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The dean is the chief administrative officer of the university's School of Medicine. Founded in 1879 by Thomas W. Harris, the school was originally private, although its courses in the basic sciences were taught by the university. From 1890 until 1896, the curriculum was only nine months long and was intended to prepare students for entrance into degree-conferring medical schools. In 1896, the program expanded to two years; and from 1902 until 1910, a four-year course was offered, with the last two years devoted to clinical subjects in Raleigh. The Raleigh branch was discontinued in 1910, however, and the school reverted to a two-year program until 1946, when on the recommendation of the North Carolina Medical Care Commission, the Board of Trustees of the university approved a four-year school. The new University Medical Center, including the expanded School of Medicine and the newly constructed North Carolina Memorial Hospital, opened in 1952. From 1956 to 1971, the Director of the Hospital reported directly to the Dean of the School of Medicine. The School of Medicine is part of the university's Division of Health Affairs, established in 1948. Until 1997, the dean reported to the head of the division, who, for most of that period, was called Vice Chancellor for Health Affairs. In 1997, the dean began reporting directly to the university's Provost.

The University of North Carolina's first medical school was established in 1879 under the direction of Dr. Thomas W. Harris. It was not a degree-granting school but a two-year program designed to prepare students to enter one of the nation's leading medical colleges. During the first year, classroom instruction was given in chemistry, botany, and physiology. The second year included anatomy, materia medica and therapeutics, and a course on the practice of medicine. Students learned anatomy by dissecting human cadavers and by studying models. There was also a brief course in surgery. Dr. Harris held free clinics weekly to give the students an opportunity to observe actual medical practice. Dr. Harris continued his private practice while he was dean of the school because, although the university made him a member of its faculty, it paid him no salary. Thus the status of the school was that of an adjunct rather than a fully integrated unit of the university. This arrangement finally caused Harris's resignation in 1885. The school was then closed.

In September 1890, it reopened with Dr. Richard H. Whitehead as dean. The revived school was again a preparatory school, offering a nine-month course that included chemistry, physics, natural history, anatomy, histology and physiology, and materia medica. Dr. Whitehead was assigned an office and lecture room in the Old West building. The small wooden dissecting hall built for Dr. Harris was renovated and again used for anatomy classes. In addition to his duties as dean, Dr. Whitehead served as physician to the student body. Beginning in the 1890-91 academic year, the university charged each student an annual medical fee of five dollars. These fees were paid to Dr. Whitehead in lieu of a salary.

In the fall of 1896 the school's program was expanded to two years. (By then most major medical colleges offered four-year curricula.) Dr. Charles S. Mangum was added to the faculty as Professor of Physiology and Materia Medica, and the school moved its offices to the New East building. Following these improvements, enrollment increased steadily; and in 1898 the school was admitted to the Association of American Medical Colleges. Another milestone occurred in January 1901, when the university's Board of Trustees voted to incorporate Medicine and Pharmacy as regular departments of the university. Thus, beginning on 1 September 1901, the school received an operating budget and salaries for its faculty.

Students who completed the two-year course under Dr. Whitehead were generally successful in gaining admission to and graduation from the degree-granting medical colleges. However, many North Carolina students who would have pursued a medical career did not because they could not afford to attend expensive northern medical colleges. Therefore, the university, in the interest of training more physicians to practice in North Carolina, embarked on a four-year program and, from 1902 until 1910, granted the M.D. degree to its graduates.

The four-year program was made possible by the establishment of a clinical department in Raleigh under the direction of Dr. Hubert Royster. Two hospitals, a public dispensary, and several state institutions located in Raleigh provided clinical facilities. The preclinical department remained in Chapel Hill under Dr. Whitehead's direction. The Raleigh department, however, was seriously underfunded; and in 1910 a survey of American medical colleges by the Carnegie Foundation for the Advancement of Teaching found the quality of its instruction inadequate. The university then reluctantly closed the Raleigh department and committed its resources toward improving the two-year preclinical curriculum in Chapel Hill.

