state of New Hampshire, Smith was able to obtain medical equipment and, by 1811, a dedicated physical plant for the school. Smith acted as the sole administrator and instructor of the medical school until 1810 when a second faculty member was hired. Smith also revamped the curriculum, allowing the school to begin offering the Doctor of Medicine (M.D.) degree in 1812. Smith ultimately left Dartmouth in 1816, founding three additional schools of medicine at Yale University, Bowdoin College, and the University of Vermont. Expansion Smith's departure provided for a period of expansion, both among the faculty and the student body. Former students of Nathan Smith's replaced him on the faculty, drawing medical professionals in the northeast such as Oliver Wendell Holmes, Sr. to join them. The first hospital at the school was founded by DMS alumnus Dixi Crosby in 1838, who used it to integrate academic instruction with hands-on patient care. In 1870, Carlton Pennington Frost, DMS '57, replaced Crosby as Dean of the school. Under Frost, the curriculum sustained another revamping, this time into a four-year program that included clinical and academic training. Frost also presided over the establishment of Mary Hitchcock Memorial Hospital in 1893, built to replace Crosby's defunct hospital. In 1908, The Carnegie Foundation for the Advancement of Teaching conducted a survey of medical education institutions in the United States. At the time, the discipline emphasized "bedside teaching" and providing students experience with a broad variety of illnesses and patients. The school's rural location was deemed too remote for proper clinical training, and the school was advised to stop offering the Doctor of Medicine degree and only provide pre-clinical instruction. The class of 1914 was the last (until 1974) to receive the Doctor of Medicine degree; subsequent classes of students attended DMS for two years before transferring to other medical schools. The drop of clinical instruction worsened the school's problems by driving away talented faculty members. After World War II, the tide of the medical discipline had shifted towards research. Although the school was well regarded for preparing students for clinical education at other institutions, its faculty was criticized for its apparent disinterest in research. The school was also criticized for using Dartmouth College's undergraduate program as a feeder school. Based on these criticisms, DMS was placed on "confidential probation" in 1956 by the Association of American Medical Colleges and the Council on Medical Education. "Refounding"