Indiana University School of Medicine
|Dean||Jay L. Hess|
|2,469 full-time and 279 part-time (2017)|
The Indiana University School of Medicine has nine campuses throughout Indiana; the principal research and medical center is located on the Indiana University – Purdue University Indianapolis campus in Indianapolis. With 1,409 M.D. Program students and 158 Ph.D. students in 2017, IU is one of the largest allopathic medical schools in the United States. The school offers several joint-degree programs, including an MD/MBA, MD/MA, MD/MPH, and an MD-PhD Medical Scientist Training Program.
The school has pioneered research in multiple specialties, including oncology, immunology, substance use, neuroscience, and endocrinology. Research discoveries include a curative therapy for testicular cancer, the development of echocardiography, the identification of several genes linked to Alzheimer's disease, and the creation of inner ear sensory cells from pluripotent stem cells.
In the 2021 U.S. News & World Report rankings of the best graduate schools for medicine, the school ranked 20th in the nation for primary care and 47th for research out of about 150 medical schools. In the U.S. News & World Report rankings of the best hospitals, the Indiana University Health Medical Center had seventeen nationally ranked clinical programs. The Riley Hospital for Children at Indiana University Health is nationally ranked in 9 of 10 designated specialties for children in the U.S. News & World Report. The IU School of Medicine is also home to the Melvin and Bren Simon Cancer Center, a National Cancer Institute-designated Comprehensive Cancer Center.
Indiana University established a department of medicine at Bloomington in 1903, but the IU School of Medicine in Indianapolis traces its founding to 1908, following the resolution of a rivalry with Purdue University over which institution had the authority to establish a medical school in Marion County, Indiana. A year after the IU and Purdue-affiliated schools were consolidated in 1908, the Indiana General Assembly authorized IU to operate a medical school in Marion County.
Founding in Bloomington, 1903
In March 1903, William Lowe Bryan, the tenth president of Indiana University, proposed the formation of a department of medicine at IU Bloomington to the university trustees. The new department was established in May of the same year. The IU School of Medicine was admitted as a member of the American Association of American Medical Colleges (AAMC) in 1904.
Founding in Indianapolis, 1908
In addition to its department of medicine in Bloomington, IU's leaders wanted to locate medical training facilities in Indianapolis. Their initial plan was to provide medical students with the first two years of coursework at Bloomington and the final two years at Indianapolis, where students would receive clinically-based training as part of their studies. Prior to 1908, due primarily to the high cost of establishing its own medical facilities in Indianapolis, IU attempted to merge with existing medical schools, but the effort was not successful.
Between 1905 and 1908 there continued to be a debate over which university, IU or Purdue, could establish a state-supported, four-year medical school at Indianapolis. In 1905, Purdue University's Medical Department joined with the Medical Department of the University of Indianapolis (the former Medical College of Indiana), the Central College of Physicians and Surgeons, and the Fort Wayne Medical College to form the Indiana Medical College, School of Medicine of Purdue University. Unable to merge with other existing institutions, IU organized a separate medical training facility in Indianapolis. In 1906 a group of IU supporters purchased the building that housed the former Central College of Physicians and Surgeons at 212 North Senate. The building became the site of the State College of Physicians and Surgeons, which offered clinical instructions to IU's third- and fourth-year medical students. State College enrolled 109 students in September 1906. In August 1907 the IU board of trustees agreed to a merger of the IU School of Medicine in Bloomington with the State College of Physicians in Indianapolis but agreed to take financial responsibility for only the school's facilities in Monroe County (Bloomington). The first two years of training continued at Bloomington and the final two years of clinical training were held at the State College site in Indianapolis, with a doctor of medicine degree conferred by Indiana University.
To resolve their ongoing dispute, IU and Purdue leaders, along with their supporters, sought approval from the Indiana General Assembly to operate their own schools of medicine in Marion County. In April 1908, IU and Purdue officials reached an agreement. The resolution consolidated the medical department at IU Bloomington with the State College of Physicians and the Indiana Medical College, School of Medicine of Purdue University, at Indianapolis and retained the name of the IU School of Medicine On February 26, 1909, the state legislature formally authorized Indiana University to operate a medical school in Marion County. With the finalized agreement between IU and Purdue, the two separate medical schools in Indianapolis were consolidated, marking the second founding of the Indiana University School of Medicine in 1908. The state legislature's authorization in 1909 allowed IU to operate its own medical school in Marion County and enabled IU's medical students to complete all four years of their medical education in Indianapolis.
