The history of evidence-based medicine: attempts by the Rockefeller Foundation to improve medical education in Dublin and Calcutta, 1915-1935

Article type
Authors
Wallace J1
1University Of Oxford, Oxford, UK, UK
Abstract
"Background
The Rockefeller Foundation is an American philanthropic organization that wished to improve medical education internationally. This wealthy, formidable agent for change focused on producing science-orientated medical doctors through an interaction between hospital, university, and laboratory.

Objective
The overall aim of this study was to increase understanding of the Foundation’s attempts to introduce a more scientific approach to medical education and treatment at medical schools in both Dublin and Calcutta between 1915 and 1935.

Research methods
This investigation involved a literature review and a case study. Employing a social-history methodology, primary printed sources utilized:
•journals such as The British Medical Journal, the New England Journal of Medicine, and The Lancet among others
•newspapers including the New York Times, The Illustrated London News, and The Irish Times
•also electronic databases, including the Lind Library, The Cochrane Library, and Embase

Findings
Extensive opposition to a more scientific approach to medical education during this period is described in the international literature. Trinity College Dublin did not embrace proposals to introduce a more evidence-based, experimental approach. Dublin turned out practically-trained, all-round medical men suited to needs of the British Empire. Dublin hospitals also wished to retain their denominal ethos. At the University of Calcutta, the Foundation’s objective was to bridge the gap between research and implementation. Calcutta wanted the application of research results to clinical practice to be immediate. In India it was accepted that the Government should utilize the skills and resources of the Rockefeller Foundation. Popular support existed for meeting the Foundation’s demands. In addition, the Foundation agreed that Indian health education would to be under Indian control.

Conclusion
Social, cultural, and religious factors can play a decisive role in how science is perceived and received. In Dublin, the Rockefeller Foundation encountered significant political, cultural, and denominal barriers to its attempts to apply a systematic research-based model to medical education. In Calcutta however, there was a pre-existing willingness to accommodate the Rockefeller approach. Consequently, after independence, the Rockefeller Foundation significantly expanded its range of philanthropic activities in the Indian health service but limited its role in Ireland after 1933.

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