Milwaukee Orthopaedic Society

A Professional Society for Orthopaedic Surgeons in Southeastern Wisconsin

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History of the MCW Orthopaedic Surgery Program

The following is a reproduction of "The History of the Medical College of Wisconsin Orthopaedic Surgery Residency Program 1946 - 1978" as prepared by Dr. Bruce J. Brewer in 1978. This history was prepared for, and delivered in part at, an Alumni Meeting dedicated to Dr. Walter P. Blount and Dr. Albert C. Schmidt in October of 1978.

You can also download Dr. Brewer's original document.


THE MEDICAL COLLEGE OF WISCONSIN

ORTHOPAEDIC SURGERY RESIDENCY PROGRAM

Bruce J. Brewer's Commemorative Alumni Meeting Honoring Drs. Walter P. Blount and Albert C. Schmidt

The graduate medical education program in Orthopaedic Surgery in Milwaukee evolved in 1946, thirty-two years ago. Its inception and achievements edify the unrelenting drive, effort, and leadership by the two men to whom this commemorative Alumni Meeting is dedicated, Dr. Walter Putman [sic] Blount and Dr. Albert Charles Schmidt. It is significant to emphasize the unity of foresight of both men to conceive, formulate, and lead graduate training in Orthopaedic Surgery in Milwaukee.

Historically, orthopaedic surgery was established in Milwaukee in 1909 when Dr. Federick [sic] Julius Gaenslen started his practice in the new surgical specialty restricted to bone and joint disease. Dr. Gaenslen was born in 1877 and graduated from Johns Hopkins Medical School in 1899. He received his surgical training at the German-American Hospital in New York City (the present Lennox Hill Hospital), and then, as was the custom, graduate training in orthopaedic surgery at the great clinics in Europe. Indeed a pioneer, and a giant with his contemporaries, Robert Osgood, Willis Campbell, Winnett Orr, Albert Steindler, and Edwin Ryerson, our heritage was strong. Dr. Gaenslen was Chairman of the Department of Orthopaedic Surgery of Marquette University School of Medicine from 1917-1920.

Sequentially in our orthopaedic evolution, Dr. Herman C. Schumm began practice with Dr. Gaenslen in 1919 following his training at Augustana Hospital in Chicago. Dr. Schumm was born in 1889 and graduated from the University of Pennsylvania in 1914. He actively participated in the academic community both in Milwaukee and Madison until his death in 1955 at the age of 66 years. Dr. Schumm was Chairman of the Department of Orthopaedic Surgery; Marquette University School of Medicine, from 1938 until 1955.

The next two men in our heritage were indeed the driving stimulus to the activation and organization of the formal Program as it exists today. They are the exciting Founder Members.

Dr. Walter Putman [sic] Blount was born in 1900, attended the University of Illinois for six years, and graduated from Rush Medical College in 1925. He received training at the University of Wisconsin Hospitals under the tutelage of Dr. Gaenslen. Upon completion of his residency program in 1928, he toured the clinics of England and Europe for many months and then began practice with Dr. Gaenslen and Dr. Schumm. Dr. Blount has been a dynamic, innovative, and imaginative force in our evolution. Scientifically active internationally, he was also Chief of the Department of Orthopaedic Surgery at Milwaukee Children's Hospital for many years, and founder of the Fracture Clinic at Children's Hospital in 1930. His foresight and ingenuity has set a standard in our heritage. Dr. Blount was appointed Chairman of the Department of Orthopaedic Surgery, Marquette University School of Medicine, in 1956 and retired in 1968 as Emeritus Clinical Professor.

Dr. Albert Charles Schmidt was born in 1902 and graduated from the University of Southern California in 1926 with a degree in Engineering. Turning directions, he graduated from the University of Nebraska Medical School in 1930. Dr. Schmidt interned at Columbia Hospital, Milwaukee Children's Hospital, and the South View Isolation Hospitals. He then spent two years of orthopaedic residency at the University of Oklahoma, and an additional year at the Hospital for Ruptured and Crippled in New York City (the present Hospital for Special Surgery, Cornell Medical Center). Dr. Schmidt began practicing in Milwaukee with Dr. Gaenslen and Dr. Schumm in 1935. He has been a stable dynamic element in our orthopaedic heritage serving as Chief of the Orthopaedic Department and Chief of the Surgical Department at Milwaukee Children's Hospital for many years. Dr. Schmidt was the first Senior Consultant at the Veterans Administration Hospital and led in the organization of the training program at that hospital. He also was an acknowledged force to gain control of orthopaedic surgery at the Milwaukee County General Hospital in 1958.