Early leadership and enrollment
Doctor Allison Maxwell agreed to serve as the first dean of the four-year IU School of Medicine in Indianapolis in April 1908; he remained as its dean until 1911. Maxwell led the fledgling school through a difficult time when financial budgets were an issue and the consolidation of IU's and Purdue's medical school faculties in Indianapolis and Bloomington was completed. The combined faculty would support the four-year medical school at Indianapolis and maintain the two-year, pre-clinical coursework at Bloomington. In addition to Maxwell, other leaders in the IU School of Medicine's early history were drawn from Johns Hopkins University, including Charles P. Emerson who was appointed as the second dean of the IU School of Medicine in 1911 and served in that role until 1931.
Willis D. Gatch became the third dean of the medical school in 1932. In 1909, Gatch had invented the Gatch adjustable hospital bed, which used a crank to raise and lower the patient's head and feet. John D. VanNuys, a 1936 graduate of the IU School of Medicine, became its fourth dean in 1947. Amelia R. Keller, department of pediatrics, was the sole woman on the clinical faculty of the IU Medical School in Indianapolis after the school's consolidation with the Indiana Medical College in 1908.
IU graduated its first class of twenty-seven students and conferred its first Doctor of Medicine degree in May 1907. The first graduation of the consolidated IU School of Medicine and the Indiana Medical College students took place the following year. The IU School of Medicine's first black student, Clarence Lucas, graduated in 1908; Lillian Mueller became its first woman graduate in 1909.
The Flexner Report
Abraham Flexner, a renowned American educator whose work helped reform many medical schools, visited the IU School of Medicine in November 1909. He noted in his later Flexner Report (1910): "The situation in the state [was], thanks to the intelligent attitude of the university, distinctly hopeful, though it will take time to work it fully."
Flexner also made a recommendation for the progress of the school: "In order to make the school attractive to highly qualified students, it will be necessary (1) to employ full-time men in the work of the first two years, (2) to strengthen the laboratory equipment, (3) greatly improve the organization and conduct of the clinical courses." The IU School of Medicine was one of a few of medical schools in the nation at the time to receive a positive evaluation from Flexner, primarily because of its strong emphasis on college preparatory coursework in the sciences prior to enrolling in medical school and its additional training in the basic sciences as part of its medical school curriculum.
In its early years in Indianapolis, the IU School of Medicine used the former Central College of Physicians and Surgeons facilities, erected in 1902 and located at the corner of Market Street and Senate Avenue. After the consolidation of the IU School of Medicine with the State College of Physicians and Surgeons and the Indiana Medical College in 1908, the medical school used the former Indiana Medical College's facilities for about ten years while it secured financing to construct new medical school buildings. Several of the medical school's early buildings in Indianapolis were erected in the 1910s and 1920s on property that would eventually become the site of the IU Medical Center on the present-day IUPUI campus.
In February 1912, IU acquired property on West Michigan Street, near the Indianapolis City Hospital, to erect the Robert E. Long Hospital. Construction on the new teaching hospital began in 1912. Although its cornerstone was laid on November 1, 1912, the Great Flood of 1913 delayed the building's opening until 1914. Long Hospital was dedicated on June 15, 1914, and admitted its first patients the following day. Emerson Hall, another early medical school building, was constructed about 200 feet (61 m) northeast of Long Hospital and completed in the fall of 1919 at a cost of $257,699.
The cornerstone of the Riley Hospital for Children was laid on October 7, 1923, and dedicated on October 7, 1924. The hospital, named in honor of Hoosier poet James Whitcomb Riley, was erected north of Long Hospital. The James Whitcomb Riley Association (later known as the Riley Children's Foundation) hoped to raise an initial $250,000 in funding to add to the state's appropriation. By 1923 it had received $911,518 in pledges from more than 30,000 citizens, including $45,000 in donations from a mass fundraising event. Significant additions to the hospital were built over the years, including three in the 1930s: a Kiwanis Unit, dedicated in 1930; a Rotary Unit, dedicated in 1931; and a hydrotherapy pool in 1935.
