Background:

About thirty years ago on the beach in front of the Scripps Institution of Oceanography, the foundations of an extraordinary school of medicine were laid. With the idea firmly in mind that a medical school's beginnings were much too important to leave to a bunch of physicians, a group of far-sighted basic science biologists, bare-footed in the sand at La Jolla Shores , planned a boldly innovative curriculum and faculty intimately tied to the just developing general university campus. They predicted this school would become a world-class institution within a decade. With a single-minded commitment to scientific excellence, they recruited a medical school faculty from Boston , New Haven, and so many from Bethesda that the UCSD School of Medicine had the nickname "NIH-West" for a dozen years.

Their proposal was to so deeply root the school of medicine in the general campus that UCSD would "...become the pearl in the necklace of the University of California 's schools of medicine." In the next three decades, the general campus and the school of medicine developed in parallel, and both have prospered. This year, the general campus has 18,000 students, 3,200 academic employees, 835 full-time faculty, an annual budget of $835 million, and ranks fifth in the nation in receipt of federal funding for research and development. The faculty now includes sixty-two fellows of the American Academy of Arts and Sciences, fifty-four members of the National Academy of Sciences, six Nobel laureates, six recipients of the National Medal of Science, and numerous other distinguished members.

The School of Medicine found distinction almost at once. The novel curriculum instituted in the late 1960's, coupled with the charter class' scoring first in the nation on the Part I examination of the National Boards, catapulted the innovative and somewhat upstart school into national attention. Repeated several times in the next several years, it became clear that UCSD had the basic medical sciences hardwired, and grants, laboratories, and publications soon followed abundantly. The School of Medicine receives just over half of the extramural research funds awarded to the campus overall, and these funds constitute about a quarter of the school's annual budget. In terms of extramural research funds per faculty member, the school has ranked among the top half-dozen schools in the nation for many years.

The clinical enterprise began somewhat more slowly, but the opening of the San Diego Veterans Administration Hospital adjacent to the School of Medicine Basic Science Building in La Jolla in 1972 augmented the clinical resources of the main teaching hospital located in downtown San Diego such that the medical school class could be expanded to its current size of 122 in the late 1970s. The growth of the clinical arm of the school has been rapid and is accelerating, and the UCSD Medical Center was recently named one of the 100 best hospitals in the nation. Last year's statistics show nearly 300,000 outpatient visits, 21,000 admissions, 16,000 anesthetics, and about 2,000 deliveries. The Medical Center includes a level-1 trauma center with helicopter support, a regional burn center, a regional poison center, extensive radiological imaging facilities (including magnetic resonance imaging), and medical, coronary, surgical, pediatric, and neonatal intensive care units.

The San Diego Veterans Administration Medical Center is an integral part of the teaching, clinical, and research activities of the School of Medicine and has been described as the most modern, best-equipped VA hospital in the country. Each resident spends about three months per year at the VA and all residents appreciate the teaching opportunities afforded by the somewhat older and often more complex VA patient population. It also provides a different and perhaps more relaxed ambiance. Last year about 4,000 anesthetics were administered.

The residency program also includes rotations at the San Diego Children's Hospital and Mary Birch Women's Center, both located near the La Jolla campus. These hospitals are busy and efficient, and offer excellent opportunities for additional exposure in pediatric and obstetrical anesthesia. About 10,000 patients were anesthetized in each hospital last year.

The Medical Center has undergone an extensive remodeling and expansion, including a major enlargement of the Outpatient Center and two additional outpatient operating rooms. Further growth is evident near the La Jolla campus where the Shiley Eye Center opened in 1992 with two outpatient operating rooms. In addition, the Perlman Ambulatory Care Center and the adjacent Thornton Hospital , with 140 beds and seven operating rooms, both opened in July 1993. These are all integral components of the UCSD Medical Center and part of its systematic extension into San Diego 's North County , an area of very rapid population growth.