The fascinating story of the Department of Internal Medicine takes us more than 140 years back in history when the AUB [known as the Syrian Protestant College (SPC) until 1920], was founded in 1866 by American missionaries. One year later, in 1867, the mission paid tribute to internal medicine by authorizing Cornelius Van Alen Van Dyck (born in 1818, in Kinderhook, New York) of Dutch origin, to accept the professorship of internal medicine and chemistry at the college. Thus, Van Dyck (MD, 1839, Jefferson Medical College, Philadelphia, Pennsylvania) became the first chairman and founder of the Department of Internal Medicine. Van Dyck was an exceptional scholar; he mastered several languages and was the youngest American ever sent to the Levant, first working as a medical missionary in Sidon and later translating the Holy Bible into Arabic in Beirut. Over a span of 16 years and until his resignation in 1883, Van Dyck taught clinical medicine and ophthalmology and conducted regular clinics at the Johanniter Hospital of the Knights of St. John, which served as the training facility for the medical school. Interestingly, after his resignation, Van Dyck accepted an invitation to join the Greek Orthodox Hospital of St. George, where he devoted most of his time to eye diseases. Van Dyck died in November 1895 from typhoid fever.
The medical program at the college was modeled after the American system of education but pioneered in extending the period of training to four years instead of three, as was the case in most American medical colleges at the time, with the exception of Harvard. Initially, the vision of the founders was to provide an opportunity for training of physicians in their native language (Arabic) to serve the health needs of the people of the region. Medical books were translated by the first pioneers of the College, but in 1883, the language of instruction in the medical school was changed to English. [The intriguing story behind this transition is detailed in Shafik Jeha’s 2005 book, “Darwin and the Crisis of 1882 in the Medical Department”, a tale of the clash of liberal and conservative views of science]. As currently is the case, the Department of Internal Medicine, formed the backbone of the medical training program at the time. The definition of separate academic departmental units for the various disciplines was well in place by 1900.
In the 1920s, during the French mandate, the AUB Faculty of Medicine came under severe financial pressure which jeopardized its degree program due to unwelcoming and, at times, hostile treatment by the French authorities who regarded the American system as a threat and competition to their own. The dramatic and forceful intervention of the Board of Trustees, supported by the Rockefeller Foundation, saved the Faculty through a major infusion of resources for new facilities and laboratories, in addition to the simultaneous recruitment of seven professors from the United States and Europe to fill positions in basic sciences as well as in clinical instruction. The Department of Internal Medicine, as a result of that, experienced a major expansion leading the way for outstanding graduates to complete advanced training in the United States, then return to lead clinical programs and chair the department during the 1950s, 1960s and early 1970s, a period considered as the Department’s “Golden Era”. Dr. George Rubeiz returned from Harvard’s Peter Bent Brigham and initiated the first cardiac catheterization in the Middle East, while Drs. Edmond Shwayri and Adel Berbari performed the first hemodialysis using the locally manufactured ‘drum dialyzer machine’ in 1959. With the help of Dr. Raja N. Khuri, who also had returned from Brigham, they performed the first peritoneal dialysis. Khuri, a distinguished renal physiologist, later became dean of the Faculty of Medicine.
In the 1960s, an exchange program supported by the Commonwealth Fund of New York was initiated between AUB Faculty of Medicine and Johns Hopkins, whereby leading professors from Hopkins would visit AUB for a semester or two, while professors from AUB spend time at Hopkins learning new techniques and developments in their respective fields. Among those from the department were Drs. Riad Tabbarah (cardiology), Fuad Sabra (neurology), and Edmond Shwayri (nephrology), all of whom eventually became department chairs. Dr. Samuel P. Asper, a prominent figure at Hopkins with tremendous love for Lebanon and dedication to support AUB, coordinated the exchange program. Dr. Asper later became Dean of the Faculty in 1973. By the late 1960s, ‘divisions’ were formally established to administer the clinical and academic functions of each of the sub-disciplines within the department.