Another of the medical school's early teaching hospitals was the William H. Coleman Hospital for Women. Erected west of Long Hospital and dedicated on October 20, 1927, Coleman Hospital's total cost was about $300,000. Other early buildings erected on the medical school campus in Indianapolis included the Ball Residence for Nurses, dedicated on October 7, 1928; Myers Hall, built in 1937; and Fesler Hall, built in 1939. The school's medical research building was expanded in 1947 with a five-year grant from the Riley Children's Foundation. The VanNuys Medical Sciences Building opened in 1958.
In 2003, it was one of ten medical schools nationwide chosen by the American Medical Association to develop new methods of teaching professionalism to doctors. In order to ensure that its educational process more accurately reflected its commitment to graduating caring and competent physicians, the Indiana University School of Medicine initiated a competency curriculum in 1999. To support the values expressed in the competency-based curriculum, the IU School of Medicine simultaneously implemented a school-wide "relationship-centered care initiative" to address its informal curriculum.
In 2016 the IU School of Medicine implemented a new curriculum to prepare students to meet the challenges of a complex, ever-evolving healthcare environment. The new curriculum prepares students to practice medicine in a team-based interdisciplinary setting.
Hospitals and facilities
The IU medical school helps train interns and residents in 92 medical and surgical specialties. Students train under the supervision of faculty and staff at IU Health Methodist Hospital, IU Health University Hospital, James Whitcomb Riley Hospital for Children at IU Health, Richard L. Roudebush VA Medical Center, Sidney and Lois Eskenazi Hospital, Ball Memorial Hospital, the Kenya partnership program with Moi University School of Medicine, Kenya as well as other physician offices and hospitals throughout Indiana.
On the Indianapolis campus, most of the teaching hospitals are within walking distance or adjacent to the Indiana University – Purdue University Indianapolis campus. Methodist Hospital is located a few miles from the main campus. Ball Memorial Hospital is located in Muncie, Indiana.
The school's main facilities are located on the campus of Indiana University – Purdue University Indianapolis (IUPUI) in Indianapolis, Indiana. In addition, the school maintains eight regional centers on college campuses throughout the state at Bloomington, Muncie, Fort Wayne, South Bend, Terre Haute, Evansville, West Lafayette, and Gary.
First- and second-year medical students attend classes at either the main campus at IUPUI in Indianapolis or at one of the eight regional centers. Students may elect to complete all courseworks and clerkships at a regional center.
As of 2017 the total in-state and out-of-state ratio of IU medical students is 1,445 to 534. There were 7,206 applicants for the 2017–18 academic year. The average GPA of the first-year class in 2018 was 3.75; the average MCAT score was 510.
The IU medical school offers several combined degree programs: the MD-PhD, MD-MBA, MD-MPH, and MD-MA. The MD-PhD program, which offers full-tuition and a stipend to students, is one of programs to be designated an MSTP by the National Institute of Health.
Discoveries at IUSM
The school was first in developing the use of echocardiography, a heart imaging technique using ultrasound. In the 1960s, Mori Aprison discovered the inhibitory neurotransmitter glycine. Dr. Paul Stark, another neuroscientist and faculty member at IUSM, led the clinical team at Eli Lilly and Company in the development of Prozac, a widely prescribed antidepressant. In 1984, IUSM established the first DNA "bank" in the world; blood samples from clients were used to extract DNA which could indicate the genetic risk for certain illnesses and conditions. The school researchers also discovered the use of cord blood as an alternative source of hematopoietic stem cells and pioneered their use in the clinic. In the early 1990s, the school was one of the first institutions to study the use of computer systems in reducing the costs of healthcare management.
The IU School of Medicine is the home of a National Cancer Institute—designated Clinical Cancer Center, and the only National Institute of Health—funded viral vector production facility for clinical grade therapeutics. The school is known for establishing a curative therapy for testicular cancer. The school has been a pioneer in establishing a cure for Fanconi anemia (a precancerous condition in children), specific radiation therapy techniques, techniques in a type of nerve-sparing surgery for urological cancers, the development of drugs to stimulate blood cell production, and novel drug therapies for breast cancer. Researchers at the medical school also discovered the cancer-fighting agent in Tamoxifen. In 2011, the school announced plans for an institute specializing in personalized medicine, which would pursue an individualized and genomics-based approach to treating cancer, pediatrics, and obstetrics.
