History of Health Sciences
From its beginning, faculty members of the Medical School in San Francisco routinely opened their courses of instruction with historical introductions. With support from Dean Langley Porter, and as a result of stimulating visits from notable physicians and historians like Charles Singer, George Sarton, and William H. Welch, UCSF created a separated unit in 1927. Two years later, Chauncey D. Leake, a pharmacologist, offered the first formal course in medical history in 1929. The departmental program was organized in association with library developments. Sanford V. Larkey, a scholar of Tudor England, was appointed librarian and associate professor of medical history and bibliography in 1930, when the new Clinic Building came to host the Department of Medical History and Bibliography, the first academic unit of its kinds to be organized in the country.
During the 1930s and 1940s, the Department flourished under the leadership of John B. de C. M. Saunders, a Professor of Anatomy and University Librarian. Another anatomist, Herbert M. Evans, offered a formal, one-semester course with Saunders, and Leake, open to all students at the San Francisco campus, together with special seminars for graduate students accepted for advanced study. Fueled by the Oslerian cultural ideal, the medical classics were read and quoted since many educated physicians still could read Latin. these activities were also meant to convey to UC Regents the notion that the Parnassus campus provided a cultural environment that would preclude the removal of the Medical School to the Berkeley campus.
In 1935, when Larkey went to Johns Hopkins Medical School as librarian of the Welch Memorial Library, Leake became librarian and professor of medical history and bibliography and continued to promote the program. Frances Tomlinson Gardner became curator of the Medical History Collections, which grew to some 14,000 items by 1941. Special gifts were made by many: general English classics from Hans Lisser; sixteenth-century classics from Leroy Crummer; a comprehensive Osler collection from Esther Rosencrantz; Greek medical classics from Pan S. Codellas; California medical classics from Henry Harris; and a large collection on the history of anesthesia from Leake. Publications from the department were made by Mrs. Gardner, John M. D. Olmsted, Felix Cunha, Saunders, and Leake.
When Leake left for Texas in 1942, Saunders became librarian and chairman of the department. Unfortunately, the speed-up training program of World War II resulted in abandoning the formal course on medical history. Yet, the historical collections were fostered and special seminars were offered by Otto Guttentag, Evans, and Saunders. In 1958, a new library facility was provided and the historical collections were housed in appropriate quarters. Important publications on da Vinci, Vesalius, and Egyptian medicine were made by Saunders and his colleagues. The studies on Egyptian medicine by Leake and by Saunders were featured in Logan Clendening Lectures at the University of Kansas.
Leake returned in 1963, when president of the American Association for the History of Medicine, and offered a voluntary summer course in the history and philosophy of medicine. Many special historical exhibits were arranged. The well-known authority on Oriental medicine, Ilza Veith of the University of Chicago, came in 19645 as professor of medical history. A large collection of Oriental medical classics was obtained, and the historical collections grew under Saunders's guidance to over 20,000 items. The department offered special seminars and medical students were encouraged to try historical research. Significant publications were made by staff members, including import items by Evans, Karl F. Meyer, Salvatore P. Lucia, and Veith.
During these decades, the medical history program's stewardship of archival materials and historical collections expanded, particularly with the acquisition of Oriental medical titles. Leroy Crummer, a notable bibliophile and veteran book collector, joined the academics. To accurately reflect the interests of the entire campus, the name of the unit changed to History of Health Sciences in 1965. Dr. Saunders was appointed Regents Professor of Medical History, a post he occupied until his retirement in 1973. His long tenure included the development of a graduate program of studies leading to M.A. and Ph.D. degrees. Saunders's successor, physician and historian Gert H. Brieger, then guided the department from 1975 to 1984, ending with another change in the name: History and Philosophy of Health Sciences. The new designation was intended to accommodate a growing campus interest in medical ethics and thus reinforce its humanistic mission.
