war, and aided him in the solution of multiple problems ever present in such an institution.
Shortly after Dr. Haynes was appointed, Dr. Albert C. Kerlikowske ('24m) became Chief Resident Physician and, in 1928, Assistant Medical Director of the Hospital.
Development of intern system. — Throughout the early years of the Hospital, the problem of interns, or house physicians, was never satisfactorily settled. Although essential to the proper conduct of a hospital, for many years they occupied an inferior position and were more or less looked down upon by the hospital chiefs. By 1890, however, it came to be recognized in medical schools that experience was a valuable asset for young doctors before they went into practice.
Thus, although the beginnings were very modest, a system of internship gradually developed. A Hospital physician, later called resident physician, was first appointed in 1874 and doubtless performed many of the functions of an intern. In 1895 both a house physician and a house surgeon were listed in the Announcement. The first interns under that designation, four in number, were listed in the Calendar for 1899-1900 and were given a salary of $125 a year with room and board.
For some years after those first appointments the intern system was far from satisfactorily organized. Some ambitious students in applying for positions as interns secured recommendations to more than one hospital, leaving to their faculty sponsors the duty of explaining their failure to accept appointments in other hospitals to which they had applied. This led, of course, to great confusion.
To meet this situation the medical faculty in 1911 appointed a committee to systematize the entire program. To this committee, composed of Dean Vaughan, Dr. Hewlett, and Dr. Peterson, all requests and recommendations for internships were to be referred. Dr. Peterson in laying the matter before the Council on Medical Education of the American Medical Association reported that the committee felt that a firsthand knowledge of the best hospitals throughout the country should be obtained and that appointments to positions in these hospitals, as well as certification of the students' fitness, should be made. A plan for a fifth clinical year in the medical curriculum at Michigan was considered, but was never put into practice.
The admission of students to internship in the Hospital was thus gradually systematized. The situation was strengthened in 1922 by the passage of a law requiring all medical graduates to serve one year in an accredited hospital before beginning to practice. In 1940 thirty-five interns were on the Hospital staff. They rotated among the various clinical services. There were also approximately forty assistant residents, who served for a second year, and thirty resident physicians, who stayed for a third year.
As the University Hospital expanded and more and more interns were required the question of adequate quarters for them, as well as for the house physicians, became pressing. An old residence, moved to the Hospital site, was made over into an interns' home in 1914 at a cost of $2,500, and three years later an enlargement was authorized, so that the building accommodated fourteen men. The third floor of the Hospital Administration Building was also used, as well as a near-by residence taken over for the purpose. These makeshifts were so unsatisfactory, however, that in 1939, a new building for interns, housing some seventy-five men, was erected at the rear of the main Hospital building.