In 2012, federal officials designated the IU School of Medicine and the Rehabilitation Hospital of Indiana as a Traumatic Brain Injury Model System site. As one of sixteen sites in the United States, the federally-funded center received a five-year, $2 million grant to research and treat traumatic brain injury and its impact on the lives of patients and their families. The IU School of Medicine is also a leading member of the NCAA and the U.S. Department of Defense CARE Consortium, a $30 million initiative to study concussions among student-athletes and use that knowledge to improve safety and health of athletes, military service members and the general public. CARE Consortium research includes exploration of post-concussive symptoms; the performance and psychological health of student-athletes; and the analysis of data related to biomechanical, clinical, neuroimaging, neurobiological and genetic markers of injury.
Research centers, institutes and groups
- Alzheimer's Disease and Related Disorders Center
- Bowen Research Center
- Center of Excellence in Women's Health
- Diabetes Translational Research Center
- Hartford Center of Excellence in Geriatric Medicine
- Herman B Wells Center for Pediatric Research
- Indiana Alcohol Research Center
- Indiana Alzheimer Disease Center
- Indiana Center for Musculoskeletal Health
- Indiana University Center for Diabetes and Metabolic Diseases
- Indiana Clinical and Translational Sciences Institute
- Indiana Spinal Cord and Head Injury Research Center
- Indiana University Melvin and Bren Simon Cancer Center
- Indiana University Center for Aging Research
- Institute of Psychiatric Research
- Krannert Institute of Cardiology
- Regenstrief Institute, Inc.
- Stark Neurosciences Research Institute
- Wells Center for Pediatric Research
Notable alumni and faculty
- Jerome Adams, former Indiana State Health Commissioner and confirmed as the 20th Surgeon General of the United States in 2017
- Kent Brantly, physician and author known for treating and contracting Ebola.
- Otis R. Bowen, former Indiana governor and former secretary of Health and Human Services
- P. Michael Conneally, Distinguished Professor Emeritus of Medical and Molecular Genetics at IUSM; instrumental in the discovery of the gene causing Huntington's Disease; a leader in the Human Genome Project
- William S. Dalton, named president and CEO of the H. Lee Moffitt Cancer Center & Research Institute in 2002; former dean of the University of Arizona School of Medicine (2001–2002)
- John P. Donohue (1932–2008)–former chair of the IU School of Medicine's urology department and distinguished professor emeritus; pioneered treatments for testicular cancer. His work with Lawrence Einhorn led to an increase in the cure rate of testicular cancer from 5% to 90%.
- Lawrence Einhorn, distinguished professor of medicine, IU Medical Center; recipient of a Presidential Medal of Honor; pioneered the development of the medical treatment in 1974 for testicular cancer, increasing the survival rate from 10% to 95%.
- Henry Feffer, American neurosurgeon
- David L. Felten, a former professor at IUSM; MacArthur Fellow and neurobiologist whose research established a link between the immune and central nervous system
- Tatiana Foroud, internationally recognized genetics researcher
- Tom Hayhurst, doctor and politician
- Jane E. Henney, oncologist; first woman to serve as commissioner of the U.S. Food and Drug Administration
- Chet Jastremski, Olympic swimmer and medalist
- Suzanne Knoebel (1926–2014)–cardiologist; pioneer of computer technology for heart disease research and diagnosis
- R. Ellen Magenis, distinguished American pediatrician and geneticist
- Joseph E. Robertson, president of Oregon Health & Science University since September 2006.
- Adam M. Robinson, Surgeon General of the United States Navy
- H. Michael Shepard, led the discovery and development of breast cancer drug Herceptin while at Genentech and was a Damon Runyon Cancer Research Foundation Fellow at Indiana University.
- Jill Bolte Taylor, neuroanatamist; in a TED talk she shared her experiences of studying herself during a stroke; authored My Stroke of Insight: A Brain Scientist's Personal Journey, a best-selling book which will be made into a major motion picture by Sony Pictures Entertainment and Imagine Entertainment
- Jack Yang, editor-in-chief of the International Journal of Functional Informatics and Personalized Medicine (IJFIPM).
