time and great need for improvements.”

So, members of the graduating class, do not underestimate yourselves! You will be needed here more in the future than I was in the 1950s – partly because the percentage of young people is half what it was then and getting smaller. Also, more than one career per person is becoming increasingly common – and many persons here today will return to university to make this change or to pursue interests they had not been able to indulge previously.

Take good care of this special part of our planet! Provehito in altum! – with optimism.