The appointment of physician-historian Guenter B. Risse in 1985 and the subsequent arrival of historian Jack Pressman not only allowed a resumption of graduate M.A. and Ph.D. programs but signaled a new direction: the development of new elective courses specially designed for the new Medical School curriculum. With bioethics rapidly becoming an independent field, the previous designation--History of Health Sciences--returned. Affiliations with the History Department at UC Berkeley and the Wellcome Institute for the History of Medicine in London allowed for faculty, postdoctoral, and student exchanges and seminars. For UCSF medical students, elective tutorials were organized to allow for guided explorations of the process of becoming a physician--emotional and technical--with the help of historical case studies and supported by a departmental library and audiovisual collection.
During the 1990s at the Parnassus campus, a program of noon-hour illustrated lectures opened to faculty, students, and staff that presented the historical contexts of contemporary health and medical significance. Among the most prominent themes presented were a history of the Western hospital from antiquity to AIDS and another explaining alternative healing traditions.
With the arrival of historian Nancy Rockafellar, the department also began a series of oral histories featuring interviews with eminent UCSF faculty members. Local and extramural support for guest visitors and lecturers allowed the unit to flourish, allowing the department to remain at the forefront of similar academic medico-historical institutions in the country and the world. However, Jack Pressman's untimely death and Guenter Risse's impending retirement led to the decision to merge historical studies with other, previously independent, fields of study, leading to the establishment in 1998 of the interdisciplinary Department of Anthropology, History and Social Medicine.
Medical Anthropology
The history of the Medical Anthropology program at UCSF owes its existence largely to the dedication and energy of Dr. M. Margaret Clark. Dr. Clark was first hired at UCSF as a "Senior Research Anthropologist" in the Geriatrics Research Program and was then appointed Professor in Residence in the Departments of Psychiatry and International health before finally becoming Professor of Anthropology within the Department of Epidemiology and International Health (now Epidemiology and Biostatistics).
During Dr. Clark's career, the field of Anthropology was forming new disciplinary subdivisions, including medical anthropology. The Society for Medical Anthropology was founded in 1970, providing a model for research questions and themes that were quickly thereafter integrated into graduate programs in anthropology across the country, including the only UC campuses that offered a Ph.D. in anthropology at Berkeley, Los Angeles, and Davis. That same year, the first course in medical anthropology--"Anthropology and Mental Health"--was offered at UCSF. In 1971, an interdisciplinary faculty of health care practitioners, human biologists, and both sociocultural and physical anthropologists formed the "Graduate Group in Anthropology" at UCSF, with more elective courses offered through the Institute for Medical Research and Training Program. With the support of Dr. Julius Krevans, then Dean of the School of Medicine, and Dr. Harold Harper, Dean of the Graduate Division, and with the assistance of a grant, Dr. Margaret Clark and other UC faculty, including Frederick L. Dunn, Renaldo Maduro, Joan Ablon, Lucille Newman, and Christie Kiefer, worked to build on the foundation to form a joint Ph.D. program in Medical Anthropology with UC Berkeley. Collaborating closely with Dr. George Foster and others at Berkeley, the first draft proposals for this were penned in 1973.
The following year, 1974, a program announcement from the Alcohol, Drug Abuse, and Mental Health Administration to fund predoctoral and postdoctoral training in specified areas of biomedical and behavioral research provided a welcome opportunity to raise the money needed for this endeavor. In 1975, Dr. Clark obtained a training grant for $655,878 from the Department of Health, Education, and Welfare to fund a percentage of faculty time at UCSF and UC Berkeley for five years "to provide intensive research training on a range of mental health problems for a total of twelve advanced graduate students, leading to a Ph.D. in medical anthropology." In April 1974, the Chancellor of UCSF, Dr. Francis Sooy, wrote to congratulate Dr. Clark on the approval of the joint degree program by the Regents of the University of California. While several other universities in the United States offered graduate study in medical anthropology by that time, the training at UCSF-UCB would provide the first fully-specialized program leading to a Ph.D. in that field.
The program was built around the development of students with a strong background in graduate-level training, accepting only those with a Master's degree in social science or a relevant health profession, and five distinct components, each representing separate aspects of the student's methodological, theoretical, and professional education, including:
- Two years of core course work examining the links among culture, medicine, and health.
- Two years of apprenticeships with faculty involved in ongoing research.