- Hess, the IU medical school's tenth dean, succeeded D. Craig Brater, who retired in 2013. See: "Jay L. Hess, MD PhD". Indiana University School of Medicine. Retrieved January 26, 2018. See also: "D. Craig Brater, MD". Critical Path Institute. June 17, 2013. Retrieved January 26, 2018.
- "Indiana University School of Medicine Fact Sheet" (PDF).
- "Table B-1.2: Total Enrollment by U.S. Medical School and Sex, 2013-2014 through 2017-2018" (PDF). Association of American Medical Colleges. Retrieved 30 January 2018.
- "How Lance Armstrong Beat Cancer". Archived from the original on 2012-03-28. Retrieved 2011-07-24.
- "Study Finds Novel Gene Associated With Alzheimer's Disease Development". Alzheimer's News Today. 14 October 2015. Retrieved 23 January 2018.
- Koehler, K. R.; Mikosz, A. M.; Molosh, A. I.; Patel, D.; Hashino, E. (2013). "Generation of inner ear sensory epithelia from pluripotent stem cells in 3D culture". Nature. 500 (7461): 217–21. doi:10.1038/nature12298. PMC 3739998. PMID 23842490.
- "Best Medical Schools". U.S. News.
- Burton D. Myers, "A History of Medical Education in Indiana" in Dorothy Ritter Russo, ed. (1949). "VIII". One Hundred Years of Indiana Medicine, 1849–1949. Indianapolis: Indiana Medical Association. pp. 63–64. OCLC 14676916.CS1 maint: extra text: authors list (link)
- Myers, pp. 79–80.
- Ralph D. Gray (2003). IUPUI–The Making of an Urban University. Bloomington: Indiana University Press. p. 13. ISBN 9780253342423.
- IU's relationship with the Indiana Medical College, organized in Indianapolis in 1869, was dissolved in 1876; other early efforts to establish a training facility in Indianapolis also failed. A proposed merger with the Central College of Physicians and Surgeons, organized in Indianapolis in 1873, did not materialize in 1903, and no agreement was reached to merge with the Medical College of Indiana in 1904. See Myers, pp. 62, 71–73.
- IU believed that under a legislative act approved on February 15, 1838, it had the authorization to provide instruction in medicine, as well as other professional fields, but the development of a four-year, state-supported medical school was delayed due to lack of sufficient funding. See Gray, pp. 14–16, and Myers, pp. 63–64.
- The Indiana Medical College offered training in the former Medical College of Indiana's facilities on Senate Avenue. The building that housed the Central College of Physicians and Surgeons was sold. See Myers, pp. 63–64; 74–75.
- Myers, pp. 75–76; Gray, pp. 13, 15–16.
- Gray, pp. 14–16; Myers, pp. 63–64, and 74.
- Myers, pp. 79–80.
- Gray, p. 17; Myers, pp. 79–81, 87.
- Myers, p. 81. See also: "Founders and Early History". Indiana University School of Medicine. Retrieved 7 December 2017.
- Myers, p. 88.
- Myers, pp. 75–76; Gray, p. 16.
- Abraham Flexner (1910), Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching (PDF), Bulletin No. 4., New York City: The Carnegie Foundation for the Advancement of Teaching, p. 221, OCLC 9795002, retrieved 23 January 2018
- Flexner, "Medical Education in the United States and Canada," pp. 221–22.
- Gray, p. 16. See also: Flexner, "Medical Education in the United States and Canada," pp. 28, 72, and 75.
- Andrew H. Beck (4 May 2004). "Flexner Report on Medical Schools". Journal of the American Medical Association. Archived from the original on 1 March 2011. Retrieved 6 December 2017.
- Gray, p. 18; Myers, pp. 81–83.
- Gray, pp. 17–18; Myers, pp. 83–84.
- Gray, p. 19; Myers, pp. 84–85.
- Myers, pp. 85–86.
- "Founding and Early History". Indiana University School of Medicine. Retrieved 7 December 2017.
- Wear, Delese; Aultman, Julie (2006). Professionalism in Medicine: Critical Perspectives. Springer. p. 275. ISBN 0-387-32726-6. Retrieved 22 July 2011.
- "The Relationship-Centered Care Initiative". Retrieved 16 September 2013.
- "Curriculum FAQ". Indiana University School of Medicine. Retrieved 6 December 2017.
- "Indiana University School of Medicine". Our Partners. AMPATH. Retrieved 2 September 2013.