The impetus to Orthopaedic Surgery during World War II extended into the postwar years with increasing demand and need for graduate education residencies and certification of training programs by the American Board. Simultaneously the medical profession and the government recognized the need to improve the facilities of the Veterans Hospitals and to establish academic and scientific excellence by affiliation with medical schools. In addition, as an organizational extension of the war years, skeletal trauma and fractures were designated within the orthopaedic realm rather than in surgery.

In July 1946 two separate graduate medical education programs in orthopaedic surgery were established, the Columbia Hospital Program, which included Milwaukee Children's Hospital, and the Veterans Administration Hospital Program. Although the faculty of both Programs were members of the Faculty of Marquette University School of Medicine, each Program was administered separately.

The Columbia-Children's Hospital Program was conceived and initiated by Drs. Blount and Schmidt, and was a three year program encompassing adult and reconstructive surgery, skeletal trauma and fractures, children's orthopaedics, and office orthopaedics. The Program was governed by the unity of command of both Drs. Blount and Schmidt and staffed by the faculty at both Columbia and Children's Hospital.

The first Resident was Dr. Donald McCormick who started in 1946, and with Army Credit, graduated in 1948.

The academic affiliation of the Veterans Administration Hospital with the Marquette University School of Medicine was initiated by the Dean's Committee in 1946. Dr. Herman Schumm as Chairman of the Department of Orthopaedic Surgery at the School of Medicine was a member of the Committee. Dr. Peter L. Carnesale was the first full time staff member of the Veterans Administration Hospital having been appointed in April 1946. The Committee appointed Dr. Carnesale, Chief of Service, Dr. Albert C. Schmidt, Senior Consultant, and Drs. Paul Collopy, J. Howard Johnson, and John O'D. McCabe, Junior Consultants. The Program was a two year program of adult and reconstructive surgery, and skeletal trauma and fractures. Dr. Carnesale administrated the Department with excellence, and the firm principles of basic orthopaedics were always manifest. Dr. Howard Mitchell was the first Resident graduating in 1948. His training in children's orthopaedics was obtained in Lincoln, Nebraska. Dr. Raymond Waisman, who also started his residency in 1946, was the first Veterans Administration Hospital Resident assigned to Milwaukee Children's Hospital for training in July 1948.

The ensuing years were those of glory and achievement. The image of Milwaukee Orthopaedics was meteoric through the efforts of Dr. Blount and Dr. Schmidt. Their efforts in the multitudinous interests of scoliosis and the Milwaukee Brace, fractures in children, osteotomy of the fused spine, stapling, osteotomy of the hip, closed osteoclasis of bone, tibia vara, etc. promulgated their names nationally and internationally. Through their efforts, the famous men in international orthopaedics were guests of the Milwaukee Orthopaedic Community.

Simultaneously with the growth of the orthopaedic community was the gradual amalgamation of the two Residency Programs into a combined Milwaukee Orthopaedic Residency Program. The incorporation was a gradual melding of the needs and desires of the leaders of both Programs. Consumation [sic] of the unity occurred ln 1956, the year that Dr. Blount was appointed Chairman of the Department of Orthopaedic Surgery at the Medical School. It has been a happy and productive unity of academic and scientific orthopaedic surgery.

The role of the Department of Orthopaedic Surgery in the Medical School was always poorly defined, and inactive in undergraduate medical education. The lack of involvement was in the impotence of the Department as a Section in the Division of Surgery. In addition, because of the organizational structure, Orthopaedic Surgery was under the control of the Division of Surgery at the major teaching hospital, the Milwaukee County General Hospital. The Hospital had been approved for one year of graduate training in trauma and fractures since the late thirties. The Attending Staff infrequently supervised the Service and it was a token academic experience. Some orthopaedists did obtain experience there, Drs. Irving Tuel (1939), Don Moore (1940), Paul Collopy (1941), and Bruce Brewer (1942).