- Three years of workshops in research design and techniques, analysis, and the reporting of research data and dissertation preparation.
- Three years of internships in a medical setting.
- Supervised field research for the dissertation.
Members of the medical anthropology faculty were early-on engaged in a wide variety of research projects, including aging and human development, reproductive health, community mental health, comparative medical systems, ecology of disease and population health, and disability.
Among other large training programs at UCSF that were spearheaded under Dr. Clark's direction was the Multidisciplinary Program in Applied Gerontology, developed in the late 1970s and early 1980s with support from the Federal Administration on Aging. This pioneering program focused on training teams of students from diverse professional backgrounds (medicine, nursing, pharmacy, dentistry, and social sciences) to optimally assess, diagnose, and treat patients in a variety of long-term geriatric settings, ranging from the community through residential care facilities.
Expansion and diversification of topical interests of faculty, post-docs, and graduate students throughout the 1980s and 1990s are well represented by the dissertation titles of graduates from the program and their supervising faculty. This expansion included examination of the HIV/AIDS crisis and that of other infectious diseases; emerging technologies, especially but not exclusively organ transplantation and other hybrid techniques and end-of-life care issues; the interface of the clinical enterprise with health policy and the organization of professional practice, not just for medicine but for nursing and ancillary health care disciplines; complementary and alternative medical practices; substance use and misuse; as well as a focus on the interface between health and poverty, migration, and the increasing ethnic diversity within the U.S. population in general and the Californian population in particular. Graduate students and faculty continue to consolidate their involvement in the examination of these topics as well as increasing the breadth of issues investigated.
While the specific requirements of the Ph.D. program have changed slightly since its inception, it is still strongly anchored by an increase in excellence in theory in both anthropology in general and medical anthropology particularly, methods--especially research design and data analysis, and a thorough grounding in substantive topics of relevance to the disseration. A strength of the program has been its ability to attract and graduate students from a diverse range of disciplinary and personal backgrounds--50% of students enter the program with a Master's degree in anthropology or other social sciences, 25% from public health, and the other 25% from various clinical disciplines (e.g., nursing, medicine, occupational therapy, and social work).
In 1999, coeval with substantial reorganization of divisions within the Department of Epidemiology and Biostatistics, the Medical Anthropology Program moved to a new home in the School of Medicine, merging with the existing Department of the History of Health Sciences to form the Department of Anthropology, History, and Social Medicine.
Over those years, the Department had approximately 25 doctoral students and residents in any given year. It developed an Area of Concentration in Medical Humanities for fourth-year medical students. Several electives were offered for medical and nursing students including "Medicine and the Movies" and "Medical History to Complement the Essential Core." the Department also contributed to the Cultural and Behavioral Studies syllabus in the Essential Core for first- and second-year medical students and several faculty lead small groups in the "Foundations of Patient Care" course offered to first- and second-year medical students. As the medical curriculum changed, the department has adapted its teaching and contributions to the essential core and has provided faculty leadership from both medical anthropology and history in curricular development, particularly in areas of structural competency, anti-racism in medicine, health policy studies, and the development of health systems.
In the 2000s, the chairship of the department alternated between faculty from Medical Anthropology and History of Health Sciences, beginning with Dr. Philippe Bourgois (1998-2003); Dr. Dorothy Porter (2003-2008); Dr. Nancy Milliken (2008-2013); Dr. Sharon Kaufman (2013-2018); and Dr. Brian Dolan (2018-present).
Department of Humanities and Social Sciences
In June 2020, UCSF Chancellor Sam Hawgood approved the renaming of the Department of Anthropology, History, and Social Medicine to the Department of Humanities and Social Sciences (H&SS). This adjustment helps the department articulate a broader vision for research, scholarship, and teaching in multidisciplinary areas that fosters collaboration among faculty, students, and trainees across UCSF.
Narrative about the History of Health Sciences was written by Dr. Guenter Risse. Information about the history of Medical Anthropology was contributed by Drs. Vincanne Adams, Philippe Bourgois, and Judith Barker.
For information on the history of medicine at UCSF, see "A History of the UCSF School of Medicine" by Dr. Nancy Rockafellar.