"German methods," "unconditional gifts," and the full-time system: The case study of the University of Toronto, 1919-23

Abstract

At the end of 1919, The University of Toronto got word that the Rockefeller Foundation was looking to give the university a gift of one million dollars (US) to "aid medical education.". This was in addition to a gift of $500,000 (Canadian) from merchant millionaires Sir John Craig and Lady Eaton. The implementation of the full-time system of clinical instruction made possible by these large gifts touched off a fiery debate among the medical profession and prompted a provincial government inquiry that would have thwarted long-awaited innovations in medical teaching and threatened the autonomy of the entire university. Much has been written about the full-time system of clinical medical education, most of it dealing with the United States. Some have documented cases where donor dollars were scorned in aiding the shift to full-time clinical teaching. Less well known is the tale of the University of Toronto. "The Provincial University" is an unique case study of a public university that tried to satisfy donor conditions even as it served its constituency- the people of Ontario. The challenge of implementing a new medical pedagogy between 1919 and 1923 was that Toronto lay at the centre of three poles: private versus public funding; "research" or laboratory medicine versus "experience" or "practical" medicine; and those who wanted to try the full-time system versus the established "old guard."