We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Commentary |

The Department of Surgery, University of California, San Francisco

Pamela Derish, MA; Nancy L. Ascher, MD, PhD
Arch Surg. 2005;140(12):1143-1148. doi:10.1001/archsurg.140.12.1143.
Text Size: A A A
Published online


The Department of Surgery at the University of California (UC), San Francisco, was shaped by Gold Rush–era adventurers who stayed on after the gold ran out. In 1852, South Carolina surgeon Hugh H. Toland, MD, was lured to California by gold fever, crossing the 2000-mile overland route by wagon train. By then, gold reserves were declining and the number of miners was increasing dramatically. Whereas many other forty-niners headed home or turned to poker or crime, Toland established an enormously successful surgical practice in the boomtown of San Francisco. He founded the second medical school, Toland Medical College, in the Far West in 1864, timing that coincided with a new state law permitting the use of paupers’ bodies for study by accredited physicians (Figure 1).1 Through the efforts of Richard Beverly Cole, MD—another Gold Rush pioneer and an accomplished surgeon who had arrived in San Francisco aboard a steamship in 1852—the college became the Medical Department of UC in 1873, with Cole as its dean and Toland, the first chair of the Department of Surgery. The early surgical curriculum consisted of “lectures on the principles and practices of surgery, demonstrations of surgical technique on the cadaver, and clinical lectures at the college building and the adjacent county hospital.”2 Anesthesia was scarce, when it was available at all, and Toland, Cole, and the other surgeons performed operations on a table in the middle of the ward. “Blood and noise were the principal features observed by the goggle eyed spectators.”3(p39)

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure 1.

Hugh H. Toland, MD, and the Toland Medical College, San Francisco, Calif. A, Toland (1806-1880). B, Illustration of Toland Medical College, circa 1866. C, Medical students in the Toland Medical College Dissecting Room, circa 1870. Photograph by Edward Muybridge.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

The University of California Medical Department, San Francisco, Parnassus Heights location. A, Photograph of the new Parnassus Heights campus with a streetcar in front. B, The Medical School building at Parnassus, refitted to house a 75-bed teaching hospital in 1907, is shown here in a 1947 drawing by Ralph W. Sweet (1892-1961), professor of Medical Arts and Illustrations at University of California Medical School. C, Robert A. McLean, MD (1858-1918) in an 1874 photo.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.

Saxton Pope, MD, Howard C. Naffziger, MD, and H. Glenn Bell, MD. A, University of California surgeon Pope, a close companion of the last Yahi Indian, Ishi. B, Naffziger (1884-1961) in his military uniform in 1918. C, Partial scene from a 1937 mural by Bernard Baruch Zakheim depicting the history of medicine. Called the Cole Hall Murals after their original location at the University of California Medical School building lecture hall named for University of California, San Francisco, founder Richard Beverly Cole, MD, this scene shows Bell (1893-1981) performing surgery in the left center foreground.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis