Alterations were made in the organization of the M. D. Anderson Cancer Center in August of 1969, when the Board of Regents of The University of Texas System changed the title of the chief administrative officer from Director to President. Dr. Clark, previously Director, therefore became the first President. He was appointed by, and was responsible to, the Board of Regents of The University of Texas System and was assisted most closely in the coordination of institutional activities by the Executive Vice President and Director and other administrative officers. Chairmen of advisory committees on administration, research, education, and patient care also made recommendations to Dr. Clark, as members of the President’s Advisory Council.

The primary responsibilities of the President were to coordinate programs in patient care, research, and education at the highest level and coordinate public information for the institution. The following staff were responsible to the President’s office: Executive Vice President and Director, Vice President for Professional and Public Affairs, Information Coordinator (later the Department of Information and Publications), the University Cancer Foundation, and the section of experimental animals. Additionally, the office was engaged in planning and development of The University of Texas Environmental Science Park. Also at that time, the Office of Development was established as a part of the office of the President and an assistant for development was appointed.

In October of 1972, as identified by the National Cancer Act of 1971 (and later its 1974 amendment), M. D. Anderson Hospital was designated the central unit for a newly created University of Texas System Cancer Center. Dr. Clark became President of the entire system, which included the M. D. Anderson Hospital and Tumor Institute, an Extramural Programs Division, and the University Cancer Foundation, guided by the advisory Board of Visitors. Through the Extramural Programs Division, the Cancer Center was responsible for the coordination of cancer activities among the units of The University of Texas Health Science Centers at Dallas and San Antonio, The University of Texas Medical Branch at Galveston, The University of Texas System School of Nursing, and the units of The University of Texas Health Science Center at Houston. The Health Science Center was organized in 1972 to include the seven other biomedical units of The University of Texas at Houston. The University of Texas Environmental Science Park was administered through the Extramural Programs Division. Dr. Clark held this position until he assumed President Emeritus status in August of 1978. The President Emeritus serves as a consultant to the President, with responsibility for carrying out programs and projects assigned to him by the President.

By 1974, the responsibilities of the President’s Office were defined as the development of institutional policy and as the administrative center for approval and coordination of programs for the System Cancer Center, the Extramural Programs Division and the University Cancer Foundation. From this office, the institution’s operating budgets, policy proposals, and other special actions were recommended for approval by the Chancellor and Board of Regents of The University of Texas System; expenditures were supervised; members of the staff and faculty were recommended to the Chancellor and the Regents for appointment, promotion, retention, retention or dismissal; and long-range plans for programs and physical facilities were developed.

From the period 1969-1978, M. D. Anderson experienced many changes as it grew and expanded its programs. During the time that Dr. Clark served as the first President, several building expansions occurred, perhaps the largest being the Lutheran Pavilion, completed in 1976, which added 350 beds to the facility. Outpatient visits grew from 342,657 in 1968-1970 to 656,694 in 1976-1978. There were 12,566 persons admitted to the hospital in 1968-1970 and 17,279 in 1976-1978. During the same time period, the full time professional staff grew from 185 to 454 persons and the institutions formed several new departments, including: Clinical Pathology; Anatomical Pathology; Rehabilitation Medicine, and the Environmental Science Park near Smithville. The Departments of Anesthesiology and Gynecology became operational in September 1972, having formerly been sections of the Department of Surgery. Several pieces of new equipment for cancer treatment were purchased, tested, or developed at the institution, including a 25-Mev Linear Accelerator (1970) and the Variable Energy Cyclotron from Texas A&M University (1972).

Hundreds of research projects were carried out at M.D. Anderson during this time period, many of which focused on the role of genetics in cancer, treatments for leukemia, and methods of radiotheraphy. Research programs were proposed to the Research Committee, part of the Office of Research headed by Dr. Felix L. Haas, by the individual investigators through the department head or by the chairman of a study section. Appropriate recommendations were made by the committee to the President, in consultation with Dr. Haas, through the President’s Advisory Council. A research project was approved by the department head or chairman of a study section when, in his judgment, the project could be conducted with the facilities and funds available and was then registered with the Research Committee. Any new project or program proposing to perform research activities that would involve human subjects, or specimens from human subjects, had to be approved by the Surveillance Committee. Following initial approval by the Research Committee, proposals involving human subjects were forwarded to the Surveillance Committee, also a part of the Office of Research, and were reviewed for compliance with institution and Department of Health, Education, and Welfare regulations regarding patients’ safety, informed patient consent, proper specimen use, etc. Every clinical project was reviewed by the committee at least once annually, and more often if warranted.

The Office of the President included the headquarters for the National Large Bowel Cancer Project, one of the four active organ site programs supported by the Division of Cancer Research Resources and Centers of the National Cancer Institute. This program was established in conformity with the National Cancer Plan, which had an overall goal to develop a means to reduce the incidence, morbidity, and mortality of cancer in humans. The Headquarters staff and a working group of distinguished biomedical scientists and clinical investigators, with the advice of consulting cancer biologists and clinical investigators, developed a National Organ Site Plan and expanded programs of research designed to clarify the biology and promote the control of colorectal cancer.

Another program of the President’s Office was the Historical Resources Project of the Texas Medical Center. This project’s objective was to develop an oral and audiovisual history of the development of the Center and its component units through research and recording and videotaping interviews with individuals instrumental or influential in the planning, development and philosophic guidance of M.D. Anderson. Several books authored by Don Macon, director of the project, on some early leaders of the Texas Medical Center concept have been published, including “Clark and the Anderson: A Personal Profile.”

By the end of 1978, more than 2,300 physicians had received advanced clinical experience in cancer management at M.D. Anderson. Specialized cancer rotations were open to medical, dental, nursing, and allied health professions students enrolled at several Texas universities. Graduate students participating within the institution and in conjunction with the Graduate School of Biomedical Sciences of The University of Texas Health Science Center at Houston earned an M.S. or Ph.D. degree. The education and training of clinical fellows who came to M.D. Anderson for specialized oncology training after they became board eligible or board certified in one of the clinical specialties was emphasized. Many of these physicians later became involved in other training programs throughout the country and the world. Approximately 55% of the advanced clinical trainees assumed full-time academic positions after leaving M.D. Anderson. Another 9% assumed combination practice and academic positions, and 36% entered private practice in one of the oncology subspecialties. Residents, interns, and medical and dental students from affiliated and integrated training programs within and outside The University of Texas received training at M.D. Anderson and the in-service training in nursing oncology for the institution’s nurses was a model program.