The rise of Orthopaedic Surgery during and after World War II, and the identification of skeletal trauma and fractures as the realm of Orthopaedic Surgery served as a stimulus to govern orthopaedic surgery at Milwaukee County General Hospital. The desire for governance encompassed two years of bitter political strife between Dr. Joseph King, Chief of Surgery, Dr. Edwin Ellison, Chairman of the Department of Surgery, and Drs. Albert Schmidt and Walter Blount. The hierachy [sic] of Surgery deemed Orthopaedic Surgery an asset both in the power structure, and as a provider of departmental funds for their support through the newly constituted Medical Service Plan. The Department of Orthopaedic Surgery was steadfast in its demands and control of Orthopaedic Surgery at the Milwaukee County General Hospital was finally achieved. The memorable date was January 1958, twenty years ago. The Staff was reorganized and reconstituted from the Orthopaedic Faculty under the direction of Dr. Blount and Dr. Schmidt. Dr. Dudley Keever was the first resident assigned to the Milwaukee County General Hospital from the Milwaukee Program.

Dr. Karl H. Mueller was the first full time academic staff man in the Department of Orthopaedic Surgery. His appointment was made in January 1965 as Chief of the Department at the Milwaukee County General Hospital. Dr. Mueller had trained in Neubrücke, Germany, on the staff of the 98th General Hospital (The American Orthopaedic Center in Europe) from 1954 to 1958. He was then appointed a Fullbright Scholar and spent six months at Milwaukee Children's Hospital (January-July 1959), and twelve months as senior resident at the University of Illinois with Dr. Robert Ray. He returned to Germany to the Staff of the Orthopaedic Clinic at the University of Cologne with Professor Hackenbroch until 1963. Dr. Mueller then spent twenty months in orthopaedic laboratory research at the University of Illinois prior to his appointment at the Milwaukee County General Hospital.

The Orthopaedic Surgery Service at Milwaukee County General Hospital expanded rapidly by his efforts, and his relationship with other departments fostered the growth. In addition, residents rotated through a research assignment under his guidance. The number of residents assigned at Milwaukee County General Hospital increased from three to eight, and he initiated the famous "Gray" and "Orange" Services that still exist. He will always be remembered as the "Patron" of closed intramedullary femoral nailing in mid-America. Dr. Mueller achieved the breakthrough into academic medicine for the orthopaedic community. It was with our regret that he resigned in 1970 and entered private practice. He is still involved in orthopaedic research and teaching.

Many factors in the academic and fiscal scene became apparent with the greater participation of the Department of Orthopaedic Surgery in Medical School activities. Discussions and decisions regarding our departmental destiny were made with less than adequate representation. Decisions regarding departmental activity and funding had to be presented to, agreed by, and forwarded for action by the Chairman of the Division of Surgery. It seemed enigmatic that our Department, actively growing and expanding, had to appeal through an intermediary for support or action. Similarly incongruous was the distribution of monies earned by our departmental activity.

At the June 1966 Orthopaedic Surgery Faculty Meeting the decision was made, and unamiously [sic] supported, to request separation from the Division of Surgery and become a separately budgeted, autonomous department in the organizational structure of the Marquette University School of Medicine. After conferences with Dean Kerrigan and Dr. Ellison elucidating the necessity of autonomy for continued growth and development of the Department, a formal request for a separate department was submitted to Dean Kerrigan on September 15th, 1966. Formal approval of the change in the status of the Department was received from the Academic Vice President of Marquette University on March 10th, 1967. It was indeed another memorable date in the history of academic orthopaedics in Milwaukee.

The June 1968 Faculty Meeting proceeded with graduation and business as usual until saddened by Dr. Blount announcing his resignation as Chairman of the Department. All of the faculty were stunned by the incredible thought of losing our leader - the "Father" of the Program, the man who dedicated most of his life to achieving the best for orthopaedic surgery in Milwaukee and the Residency Program. It was a shock to all of us.

