The first steps toward the establishment of a Faculty of Medicine and Surgery were taken in 1847. The Medical Building was not completed, however, until two years later, and the formal opening of the new Department did not take place until October 1, 1850. On this occasion Abram Sager, the first President, or Dean of the Faculty, as we should now call him, delivered an address to ninety matriculates, at a time when there were only sixty-four students all told in the Literary Department. The period was propitious for the installation of a strong school, for although there were a few struggling medical institutions in the West, the vigorous growth of the new Department showed how inadequately this part of the country was served in medical education. The entrance requirements were simple; a fair high school education, with Latin and Greek sufficient for the understanding of medical terms. For graduation, at least three years' study with a reputable physician was required; but this might include the two six-month courses of lectures which comprised the work of the Department. Even this very slender medical preparation was not required of college graduates, or of students who had already practised medicine four years, for whom one course was deemed sufficient. A thesis was also necessary for graduation, and tradition has it that in a few cases during the earlier days of the Department, they were actually written and delivered in Latin. Special attention was given to laboratory work in chemistry and anatomy, though for the most part the training was given through lectures and quizzes. The conservatism of the Literary Department in educational methods here also found its parallel, even in the comparatively new sciences.
The introduction of clinical methods came slowly, though the growing city of Ann Arbor furnished many opportunities for actual diagnosis and treatment. The lack of practical facilities for study was early recognized, however, and within a few years some of the members of the Medical Faculty established a school for clinical instruction in Detroit, which eventually led to the first effort for the removal of the school mentioned in the last chapter. In spite of this difficulty the Department grew so rapidly that within ten years it had an enrolment of 242 matriculates and 43 graduates; more students than were enrolled at Yale, Harvard, or Virginia, the leading medical schools of that day. The growth came so rapidly, in fact, that it proved embarrassing and the Regents experienced great difficulty in finding accommodations for the students. In 1864 an addition was made to the original Medical Building which more than doubled its capacity and in 1868 one of the professors' houses on the north side of the Campus was fitted up as the first University Hospital. By 1874 Latin and Greek had been dropped from the requirements for admission; a possible backward step which was more than counterbalanced three years later by the extension of the annual course of lectures to nine months. Finally in 1880 an extra year was added to the course.