Obtaining the B Rating: The Story of Accreditation at CME—Part II, Continued

THE securing of a charter in 1910 for the Col­lege of Medical Evangelists was a definite milestone of progress. It was significant in that it represented the concerted action of the de­nominational leaders and the decision to oper­ate a medical school. But the handicaps of a C rating were apparent from the beginning. In the first place, a C rating was the mark of a nonacceptable college; and in the second place, as early as 1913, twenty-five of the State boards had made a ruling excluding from examination students graduating from C-grade schools. It would be only a matter of months before many more would take the same action. For a peo­ple who had been counseled to be "the head, and not the tail," it was inevitable for them to begin working immediately toward a higher rating.

Elder G. A. Irwin, president of the CME Board of Trustees at that time, presented this to the constituency in the January meeting, 1913: "These facts make it clear that some ac­tion must be taken by us to ensure a better rat­ing, or else we will be compelled to abandon our efforts to graduate physicians who will be allowed to practice in harmony with the laws of our country."¹

A review of the events of the years between 1910 and 1917 (when CME received its B rat­ing) points up that during this time CME was continually in a state of crisis, testing whether a college "thus established shall long endure."

Dr. Wells A. Ruble was called to the pres­idency in May, 1910, and immediately fell heir to almost insurmountable burdens—the con­struction of a laboratory and dormitory at Loma Linda, with the money not yet in sight; the augmenting of the teaching staff from Sev­enth-day Adventist physicians tied t» private practice or holding other positions in the de­nomination; the providing of clinical experience without facilities; and finally the soon opening of school without any of these prob­lems having been solved.

Financial Problems: The members of the General Conference Council had agreed that the financial responsibilities of the medical school should be shouldered by all the union conferences of North America, and had recom­mended specifically that each conference should forward, as soon as possible, S1,000 for the new laboratory and dormitory. But by November 20, 1910, Dr. Ruble reported in a letter to W. C. White that "up to the present time we have re­ceived only $1,000 from the Lake Union and $600 from the Pacific Union Conference." Dur­ing these months Dr. Ruble wrote many let­ters to influential friends and leaders in the de­nomination, telling of the financial plight of the school. There were still many conference leaders who were not convinced that conduct­ing a medical school was a feasible project.

Teaching Staff: To obtain qualified instruc­tors willing to connect with this young institu­tion was not easy. Dr. Ruble looked over the roster of eligible Seventh-day Adventist physi­cians, so to speak, and began writing letters. In his efforts to enlist the best medical men in the denomination, he wrote to Dr. George Thom-ason at St. Helena, Dr. Newton Evans in Ten­nessee, Dr. W. H. Holden in Oregon, Dr. F. M. Rossiter in Washington, Dr. C. H. Hayton in England, the Drs. Keller in Australia, and many others far and near. A typical letter of in­ducement is the one he wrote to Dr. E. H. Risley, September 1, 1910:

You know what the work of the denomination is. You realize the object of our medical missionary work. From my acquaintance with you I believe that you would be able to identify yourself with us in every way. . . . You will realize in coming that this is a new undertaking. We must begin at the bottom and build up. I know you will be willing to do this. There will be difficulties to meet, but it is the strong young men who have had an experi­ence as you have that can be of the most help in building up this institution.

I shall hope to hear from you favorably at an early date. ... I might say that physicians are accepting a salary of $20 a week. This is the most that is paid to anyone. . . .

Clinical Facilities: The third problem fac­ing Dr. Ruble, the staff, and the Board of Trustees was the matter of clinical facilities. It had been hoped in the beginning that there would be sufficient opportunity for clinical practice at the Loma Linda Sanitarium and the County Hospital at San Bernardino. But this proved to be far from adequate, and this lack was primarily the basis for the low rating the college had received.

When a representative from the A.M.A. and one from the Association of State Examining Boards had inspected the college in 1911, they pronounced the school satisfactory as far as laboratory courses were concerned and assured the administration that if the rating could be based on the first two years alone, the college would be accepted and placed high in class B. This fact, plus the difficulty of determining the financial responsibility of certain groups, in­fluenced some of the brethren to feel that it would be wiser to offer only two or three years of the medical course. Once again this question came before the Medical Council at Loma Linda, and in the fall of 1913 the matter was decided favorably to the full course.

Speaking of this in a letter to Dr. Thomason (April 7, 1914), Dr. Ruble wrote: "Our breth­ren related themselves to the work here at Loma Linda far differently than actions previ­ous to the meeting indicated. It was rumored that some of the men from the East had come with a big sword to decapitate our school, leav­ing us with but three years at most. I heard not a word of this, however, during the Council."