While the Raleigh department endured, several important changes took place in Chapel Hill. In 1905 Dr. Whitehead resigned, and Dr. Isaac Manning replaced him as dean. In 1906 the School of Medicine occupied the newly renovated Person Hall, which was far superior to its previous facilities. The following year the old dissecting hall was burned and replaced by a more adequate structure. The school moved to Caldwell Hall in 1912. Caldwell was the first university building specifically designed for health sciences instruction. The school remained there until 1939, when it moved to MacNider Hall, initially constructed to house both the School of Medicine and the School of Public Health.

In 1909 the school raised its entrance requirement to one year of college work including biology, chemistry, physics, and a modern language. In 1916 the requirement was raised to two years. By 1929 the school recommended that entering students have a bachelor's degree, if possible. Also in 1929 the school organized itself, for the first time, into departments. The original departments were Anatomy, Bacteriology, Pathology, Pharmacology, and Physiology.

As early as 1920, Dean Manning began to push for the expansion of Chapel Hill's medical program to four years. No action was taken, however. Meanwhile, in 1924, Duke University in Durham, N.C., established its four-year, degree-granting medical school. Twenty years later, Governor Melville Broughton appointed a Commission on Hospital and Medical Care to study North Carolina's medical care needs. When the Commission submitted its report in October 1944, one of its recommendations was the establishment of a four-year, state-supported medical school and teaching hospital.

The following year the General Assembly established a permanent commission, the North Carolina Medical Care Commission, which continued to study the state's health care needs. In 1946 the commission recommended Chapel Hill as the site for the four-year medical school. The General Assembly provided funds for the expansion in 1947. The appropriation also provided for the enlargement of the medical sciences building and the construction of a 400-bed hospital; a School of Nursing; and residence halls for nurses, interns, and resident staff. Additional funds were appropriated in 1949 for a 100-bed tuberculosis and chronic respiratory diseases hospital (Gravely Sanatorium) and in 1951 for a 54-bed psychiatric wing (South Wing) to the general hospital. The 1949 General Assembly also approved legislation establishing a School of Dentistry, which had not been part of the plan recommended by Medical Care Commission.

The University Medical Center, which was the sum of all these new and expanded facilities, opened in September 1952 with the admission of the first patients to the hospital. The School of Medicine admitted its first third-year class in October. Seven new departments were created in the expansion of the school: Medicine, Obstetrics and Gynecology, Pediatrics, Preventive Medicine, Psychiatry, Radiology, and Surgery.

The 1951 General Assembly had officially named the hospital North Carolina Memorial Hospital and designated it the state's memorial to the dead of all wars. Memorial Hospital, along with the expanded School of Medicine and the other health sciences schools, became an administrative unit of the newly created Division of Health and Medical Affairs (later Division of Health Affairs). The director of the hospital was originally responsible only to the administrator of the division. That arrangement soon proved unsatisfactory to the School of Medicine, which felt the need for more control over the hospital. Thus, on 1 September 1956, in spite of the opposition of the other schools, the director of the hospital was made responsible to the Dean of the School of Medicine in matters of policy and operation.

Administration of the hospital continued to be a difficult issue, however, especially in the area of financial management. Problems associated with the operation of the hospital worsened in the years after 1964, and in 1969 Chancellor Sitterson appointed the Task Force on the Governance of North Carolina Memorial Hospital to investigate and make recommendations regarding these problems. In July 1971 the General Assembly passed legislation recommended by the task force, creating a Board of Directors for the hospital and separating it administratively from the School of Medicine and the university at Chapel Hill. The new board would be appointed by the UNC System Board of Trustees (now the Board of Governors). It would have full responsibility for the operation of the hospital, including the hiring of its director. The hospital would continue its cooperative association with the Health Affairs schools and with the university at Chapel Hill but would have independent authority over its personnel, finance, and purchasing functions. These administrative arrangements have continued, with only slight revisions, to the present.

Also in 1971, federal health manpower legislation made funding available for the development of the Area Health Education Centers Program (AHEC). This program, established in 1972, evolved into a statewide system of nine AHECs. It is administered by the School of Medicine in cooperation with the other University of North Carolina at Chapel Hill Health Affairs schools, the other North Carolina medical schools, and various community hospitals. Each AHEC accepts responsibility for community-based student rotations and health manpower development in a defined geographical area. Currently, about 40 percent of all clinical education for University of North Carolina at Chapel Hill medical students occurs in the AHECs.

The following have served as Dean of the School of Medicine: