this fruitful collaboration with Wallie Jeffries, who had completed Medical School and residency at Michigan, and served as head of ObGyn at St. Joseph. Willson and Jeffries worked together to create rotations and clerkships that ensured that students and residents had access to the best of both worlds – general obstetrics and sub-specialty training.10 As the 1960s progressed, several new faculty appointments were made each year and there was a steady stream of residents. Within four years after Willson’s installation, the Department counted two full professors, eight associate professors, and seven assistant professions, as well as six instructors and 21 residents.11 Obstetric volume rose accordingly; in 1968 there were 8,000 patient visits resulting in 1,125 hospital admissions and more than 800 service deliveries.12 Pleased with the rebuilding of the Labor and Delivery area in 1971, the move of the entire gynecologic service to the 12th floor of the Main Hospital in 1970, and the ongoing construction on the Holden Perinatal Unit, in the early 1970s, Willson knew the Department needed more faculty and more space. He explained, “at the moment we need at least 4 more obstetrician-gynecologists to 8. Willson to William N. Hubbard, June 2, 1966, “Activities of the Department of Obstetrics & Gynecology during Fiscal Year 1965-66,” Willson Papers, Box 3, BHL, UM. 9. Department of Obstetrics & Gynecology, Annual Report, July 1, 1966-June 30, 1967, Willson Papers, Box 3, BHL, UM. 10. Interview with Wallace Jeffries by Alexandra Minna Stern, June 11, 2014. 11. Department of Obstetrics & Gynecology, Annual Report, 1967-1968, Willson Papers, Box 3, BHL, UM. 12. Department of Obstetrics & Gynecology, Annual Report, July 1, 1968-June 30, 1969, Willson Papers, Box 3, BHL, UM. 36 Obstetrics and Gynecology provide service,” emphasizing that “the need will increase when abortions are legalized.” 13 Willson’s continual requests for multi-pronged expansion were based on the immediate necessities of the Department as well as what he anticipated to be the evolving needs of academic medical centers. As Willson said to the Dean in 1969, “unless we can provide jobs which make it possible for our faculty to teach, do research and practice and unless income approaches that for private practice, we will not only lose important faculty members but will be unable to recruit replacements.” 14 Willson was keenly aware of tectonic shifts afoot in academic medicine. Indeed, medical schools grew dramatically beginning in the 1960s. For example, when Willson became chair, there were 88 medical schools in the U.S. with a total of 8,900 entering students and about 7,400 M.D. graduates. When Willson passed the torch to his successor in 1978, that number had risen markedly, to 125 medical schools, just over 16,660 entering medical students, and nearly 15,000 M.D. graduates.15 An important motor of this change was the passage of Medicaid and Medicare, which dramatically altered American medicine. These hallmark federal programs provided new financing for residency programs, which incentivized their growth. In addition, Medicaid and Medicare provided sizable streams of clinical revenue for a whole range of procedures, many of which previously had been delivered free as “ward” services for the indigent and some of which had been utilized by “private” patients who visited the hospital for specific services such as labor/delivery or chemotherapy. For Medical School administrators, this new clinical revenue was most welcome; for chairpersons, like Willson, it was both a blessing and curse. Burgeoning clinical income fomented growth and specialization, especially in the clinical areas of the Department, but at the potentially heavy price of pulling faculty away from research and burdening them with added 13. Department of Obstetrics & Gynecology, Annual Report, July 1, 1970-June 30, 1971, Willson Papers, Box 3, BHL, UM. 14. Department of Obstetrics & Gynecology, Annual Report, July 1, 1968-June 30, 1969, Willson Papers, Box 3, BHL, UM. 15. Kenneth M. Ludmerer, Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care (Oxford: Oxford University Press, 1999), p. 212. Obstetrics and Gynecology (2016) 37 administrative work that left little “freedom from the demands of day-to-day clinical practice.” 16 As a matter of principle, Willson was troubled by the prospect of subordinating the academic mission to clinical income, which he described to the dean as “the most important and potentially destructive current issue within the Medical Center.” 17 A common theme of the Willson era was frustration, about escalating clinical demands, encroaching administrative tasks, and the ever-increasing sizes of incoming classes of medical students, which Willson saw unfolding without corresponding departmental support. Through these challenges, Willson soldiered on and the Department flourished. By the mid-1970s, the obstetric service had hit its stride. In response to rising obstetric volume, the Department had re-organized obstetric outpatient services along a team system in which staff, residents and students were divided into three mixed teams, each of which spent three half days in the obstetrical outpatient unit (this replaced an earlier two team model which had not worked as well).18 This model