1. Project Background

To understand and appreciate the circumstances that led to the Yale Medicine Thesis Digital Library ETD project at the Yale School of Medicine, a short history of the medical student thesis in the Yale medical school curriculum is in order.

The M.D. thesis at the Yale University School of Medicine is a tradition that dates from class of 1839. Most of the 1839 graduates, seventeen in number, presented dissertations on such subjects as dysentery, chlorosis, the color of the skin, or epilepsy. One future psychiatrist wrote on “Hope as a Remedial Agent." The 19^th century history of the Yale Medical thesis was characterized as a well-intentioned strategy to keep students away from non-academic distractions, an academic formality without methodological requirements.

A renewal of the scientific foundation of thesis activity occurred during the period 1920-1925, when a unique institutional program of medical education known as the "Yale Plan" was inaugurated. The Medical School Dean of that era, Milton C. Winternitz, featured in the “Yale Plan“ the presentation of a dissertation, based on original scientific investigation, as one of the major requirements for graduation. The “Yale Plan“ also stipulated that students could also decide whether or not to attend class. Class instruction, when attended, would not result in comparative grading. Students were given the maximum latitude to manage their own time.

Today, students continue to manage their own time and consider attendance at class optional, and all students continue to engage in thesis research, with the only possible exception being students who have already attained a Ph.D. degree. For all medical theses, there must be a specific hypothesis. A wide choice of subjects for research is permitted. Students may also perform a meta-analysis of existing research data in publications, using a new hypothesis to generate new data and evidence. Research must be designed by the students themselves, though each student works closely with a specific faculty research mentor. The production of medical student theses at Yale is a direct effect from the emphasis on the student research experience. The student-mentor collaborative experience at Yale also has a high probability of producing a scholarly research paper submission to a leading peer-reviewed biomedical journal.

The final approved and written thesis is presented to the Medical School Office of Student Research . An Awards Committee critiques and ranks all student theses submitted for honors. The highest ranked papers are presented in a Student Research Day program chaired by the Dean of the School, and graduation prizes are awarded for outstanding student research.

Traditionally, the medical library has received one printed copy of each student thesis. Due to the significant amount of time involved in cataloging, the library was forced to stop doing in-depth subject analysis. Consequently, the only current way to find a thesis in the online catalog is with author or title words. A separate project is already underway to digitize thesis abstracts and add them to the catalog.

A further access barrier to print theses is their locked shelving location. Print medical theses are considered archival copies. Theses are retrieved only twice a day by library staff and may not be removed from the library. Additionally, all theses written between 1900 and 1974 are shelved in a facility about one mile away. Due to these significant barriers, the original student research contained in the print theses is hidden, inaccessible, and either undiscovered or overlooked.

The emergence of the concept and potential benefit of the ETD to the Yale Medicine student research community has occurred in our unprecedented 21^st> century era of electronic journal publishing. As widespread electronic journal access has reduced the perceived need to visit the library, there is also absolute certainty that locked shelving and skeletal cataloging for the thesis collection was rapidly relegating usage to an unprecedented level of insignificance. The path to obsolescence was taking shape.

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