1889

Following opening of Johns Hopkins Hospital, Halsted breaks with tradition and lengthens surgical residency, in order to give resident surgeons opportunity to develop true expertise and operate on difficult cases. He thereby founded a school of surgery characterized by gentle handling of tissues (Crowe, 47; see 53-54 and Imber [202-204] on Halsted’s guiding surgical principles and procedures). Johns Hopkins Hospital established modern residency with residencies in medicine, surgery, and gynecology, based on the system of “house assistants” in German university medical clinics (Ludmerer, 83). Halsted performed his radical mastectomy, which he began to work out in 1882 (Harvey, 70-71). Finney interviews Halsted about coming to Johns Hopkins and is appointed to the surgical staff (Finney, 85-86). Cushing recounts that “Both Finney and I must have profited much from the Boston school of operating surgeons . . .” (Fulton, 125). Flexner arrives in Baltimore to work in Welch’s lab (Flexner, 160ff.). Howard Kelly appointed gynecologist and obstetrician to the hospital (Davis, 67ff.), holding that all gynecologists should first become abdominal surgeons (73).