In early 1929, two men walked through the shell of what would soon become the Duke University School of Medicine.
One of the men was Dr. Wilburt Davison, the first dean of Duke Hospital and the School of Medicine. He told the other he had received several letters from prospective students asking whether Duke would be a "Class A" medical school.
"It will. Won't it?" asked the other man, Dr. Ray Wilbur, then chair of the Council on Medical Education and Hospitals of the American Medical Association.
Davison affirmed that it would be.
"Answer all letters from now on in the affirmative," Wilbur said, effectively granting the school the premier classification.
University lore holds that Duke was the first medical school to be approved by the Council before students were admitted instead of waiting, as is the rule now, until the first class graduates.
The story, which is retold in Davison of Duke: His Reminiscences, marks the beginning of what later became one of the top medical schools in the nation.
In Duke University Health System's 75th anniversary year of medicine, more than $100 million are invested into construction projects across the campus, and new scientific breakthroughs are being announced regularly.
But at the institution's beginnings, Davison was struggling to secure $300,000 in funding for a four-year medical school.
At the time, schools around the area had two-year, purely clinical curricula. Officials from the University and Duke Endowment wanted to follow the wishes of James B. Duke, a benefactor of both, and establish the medical school as a four-year institution, containing both preclinical and clinical instruction. Funding, however, was limited.
Davison scoured the nation, seeking money from the Rockefeller Foundation and the General Education Board, among other potential donors.
After a summer of uncertainty, the Board approved Davison's proposal in November 1929.
"[The money] is even more significant as an indication that American philanthropy and the American public will not withhold gifts from Duke University because one man has made it a very great gift," then-Duke President William Few said to the University trustees after the funds were promised.
With money in hand, Davison's vision for the four-year medical school was taking shape.
The curriculum was originally designed to meet the needs of the Carolinas and Virginia, as many doctors who graduated from Duke would go on to staff clinics in this area.
Other goals in the beginning were to emphasize the importance of sound teaching and good medical care, create informal student-faculty relations and give students a sense of what Davison considered the master word of medicine: work.
"The content and arrangement of the curriculum are less important than the enthusiasm and interest and desire to work, which a dedicated instructor can instill into a student," he wrote.
After receiving some 3,000 applications, 30 first-year and 18 third-year transfer students were admitted.
Similar to the admissions process today, officials looked at the applicant's curricular and extra-curricular college records carefully, along with an interview and scores from the Medical College Admission Test.
"Preference is given to the sons and daughters of... physicians because they are familiar with professional ideals and ethics and the problems of the practice of medicine," Davison wrote.
The students converged to Duke Oct. 2, 1930 to begin classes. Because enrollment was initially far below the capacity of 70 students per class, professors developed personal and individual relationships with their students.
"There wasn't a boy who went through medical school that didn't feel that Dean Davison was a second father," said John Yarborough, Trinity '41 and School of Medicine '44, to the Duke University Medical Center Development Office.
Students typically called professors by their first names.
"Whenever I am called Dr. Davison, I am embarrassed and feel that trouble is brewing," Davison wrote. "I have difficulty in remembering last names, though I easily recall the first names of the students of the first 30 classes."
Students and faculty also engaged in baseball games and dinners. "How can you be dignified while eating barbecue or spaghetti?" Davison wrote of the casual relationships in the school.
When the School of Medicine opened, the school year was split into four quarters of 11 weeks.
To graduate, students could take three terms each year for four years or four terms for three years. Students were encouraged to spend one quarter abroad or in a community hospital.
Most students found the work difficult. At the end of two quarters, 13 first-year students received "strong warnings," indicating their work needed improvement.
Another 14 first-year and six third-year students received "mild warnings."
An honor system was instituted in April 1931. It was modeled after Princeton University's code, with which Davison was impressed during his studies there.
He said at Princeton, cheating was rampant and proctors monitored each test. After the honor system was put into place, students curbed their cheating habits and held themselves to a higher standard.
All 18 third-year students graduated June 8, 1932.
For the graduation ceremony, Davison borrowed another Princeton tradition- planting ivy cut from England in front of the school.
"It was a very pleasant occasion," Davison wrote.
Days afterward, however, the U.S. Department of Agriculture said that a faculty member had applied for a permit to import that ivy and had been refused.
"I was furious because all garden lovers know that no one except experimental nursery-men can legally import plants," Davison wrote, noting he smuggled it to the United States in his pocket.
Davison was facing a jail sentence as a penalty. He appealed to a senator and told him the whole story, including that the ivy had already died as a result of the glaring sun.
The incident was quietly settled.
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