Long-Range Plan Called for SDA Clinic

There was agreement that in order to pro­vide more adequate clinical facilities it would be advisable to open a dispensary in Los Ange­les, and secure, if possible, the privilege for students to attend clinics at the County Hospi­tal. The long-range plan, however, called for a hospital of our own. It was felt that there could be no substitute for a plan whereby CME stu­dents could receive their clinical instruction under the guidance of doctors who understood the special lines of therapeutics held by the denomination. Dr. Ruble expressed it this way, in his annual report to the constituency: "If we had access to all the county hospitals in Cali­fornia, this would not at all suffice for giv­ing the education which must be imparted to our students."²

When the matter of experience for students to be obtained in Los Angeles was first sug­gested, Mrs. White was consulted. She attended the meeting of the Board of Trustees in Los Angeles in April, 1912, and was requested to answer questions that were perplexing the mem­bers of the Board. Elder W. C. White presented to her three plans that had been considered: (1) Erect a large hospital at Loma Linda and give the students all of their training there; (2) build up the work in Los Angeles and let them get their experience there; (3) offer part of the work at Los Angeles and part of the work at Loma Linda. Mrs. White "spoke up very cheer­fully and promptly, and said that that was the better way to do—part of the work here, and part of the work in Los Angeles."³

Combination Plan in Two Locations Adopted

Our First Street Dispensary in Los Angeles opened its doors on Monday, September 29, 1913. Within the year it was necessary to in­crease the accommodations by the erection of a small building on the back of the dispensary lot, to be used for medical examinations and for a classroom.

Although the facilities were simple, the in­struction was excellent. Many doctors contrib­uted their time. Dr. Ethel Leonard, one of the visiting physicians who had been connected with medical schools for years, was asked how she thought the students would stand at State Board. "You need not fear in regard to those students," she replied. "They are the best-pre­pared senior class I have ever had."

As the work in Los Angeles grew rapidly, and plans for expansion were being considered, the faculty were convinced that with this in­crease in clinical opportunities for the students, it might be possible to raise the rating of the school. In the fall of 1914 Dr. Newton Evans, who was teaching pathology at the University of Tennessee, accepted the presidency of CME, after considerable pressure from Dr. Ruble. Dr. Ruble remained as teacher of pathology for some months and then was called to become medical secretary of the General Conference. Dr. Evans felt that Dr. Percy T. Magan, who with Dr. E. A. Sutherland had been connected with the Madison self-supporting enterprise in Tennessee, would be able to help with the mat­ter of the rating of the College of Medical Evangelists. He wrote to his old friend and asked him to wield his influence for the college at the next meeting of the Council on Medical Education of the American Medical Associa­tion. Dr. Magan was an intimate friend and former pupil of Dr. J. A. Witherspoon, recently retired from the presidency of the A.M.A.

The Council was held in Chicago on Feb­ruary 15, 16, and 17, 1915, with three subordi­nate associations meeting in the Congress Hotel. These subordinate sessions were the Federation of State Medical Examining Boards, the Coun­cil on Medical Education, and the Association of American Medical Colleges. Dr. Evans, Dr. Ruble, and Dr. Magan were appointed as a committee to represent CME. Dr. Magan brought with him a letter from Dr. Wither­spoon, introducing him "in a very kindly and favorable manner" to Dr. Arthur D. Bevan, who was chairman of the Council on Medical Education.

But the hopes of the committee from CME were disappointed. The action of the Council was unfavorable. The story is told by Dr. Ma­gan in a long letter to W. C. White after the Council, in which he reported in detail the con­versation held with Dr. N. P. Colwell and oth­ers, and explained the reasons for the final No that had been given to the request for a higher rating. High points in the criticism leveled at the college were inadequate staff and facilities; studies not scientifically organized; scattered condition of the departments.

The CME Board and Constituency felt that this action of the Council was final, and that the requirements which would have to be met before reaching the standard for the B rating were far beyond the realm of any possibility in the near future: a two-bed clinical hospital in Los Angeles; a $100,000 yearly budget for operating; the teaching staff to be paid profes­sors instead of practicing physicians. An ad­ditional reason for discouragement was the fact that at this Council the basis for classification of medical schools had been changed so that A and A-plus schools were to be classified as A; B class included those that were questionable; and C class those that could not be recognized at all.

Legal "A" and Spiritual "A" Grade Rating

The situation at Loma Linda looked des­perate to many. "But frankly, I do not so re­gard it," said Dr. Magan. He also wrote:

I do not see that there is any way under heaven unless God works miracles whereby we can get out of this state of affairs. It does not seem to me, how­ever, that this should cause us to lose interest or be discouraged. I kept telling Dr. Evans that no matter how hard things are, God would work something out for the whole experience. I have felt for a long time, and you pardon me for saying it, that Loma Linda needs a deeper experience in the real mis­sionary spirit of sacrifice and in God's ways of healing the sick.

To my mind it would be one of the worst things in the world if Loma Linda should be able to get into the legal "A" grade and at the same time not be in the spiritual "A" grade. . . .

I do not believe that because of the present situation, we ought to give up the idea of training men and women to meet the legal standard. I think we ought to go ahead and perfect our plans and our school to the very best of our ability.⁴

One net gain from the experience, perhaps, was a greater awareness of the inadequacies of the physical plant, and the need for a better-organized teaching program. Less than a month following this, the board recommended that plans be drawn up for a new dispensary and a hospital, and on June 17, 1915, passed a resolu­tion "to inaugurate a movement to erect a building for dispensary purposes."

