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December 1, 2005

The Department of Surgery, University of California, San Francisco

Arch Surg. 2005;140(12):1143-1148. doi:10.1001/archsurg.140.12.1143

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)