A Place in History

Nearing its 20th birthday, the ECU School of Medicine

remains true to its mission

by Jeannine Manning Hutson

The late Dr. Leo Jenkins liked to tell the story this way: his push for a medical school at East Carolina University was sparked by a 1964 visit from Dr. Ernest Furguson, a family doctor in Plymouth. Wayne Williams, director of ECU's Center for Health Sciences Communication until 1990, recently completed a history of the early years of the medical school.

Williams said that in truth the idea had been tossed about for a few years. But it was that plea from a small-town physician that sparked Jenkins to enlist East Carolina University in the cause of better health care for eastern North Carolina.

The rest really is history. After years of politicking and preaching their case, the supporters of the ECU School led by Jenkins saw their dream become a reality in August 1977, when the first students enrolled in a new four-year medical school.

Today, as the 20th anniversary of becoming a four -year institution nears, the school has changed dramatically from its early days while still holding true to its mission of training primary care physicians, granting access for minority and disadvantaged students and improving health care in eastern North Carolina. State-of-the-art technology takes specialists into the region through the telemedicine project; there are more African-American students per capita at ECU than at nearly every other medical school in the country, and a large percentage of its graduates each year choose to practice primary care.

When Jenkins began to push the idea of a medical school, eastern North Carolina led the nation in infant mortality, had one of the highest percentages of draft rejections for medical reasons and was near the bottom in the ratio of hospital beds and physicians to the population.

"And we were just saying, well, the wealthy people, if they had a tonsillectomy, they'd go to Duke or they would go to Richmond or Atlanta. But the poor fellow just had to wallow down here," Jenkins recalled in a 1988 interview. "We said that isn't right. Something ought to be done about that." What Jenkins and his early band of backers did was to start eastern North Carolinians talking about the need for a medical school for their area.

So began the "fight" over the medical school, which is well documented in Williams's account. Suffice it to say that it captured the interest of people all across the state, as Jenkins tried to outmaneuver powerful opponents while lining up support for the cause among legislators, newspaper publishers and other influential citizens.

Jenkins ultimately prevailed, by degrees. The legislature approved a two-year medical education program at ECU in 1969, although that initiative metamorphosed into a one-year, basic science-oriented school that produced three classes from 1972 through 1975. Each class of 20 students transferred to the medical school at UNC-Chapel Hill to complete their studies. All the while, Jenkins and his lieutenants pressed for a four-year school.

The person credited by Williams in his history as "the prime mover in actually bringing the school to Greenville" is Dr. Edwin Monroe. Jenkins recruited Monroe in early 1968 from his private medical practice to become dean of the newly established School of Allied Health and Social Professions and director of the school's medical education center, the precursor of the medical school.

Monroe began recruiting the nucleus of a medical school faculty. The first person he hired was Dr. Irvin Lawrence, an anatomy professor who remains the school's senior faculty member today.

"I was the guinea pig," Lawrence recalled with a laugh. "There were no major highways coming into this place. I saw a lot of poverty. When Dr. Jenkins was talking about this, it seemed an incredible dream, a vision. Then we started getting support. It was just a ground swell."

Finally, in November 1974, the UNC Board of Governors approved the development of a four-year medical school at ECU and urged the General Assembly to fund it, which it did.

The first class of one-year medical students at East Carolina University in 1972. These 20 students transferred to UNC-Chapel Hill for their final three years of study and took their M.D. degrees from Chapel Hill. Seated, front and center, are Chancellor Leo Jenkins and Dr. Wallace Wooles, dean of the one-year program.

While the money for expanding the medical school looked certain, the next hurdle the administration faced was figuring out where the students would receive hands-on clinical training. Monroe supported a joint hospital venture with Pitt County, while others favored a separate, 200-bed university hospital. But a cash shortfall for the state in 1975 proved to be a windfall for backers of a joint hospital. ECU had been appropriated $20 million to build a hospital for the School of Medicine, but by joining with Pitt County they were able to save $7 million and make the deal possible.

Today, the affiliation agreement between a county hospital and a state medical school is a widely admired model that has showered benefits on both institutions as well as the citizens of eastern North Carolina.

"It has worked beautifully," said Monroe, who has retired from the university but is still active as a Pitt County Memorial Hospital trustee.

With the funding complete and arrangements made for clinical training of students in 1975, the transition began from a one-year, transfer-oriented facility to a four-year medical school. Enrollment was suspended for two years because, as Professor Lawrence remembered, there was just so much to do organizing the curriculum, hiring faculty, preparing facilities.

Dr. William E. Laupus was hired in 1975 as the first dean of the expanded, four-year School of Medicine.

These efforts were led by Dr. William E. Laupus, hired in 1975 as the first dean of the expanded school. Attracting Laupus was a coup; the chairman of pediatrics at the Medical College of Virginia had the academic pedigree and a certain political sensitivity that were ideal for the position. After an enormous effort by him and his team, the four-year program won provisional accreditation and the first four-year students enrolled on Aug. 23, 1977.

