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JAMA marks 150th anniversary of University of Michigan Medical School with issue devoted to U-M research and history

ANN ARBOR, Mich. -- For only the eighth time in its long history, an entire issue of The Journal of the American Medical Association is devoted this week to research papers and other contributions from a single medical institution: the University of Michigan.

The edition marks the 150th anniversary, or sesquicentennial, of the U-M Medical School, one of the nation's oldest and most recognized leaders in medical education, medical research and patient care.

Six original scientific articles, reviews of four books, a commentary, a historical essay and an editorial on shaping the future of academic medicine, all with strong U-M connections, are included in the special JAMA issue.

The contributions span the range of U-M medicine, from evidence-based findings on heart disease treatments and screening for diabetic eye disease to cutting-edge life support technology and examinations of medical practice and history. A full list is below, and press materials and links for all articles are online at www.med.umich.edu/JAMA.

Even the cover art salutes U-M: It's a portrait of Victor C. Vaughan, M.D., who served as dean of the U-M Medical School from 1891 to 1921. Vaughan helped the school develop a science-based approach to teaching and research that was singled out in the landmark 1910 Flexner report praising U-M and decrying standards and conditions at many other schools. That approach continues today.

"From the beginning, our school fostered the best in academic medicine, including the early introduction of scientific methods and very early admission of women and African Americans in substantial numbers. This issue is filled with the latest representations of that tradition," says U-M Executive Vice President for Medical Affairs Gilbert S. Omenn, M.D., Ph.D. "We are honored by this recognition, and grateful for the opportunity to share both our past and our future with the American medical community."

Adds U-M Medical School Dean Allen Lichter, M.D., "Each of us, whether clinical or basic researcher, medical student or alumnus, faculty or support staff, takes pride in our history and the contributions we have made to the health of the nation's people and the understanding of the human body. This issue reflects that pride."

JAMA editor Catherine DeAngelis, M.D., M.P.H., notes: "We are delighted to produce this sesquicentennial commemorative issue ofJAMA devoted to the University of Michigan because it is such a special institution in the history of American medicine."

Only seven American medical institutions have received similar recognition from JAMA in the past. The journal has published centennial celebration issues for medical schools at Tufts University, Creighton University, the University of Texas at Galveston, Johns Hopkins University, and Washington University, as well as bicentennial issues for the medical schools at Dartmouth College and the University of Pennsylvania.

The U-M edition came about through the efforts of Howard Markel, M.D., head of the U-M Medical School's Historical Center for the Health Sciences. Dozens of U-M researchers submitted their papers and other works for consideration. JAMA's editors made the final selection through their usual stringent peer-review process.

The special issue includes:

• An editorial on the future of academic medicine at the U-M by Omenn, Lichter, U-M Hospitals and Health Centers Executive Director Larry Warren, and U-M President Lee C. Bollinger. The four leaders describe the dramatic changes made in recent years to restructure health education, research and care at the University and prepare the U-M for the challenges and opportunities of medicine in the 21st century.
• A "Contempo", or commentary, by neuroradiologist Douglas Quint, M.D., encouraging the use of magnetic resonance imaging, or MRI, in emergency situations to diagnose brain and spine injuries or problems quickly, safely and non-invasively.
• The groundbreaking report of an international cardiology collaboration, led by U-M cardiology chief Kim Eagle, M.D., and cardiology fellow Peter Hagan, M.D., that tallies high death rates and lack of consistency for diagnosis and treatment of a rare but often lethal dissection, or ripping, of the main artery leading from the heart.
• Dramatic results on the lifesaving power of extracorporeal membrane oxygenation, or ECMO, a life-support technology pioneered at the U-M in the 1980s by lead author Robert Bartlett, M.D. The remarkable data are from the first 1,000 critically ill newborns, children and adults to be placed on ECMO at the U-M.
• A surprising conclusion that not all diabetics need to be screened annually for a common eye-degrading complication of their disease, as found in a cost-benefit analysis led by Sandeep Vijan, M.D., of the Department of Veterans Affairs Ann Arbor Healthcare System and the U-M Department of Internal Medicine.
• Recommendations to help physicians better understand the perspective of families facing difficult decisions over medical care for their terminally ill relatives. The paper, by U-M medical ethicist Susan Dorr Goold, M.D., MHSA, and her colleagues, puts forth a novel "diagnosis" framework for doctors to use in dealing with conflicts between their medical opinions and the wishes of family members.
• A history by Markel of the U-M Medical School since its founding in 1850 emphasizing the example that U-M medical education, research and care have set for other institutions.
• A contribution from health law specialist Peter Jacobson, J.D., M.P.H. of the U-M School of Public Health, which has close ties to the Medical School. The paper details how physicians have lost autonomy under courts' interpretation of the federal act that regulates the managed care organizations that provide health insurance to 125 million Americans.
• Four reviews of new health-related books by U-M authors, including a book on sleep medicine, a health law text on medical decisions, a collection of essays on geriatrics, and a gastroenterology textbook.

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