As is the custom in academia, a Search Committee was formed by the Medical School to seek a new chairman. Although the approval of the Department's autonomy had been accepted by the administration of the Medical School, considerable political effort was exerted to set aside the decision and again affiliate the Department under the control of the Division of Surgery. Each candidate was steadfast in his demand for autonomy, and the issue was firmly discarded. Dr. Bruce J. Brewer was appointed Chairman of the Department on September 1st, 1968.

The transition of leadership did not change the organizational format of the Department. The Faculty continued to support the departmental teaching programs both in undergraduate and graduate medical education with enthusiasm. Undergraduate medical education was enhanced by Dr. Mueller's presence at the Milwaukee County General Hospital, and the incidence of an orthopaedic elective increased in the undergraduate curriculum. In response to the continuous expansion of the Department, affiliations for residency training were formulated with St. Joseph's Hospital, and the Mt. Sinai Medical Center in July 1969.

Dr. Sam P. Nesemann was appointed to the full time faculty of the Department of Orthopaedic Surgery on July 1st, 1971, the second full time faculty member of the Department. His appointment was to the staff at the Milwaukee County General Hospital. Dr. Nesemann was "Everyman" to everybody at County; general orthopaedics, intramedullary rodding, and spinal cord injury were his interests. His engineering background created a constant flow of innovations in design in total hip prostheses, and a unique stabilizing cylinder for Weiss springs to achieve stability in spinal fusions. He resigned in September 1977 to enter private practice. He has maintained his staff interest and participation in the Spinal Cord Injury team at County.

Financial exigencies of the Medical School brought about the legal separation of the Medical School from Marquette University in September 1967. It was incorporated as a private institution, but unnamed until September 1970 when the name was changed to The Medical College of Wisconsin. It has thrived as a privately incorporated institution in its autonomy under the presidency of David Carley, Ph.D. and of Leonard W. Cronkhite, Jr., M.D. The Medical College of Wisconsin has been innovative in undergraduate and graduate medical education, and has been accredited to award Master of Science and Doctor of Philosophy degrees in the Basic Sciences.

Dr. Raymond Waisman, our first formal "Residency Educator", initiated the increasing scope of organized teaching to the residents when he was Chief of Orthopaedics at Milwaukee Children's Hospital in the mid 1960's. In additon [sic] he assumed the responsibility of governance for the In-Training Examination. The Department is grateful for his efforts in education, and for his leadership and teaching in cerebral palsy over the years.

The growth and expansion of the Department and the increase in the number of residents demanded formalization of the residency education program. The Program is now an isolated entity with self-governance, but in competition nationally for academic achievement. Fortunate for the Department, Dr. Donald Gore accepted the appointment as Chairman of the Education Committee in May 1971. Dr. Gore can be described as indefatigable and always challenging. He has organized and expanded the formal teaching program on the concept of need evident on the prior in-training examination. It is a program that is stimulating, current, and essential. His effort has been mirrored by increasing gains in the examination score by national standards. We are appreciative of his dedication and effort.

The Veterans Administration Hospital has continued in its role as a major affiliated hospital of the Medical School and an integral teaching element in orthopaedic training. After Dr. Carnesale retired in 1959, the training program continued to be supervised by the Senior Consultants, Drs. Paul Collopy and John O'D. McCabe. All are deeply indebted to them for the many years of dedication and leadership. In March 1972 Dr. Michael C. Collopy was appointed Chief of the Department of Orthopaedic Surgery at the Veterans Administration Hospital. He has performed a superlative job of organization, teaching, and interdepartmental relationships which has enhanced the program. The assignment of two senior and two junior residents to the Veterans Administration Hospital supports two teams of residents and medical students. The service and teaching commitments have been continuously nutured by the Consultants, Drs. Paul Collopy, John O'D. McCabe, Ken Rath, Bill McDevitt, Dave Haskell, Stan Brechbuhler, and Bob DiUlio. In addition, Dr. Robert Zuege continues as Consultant in Hand Surgery, and Dr. Thomas Flatley as the Orthopaedic Consultant to the Spinal Cord Injury Unit.