For a display of a time-line of the Department's selected milestones,
In addition, the Hopkins exchange program provided the necessary support for hand-picked young medical graduates from AUB to go to Hopkins for post-graduate/fellowship training, and then return to AUB to chair various programs and departments. A total of 17 graduates benefited from this program. In Internal Medicine, among those were Drs. Nadim Cortas (endocrinology), past Vice President for Medical Affairs and Dean of the Faculty of Medicine, and Nabil Nassar, who joined the department and became director of the University Health Services from 1970 till 1995. The Department also invested in its infrastructure; for example, the Endocrinology Laboratory for the assaying of hormones and receptors was a pioneering research and clinical facility that was established in the late 1960s by Dr. Najib Abu-Haidar and with the active participation by Drs. Ibrahim Salti and Nadim Cortas. For decades now, this laboratory has been headed and supervised by Dr. Ibrahim Salti. The Intensive Care Unit (ICU) at AUBMC was launched in 1970 along with the move to the current hospital. Dr. Farid Fuleihan of the Department of Internal Medicine was instrumental in starting the ICU. He was aided by Dr. Khalil Abu Feisal of the Pulmonary Division.
The Lebanese war (1975-1990) had its impact on the Department which inevitably led to faculty attrition and the diversion of resources to more urgent needs of survival and caring for the casualties of war. All this resulted in a devastating effect on the academic program by halting its development in medical research, education and the acquirement of new technologies. However, several devoted faculty members stayed behind under the chairmanship of Dr. Khalil Abu Feisal; thanks to them, the teaching program was admirably maintained throughout this difficult period. The first chief resident in the Department to be appointed was in 1984. The post-war period (1990-2000), under the chairmanship of Dr. Samir Atweh (neurology), witnessed remarkable success in attracting new faculty mostly from promising AUB graduates who had completed training in excellent centers across the United States. Other recruits came from a variety of institutions in Europe adding a novel and unique breadth to the faculty.
Dr. Kamal Badr (nephrology), who became chairman after a distinguished career in the United States, continued many initiatives and expanded all nine academic divisions in the quality and diversity of clinical expertise, research and teaching activities. The post-residency fellowship training program continued to grow in all sub-specialty divisions. The department’s role in teaching is not limited to the clinical years but has been expanding into the teaching of the medical curriculum in the two preclinical years. The post-graduate residency training program, headed by Dr. Thurayya Arayssi (rheumatology), was modeled to meet the standards set by the Accreditation Council for Graduate Medical Education (ACGME) of the United States. Results of the ‘In-Training Examination’, which is annually administered to all house-staff by the American College of Physicians, along with other professional societies, reveal that the average ranking of the department’s residents is above the 80th percentile of all medical residency programs within the United States. The Clinical Research Unit, established by Dr. Ghada El-Hajj Fuleihan (endocrinology), was created to support the department’s faculty in conducting a large number of clinical trials. Publication output by the department in the basic and clinical sciences now represents the lion’s share of the output of the Faculty of Medicine.
In 2004, upon the request of Dr. Badr, the academic and clinical services of the department were rigorously reviewed by a team from Johns Hopkins led by the chairman of the Department of Medicine at Hopkins. The department received strong praise from the reviewers. In February 2006, the first five-day “AUB-Johns Hopkins Joint Review of Internal Medicine Course” was offered at AUB (chaired by Dr. Habib Dakik, cardiology) and was very well attended by approximately 350 individuals, 20 percent of whom came from surrounding Arab countries. The course was a major success and highly appraised by the attendees and the Hopkins team who co-organized the course.
Since November 17, 2007, the Department of Internal Medicine has been chaired by Dr. Fuad N. Ziyadeh (nephrology) - who had returned in late 2005 from the University of Pennsylvania in Philadelphia after a successful career as a prominent physician-scientist specializing in diabetic kidney disease. For more than three years at AUB, Dr. Ziyadeh also served as the Associate Dean for Academic Affairs at the Faculty of Medicine and the acting chairperson of the Department of Physiology. Since 2008, the Department has witnessed major growth and expansion in all of its academic, clinical and administrative programs. Virtually all the divisions have designed and implemented either new or revised group practice plans for each of the medical specialties. More than 20 new faculty recruits were added so that during the Academic Year 2010-2011, the Department was comprised of 75 faculty members – 59 full-time, 14 part-time, and three emeriti – distributed among nine subspecialty divisions and other programs. In addition, there are currently 10 clinical associates. The post-graduate training program also grew significantly, and now includes 107 interns, residents, and clinical fellows. Every year, several post-graduate research trainees join the Department and become actively engaged in the conduct of clinical research. Starting with the early pioneers, namely Van Dyck and John Wortabet, and over the span of more than one hundred and forty years, the department witnessed a succession of a total of 19 truly dedicated and distinguished chairpersons. They upheld its development until today, where, in fact, it constitutes the largest – and arguably the most prominent – department in the Faculty of Medicine.