In the autumn of 1915, Dr. Magan was still in self-supporting work at Madison, Tennessee, and had no thought of connecting with CME. But Dr. Newton Evans and others were looking anxiously to him, thinking that if he could be persuaded to join the staff he would be a strong influence in the matter of accreditation, fund raising, and public relations. The medical council, set for November at Loma Linda, was to be a crucial one, where members of the Gen­eral Conference Committee, the North Ameri­can Division, and the Board of Trustees were to consider the future of CME. Both Dr. Percy and Dr. Lillian Magan were invited by the Board of Trustees to attend this meeting.

Two Stalwart Men Who Turned the Tide

There was a "widespread sentiment" among the members of the council "that the entire question of the future of our institution as a medical institutional center and school for the training of physicians with legal qualifications should receive thorough consideration at this meeting."⁵ This was a delicate way of saying that it was the firm determination of many members of the council to cut back the College of Medical Evangelists to a two-year or three-year school at this time. But before the council closed, renewed courage and faith had come into the meeting, and the decision was made to advance instead of retreat. According to Dr. Magan, it was A. G. Daniells, president of the General Conference, who turned the tide. In a letter written to Elder Daniells, October 2, 1921, he recalled the occasion. Here are ex­cerpts from his letter:

Never will my anxiety at the Fall Council at Loma Linda in 1915 relative to the future of the medical college fade from my mind. As long as I live I will remember when you and W. C. White and I, and Dr. Evans, I believe, met . . . and talked over the problem as to whether the school should be allowed to go on or not. I remember so well your earnest prayer. Then came the never-to-be-forgotten Thursday morning at six o'clock in the old physiology room of the North laboratory. The scene is most vivid in my mind. Men were clamoring for the floor. Two leading men whom you may remember, but whose names I suppose I had better not mention, had made what appeared to me, most violent speeches that we only do two years' work, build no hospital, and let the students go elsewhere to finish up. . . .

Of course, I was not connected with the school then. I was just anxious about my own poor lad, Wellesley. . . . Then you got up—I can see you vet— about the middle of the room on the front row, and your opening words are most indelibly en­graven upon my soul: "I have said very little during this Fall Council. I have not felt like saying much, but I feel that I would be a coward if I did not take my stand in regard to the matter of this medi­cal college. We have always said that we believed the Spirit of Prophecy. Those writings tell us that we must hold a complete school, and must not send our students to finish in other schools, and now, brethren, here we are, before the prophet is hardly cold in her grave, taking steps to immediately close the last two years' work, and which will ultimately mean closing the entire place. We must not do it; we must have faith to go on."

"I have never told you," said Dr. Magan, "but it was your courage that made me feel to join the medical school." But according to Dr. E. A. Sutherland and Dr. Newton Evans, it was Dr. Magan who turned the tide by his speech in which he narrated his own experiences in at­tending a worldly medical school. "He told the need of securing things of real value, of the dif­ficulties of Sabbath exemption from classes, of the necessity of conducting ours [school] on a high spiritual basis as well as a standard medi­cal school. His talk swung the brethren across and saved the medical school." ⁶ "You have saved the medical school," said President Evans. "Now you must come out and help me run it."

On December 23 of the same year (1915) Dr. Magan was elected to the faculty of the College of Medical Evangelists. However, there was a stipulation that since there were not sufficient funds to add his salary to the budget, he must raise the money for his own salary, which would be, of course, on the same scale as the others. (To be continued)

Correction, CME Series

In the July issue a sentence was left out of the article on the story of accreditation at CME (second section of "Obtaining the Charter—C-Rating), by Margaret R. White. Under the sub­heading, "Articles of Incorporation, December, 1909," on page 32, two historic dates are men­tioned, but the second and more important, May 11, 1910, was omitted. The paragraph should read: "Two months later, on December 9, 1909, the Articles of Corporation for the Col­lege of Medical Evangelists were signed and recorded in Los Angeles. On May 11, 1910, the Articles of Corporation which consolidated the Loma Linda Sanitarium and CME into one corporation were signed. These two dates are history."—Editors.

1 "Report to the Constituency," January 27, 1913; G. A. Irwin, Board Minutes of the College of Medical Evangelists, 1911-1917, p. 85.

2 "President's Report 1913," W. A. Ruble, op. cit., p. 91.

3 "Advice to the Loma Linda Board Regarding the Work in Los Angeles," W. C. White, Document File No. 382.2, Historical Records Office, Vernier Radcliffe Memorial Library, Loma Linda.

4 Letter of Percy T. Magan to W. C. White, March 3,1915.

5 "Report of Committee to the brethren ot the (general and North American Division Conferences Assembled in Council at Loma Linda, November, 1915." Document File 382.2, Historical Records Office, Vernier Radcliffe Memorial Library.

6 "Chronological Arrangement of Events in the Life of Percy T. Magan," E. A. Sutherland, Historical Records Office, Vernier Radcliffe Memorial Library.

(All letters referred to are in the correspondence file of the Historical Records Office.)