This is the second article in a three-part series on the history of the School of Medicine.
The 1980s were a difficult time for medical schools nationwide, and Duke's School of Medicine was no exception to this rule. But despite a declining number of applicants, changes in the curriculum and the use of technology made the medical school an increasingly influential presence on the national stage.
After steady increases in the number of students applying to the medical school during the 1970s, the start of the 1980s marked the beginning of a gradual decrease in applications. By the end of the decade, the School of Medicine received not quite 27,000 applications per year, nearly 10,000 fewer applicants than the 36,000 who applied in 1980.
This decrease was consistent with national trends, said Robert Sabalis, associate vice president for student programs at the Association of American Medical Colleges.
"Whenever the economy is flourishing and there are exciting jobs available in interesting careers that require no extra schooling, applications to graduate and professional schools always decrease," he said.
Sabalis explained that when the economy is in a slump, students have been known to "hide out" in graduate schools until jobs become available.
"In the late '80s, there was a big trend away from medical schools to business schools as students were going for their MBAs," said Dr. Brenda Armstrong, dean of admissions for the School of Medicine.
But more interesting and higher-paying careers were not the only factors driving students away from medical school. The 1980s were a time of fear for physicians as AIDS and hepatitis epidemics affected patients nationwide. These diseases posed serious health risks to doctors, which discouraged application to medical school.
"This notion that one could die from being a physician was frightening to people," Sabalis said.
Managed care was another major concern of students at this time. Sabalis said the question of possible government intervention in managed care was seen by both those in the field and those considering medical school as a loss of autonomy.
But while the number of applicants dropped, changes in education, a greater focus on research and the introduction of new technology helped to improve the medical school's national reputation.
The school, which had already instituted major curriculum changes in 1966, made two more significant changes, said Dr. Russel Kaufman, associate vice chancellor for academic affairs at the medical school.
Kaufman said the school began to shift to an educational model of small group discussions that introduced students to clinical issues early in their education, while increasing the use of technology in the classroom.
This distinct curriculum became a model for other institutions across the country.
As part of the technology initiative, computers became increasingly common and were used to assist teaching and in laboratory endeavors.
And since students had more clinical experience, the development of medical equipment played a key role in their education.
"The integration of new technology has provided new opportunities to how we teach," Armstrong said.
The medical school's commitment to research was also a major impetus for its improving national status.
"The amount, sophistication and complexity of our clinical research provided a significant increase [in reputation], as well as institutions like the [Duke Clinical Research Institute], and our basic science research," Armstrong said.
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