In July 1973 Dr. Roger Paul Johnson was appointed to the full time faculty at the, now identified, Milwaukee County Medical Complex, the third full time faculty member of the Department. Dr. Johnson assumed control of the "Gray Team" and has created unlimited horizons of achievements. His research efforts on fractures of the carpal scaphoid and perilunate instability (in collaboration with Drs. Jack Mayfield and Ray Kilcoyne) have been accepted by the orthopaedic world, and the identification of the carpal ligaments published in The Anatomical Record. His work makes him a busy man, but not too busy to rewrite the By-Laws of the Milwaukee County Medical Complex. He is an integral part of the Department.

In 1972 the Association of Orthopaedic Chairmen was organized under the guidance of the American Association of Medical Colleges. The organization was supported by the American Orthopaedic Association, the American Academy of Orthopaedic Surgeons, the Orthopaedic Section of the American Medical Association, and the American Board of Orthopaedic Surgery. The Association of Orthopaedic Chairmen has created a unity of purpose in orthopaedic training, accreditation, and certification of candidates.

Graduate Medical Education in all specialties, including orthopaedic surgery, was strengthened by the transition of governance to the Medical School in 1975. The identification of the programs by an academic institution has afforded each program considerable stature and strength, in addition to the unity of the aggregate number of programs at the national level. An Association of Program Directors of The Medical College of Wisconsin was formed under the Chairmanship of the Associate Dean for Graduate Medical Education, Dr. Norman Engbring. Its organizational structure aids and supports the development of each component program and graduate medical education as an entity within The Medical College of Wisconsin.

Recognizing the increasing demands of administration with the expansion of the training program, the intricacies of the political academic environment, and, most important, the insufficient contact with the residents, Dr. Bruce J. Brewer joined the full time faculty on September 1, 1976. This change of primary assignment has been rewarding with a closer relationship with the residents and a reciprocal stimulation that is unattainable with a part-time contact.

August 1978 heralded further development of the Department with the addition of Drs. George W. Simons and Jeffrey P. Schwab to the full time faculty.

Dr. Simons was appointed Chief of the Department of Orthopaedics at Milwaukee Children's Hospital. He received his training at the Mayo Clinic, several fellowships in England in Pediatric Orthopaedics followed by a staff appointment at Children's Memorial Hospital in Chicago with Dr. Mihran O. Tachdjian for three years. He has an excellent background in pediatric orthopaedics, and has kindled the scientific interest in the training program at Milwaukee Children's Hospital.

Similarly fortunate to the program at Milwaukee County Medical Complex was the appointment of Dr. Schwab. A graduate of the Program in 1978, Dr. Schwab's interests in spinal disorders, spinal surgery, and biomechanics has added a much needed asset to the County Service. His multifaceted interests in orthopaedics has greatly increased the scope of the Department's involvement in the training program, the multi-specialty clinics, and in the interdepartmental relationships so important at "The Medical Center".

All of us, Faculty and Graduates, can look back thirty-two years and reminisce with pride of the part that each has played in the development and growth of the Orthopaedic Surgery Residency Program in Milwaukee. One-hundred and five residents have been graduated during those years, and speaking for the Faculty, we have been proud to wish you God-speed in your journey throughout the country. The orthopaedic world has documented your achievements as the measure of success of the Training Program. The dedication of this History of The Medical College of Wisconsin Orthopaedic Residency Program to Dr. Blount and Dr. Schmidt identifies an all encompassing heritage that each resident received during his residency program.

ACKNOWLEDGEMENT:

This manuscript was prepared by the input of many of the Senior Faculty of the Department. It was a combined effort to preserve the History of Orthopaedic Surgery in Milwaukee, and the Orthopaedic Surgery Residency Program.

Our gratitude is expressed to the Departmental Secretaries, Mrs. Marion Kuenstler and Mrs. Ilse Charleston, for the many years of painstaking attention to the details of administration and communication.

BJB/ic
4/17/79

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