Dr. George H. Moore Jr., a family physician for 12 years in Wake Forest, remembers many things about being in that first four-year class: Courses in Ragsdale Hall, a converted dormitory on the ECU campus; anatomy classes in trailers; a close relationship with the faculty; and the fact it was such a small class, 28 students, all from North Carolina.

Moore, who is an officer in the N.C. Academy of Family Physicians, recognizes that his class is special. "We were the proving ground for ECU," he said. His practice has four physicians three of whom either graduated from the ECU School of Medicine, trained as a resident there, or both. The practice often serves as a preceptor site for medical students.

"We see it as a responsibility to ECU to repay what they have done for us," Moore said. "They are training students to go into primary care fields."

These days the medical school's reputation as a fertile primary care training ground continues to grow. In its just-released 1996 survey of graduate education, the U.S. News & World Report ranks ECU 14th among the country's 76 medical schools that emphasize training in family medicine and other primary care disciplines. Recognition like that comes in part from such initiatives as ECU's Generalist Physician Program, a comprehensive effort to increase the number of primary care physicians in eastern North Carolina.

When Dr. James A. Hallock arrived in March 1988 at the School of Medicine to interview for the deanship after Laupus's retirement, he was impressed by the half million-square-foot Brody Medical Sciences Building "which springs up out of nowhere" and the fact that everybody he spoke with emphasized the three-fold mission of the school.

Hallock has quietly but consistently

hammered at one theme:

the school will be successful if it stays true

to its mission.

"Although we are the fifth-youngest medical school in the country, we probably have matured as well as any of the newer medical schools," said Hallock, who became the dean and later vice chancellor for health sciences.

Since he arrived, Hallock has quietly but consistently hammered at one theme: the school will be successful if it stays true to its mission. Aside from the production of generalist physicians, ECU has also garnered recognition for its commitment to minority education and to enhancing health care in the region, the other two components of its mission.

Last fall, for example, the Atlanta-based Southern Regional Education Board announced that ECU had the highest percentage of African American students among the 43 predominantly white medical schools in the southern United States. ECU's 1994-95 enrollment of 297 students included 44 African Americans, or 14.8 percent of the student body. That number also ranked ECU third nationally.

And from a regional health perspective, the medical school is reaching out to address the needs of communities as never before. An important part of that strategy is the telemedicine project. Via two-way television the system links a rural site such as Goshen Medical Clinic in Faison with academic physicians at the School of Medicine for consultations or professional education.

'Telemedicine has become a

vital part of the school.

It helps us begin to reach out

to deliver what we know

to the region, to educate the

region and to assist practitioners in the region to maintain

their patients locally.'

- Dr. James A. Hallock

"Telemedicine has become a vital part of the school," Hallock said. "It helps us begin to reach out to deliver what we know to the region, to educate the region and to assist practitioners in the region to maintain their patients locally."

In addition to Faison, doctors in Ahoskie, Williamston, Edenton, Elizabeth City, Belhaven and Raleigh currently consult or are in the process of being linked to the medical school from their local clinics or hospitals. The ultimate goal is a totally networked region, said Dr. Susan Gustke, medical director of the telemedicine project and executive director of the Eastern Area Health Education Center in Greenville.

"The importance of the telemedicine program is that it gives us the technology network to link health care providers like hospitals and health departments, transport information quickly, conduct medical specialty consultations without great distances to travel and have a more efficient use of physicians," she said.

Telemedicine also plays in important role in ECU's Rural Family Medicine Residency Program, which will graduate its first four participants this summer. The program allows residents to spend their first year of training at Pitt County Memorial Hospital and the remaining two years at rural hospitals in Ahoskie or Williamston while still having access to the expertise of university physicians more than 30 miles away. Program officials hope that at the end of their training, the residents will want to stay in those towns to practice.

For Dr. Domingo Rodriguez-Cue, telemedicine is one of the reasons he will be staying in Williamston after his residency training at the University Family Medical Center - Martin County. "I love rural family practice, and I enjoy the technology that this practice has to offer," he said.

Telemedicine is one aspect of the outreach programs for which the developers of the medical school laid the groundwork two decades ago. And even as its mission remains fundamentally constant, the medical school must continue to adjust to the changing world of health care to thrive.

"The development of an institution is never finished. Institutions have to continue to adapt to the environment they find themselves in," said Laupus, who retired as dean in 1988 and as vice chancellor of health sciences in 1989. "In truth, the environment in the '70s and '80s up until Dean Hallock came was one period playing itself through. It moved into another kind of period; what the medical school must be in the '90s must be different than what it had to be initially."

For his part, Hallock has an idea of what that medical school will look like.

"We're now noted as one of the top primary care schools," said Hallock. "What do we want to be in the future? I think we want to be the medical school that has dealt with the health of a region. Not the health care; the health status. That's critically important. If we do that, then ECU will train physicians and nurses and physician's assistants who understand communities and help the people in them become healthier."

Jeannine Manning Hutson is a staff writer in ECU's Office of Medical Center News and Information. Wayne Williams's history of the medical school's early years will be published in connection with the school's 20th anniversary in 1997.

Return To Contents Page