- "About Us". Ball Memorial Hospital. Archived from the original on 25 August 2013. Retrieved 2 September 2013.
- "Statewide Campus System". Indiana University School of Medicine. Retrieved 6 December 2017.
- "Archived copy" (PDF). Archived from the original (PDF) on 2013-12-04. Retrieved 2014-01-14.CS1 maint: archived copy as title (link) See also: "MD Education". Indiana University School of Medicine. Retrieved 6 December 2017.
- Time Hilchey (20 January 1993). "Study of Computerized Care Finds Big Patient and Hospital Savings". The New York Times.
- "IUSM Research Centers Overview". Archived from the original on 28 March 2012. Retrieved 16 September 2013.
- "IUSM Cancer Research Milestones". Archived from the original on 18 September 2013. Retrieved 16 September 2013.
- Andrew Pollack (30 December 2008). "Genetic Tests Offer Promise of Personalized Medicine". The New York Times. Retrieved 16 September 2013.
- Walter Jessen (22 February 2011). "IU Announces Plans for a Personalized Medicine Institute". Retrieved 16 September 2013.
- "The Traumatic Brain Injury Model System Centers Program" (PDF). National Data and Statistical Center. Retrieved 26 January 2018.
- "Center for Diabetes and Metabolic Diseases". Indiana University School of Medicine. Retrieved 6 December 2017.
- "The Regenstrief Institute conducts research to improve health care by optimizing the capture, analysis, content, and delivery of the information needed by patients, their providers and policy makers and conducts interventional studies designed to measure the effect of the application of this research on the efficiency and quality of health care." See "Regenstrief Institute". Regenstrief Institute. Retrieved 16 September 2013.
- "Jerome Adams nominated as new U.S. surgeon general". STAT. 29 June 2017. Retrieved 28 January 2018. See also: Susan Scutti (4 August 2017). "Dr. Jerome Adams confirmed as surgeon general". CNN. Retrieved 26 January 2018.
- University of Arizona News name=moffitt> Moffitt Center biography UA med school dean leaving after 7 months, Arizona Daily Star, July 10, 2002
- "John P. Donohue, M.D." The Indianapolis Star. 7 September 2008. Retrieved 26 January 2018.
- "Five honored with Herman B Wells Visionary Award". Indiana University. 15 November 2001. Archived from the original on 19 February 2013. Retrieved 17 February 2013.
- "An Interview with Lawrence Einhorn, MD: Testicular Cancer—Don't Settle for the Status Quo". Journal of Oncology Practice. American Society of Clinical Oncology. 1 (4): 167. 2005. doi:10.1200/jop.1.4.167. Retrieved 16 September 2013.
- "Jill Taylor's Stroke of Insight". Retrieved 16 September 2013.
- Cottingham, Ann H.; Suchman, Anthony L.; Litzelman, Debra K.; Frankel, Richard M.; Mossbarger, David L.; Williamson, Penelope R.; Baldwin, DeWitt C.; Jr; Inui, Thomas S. (2008). "Enhancing the Informal Curriculum of a Medical School: A Case Study in Organizational Culture Change". Journal of General Internal Medicine. 23 (6): 715–722. doi:10.1007/s11606-008-0543-y. PMC 2517875. PMID 18389324.
- Flexner, Abraham (1910), Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching (PDF), Bulletin No. 4., New York City: The Carnegie Foundation for the Advancement of Teaching, OCLC 9795002, retrieved January 23, 2018
- Gray, Ralph D. (2003). IUPUI–The Making of an Urban University. Bloomington: Indiana University Press. ISBN 9780253342423.
- Litzelman, Debra K., and Ann H. Cottingham (2007). "The New Formal Competency-Based Curriculum and Informal Curriculum at Indiana University School of Medicine: Overview and Five Year Analysis". Academic Medicine. 82 (4): 410–21. doi:10.1097/acm.0b013e31803327f3. PMID 17414200.CS1 maint: multiple names: authors list (link)
- Myers, Burton D., "A History of Medical Education in Indiana" in Dorothy Ritter Russo, ed. (1949). "VIII". One Hundred Years of Indiana Medicine, 1849–1949. Indianapolis: Indiana Medical Association. pp. 59–91. OCLC 14676916.CS1 maint: extra text: authors list (link)
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