|Date(s):||April 15, 1910|
|Tag(s):||internship, Medicine, Medical Education|
|Course:||“The History of Medicine and Public Health,” Indiana University-Purdue University, Indianapolis|
Dr. Albert Sterne was presented with a great challenge. In charge of placing recent graduates of the Indiana University School of Medicine (IUSM), he had to convince a hesitant group of Indiana physicians to accept them into their clinics as interns. As the first chairman of student affairs at the newly established Indiana University School of Medicine, Sterne was determined to see more of IUSM’s “boys” receive a highly competitive internship position. This was no easy task at a time in which the internship was seen as a “favor” to the medical school graduate. In his letter to Indiana physicians, Sterne highlighted the value that taking in interns would offer. He emphasized that IUSM would provide “highly qualified” interns. Each intern would undergo a standardized exam to demonstrate competency. Sterne went on to claim that interns would provide significant help in easing the workload.
Dr. Sterne’s push for a greater quantity of internships available to IUSM graduates occurred in 1910, even before the internship was required to practice medicine. Clinical practicums, though common in Europe, were scarce in the U.S. Despite recommendations by the American Medical Association in 1905 to incorporate the clinical internship into medical education, it was highly debated. Physician, James Herrick, for instance, argued against its incorporation stating, “But in many hospitals, the intern does little more than give an anesthetic, dress and take the blame for pus cases, and occasionally examine the urine and sputum.” Others felt internships should be reserved for the best and the brightest. Dr. Halstead of the John’s Hopkins University stated “Only the honor men of each class at graduation (should be) entitled to these positions.” Sterne was determined that all IUSM graduates should gain this “highly valuable” clinical experience, at a time in which fewer than two-thirds of U.S. medical school graduates were granted one of the coveted positions.
By 1912, the mood began to shift. The CME published its first edition of “Approved Training Hospitals” for internships, and that year, 75% of U.S. medical school graduates would receive a clinical internship. However, there was still an enormous shortage in the number of open positions, and it wasn’t until 1923 that the number of internship positions and the number of graduates began to balance out. Dr. Sterne recognized the value of clinical experience and the need for more internships early on. Looking out for the best interest of IUSM students, Sterne was determined to fill this gap. With urgency, he began sending his letter to chairmen of hospitals around the state of Indiana and creating partnerships so that more IUSM graduates could receive a position.