Dartmouth Medical School (DMS), the fourth oldest medical school in the United States, was founded in 1797 in Hanover, New Hampshire, by Nathan Smith. An entrepreneurial doctor with his own special brand of patient-centered medical care, Smith saw the fledgling Dartmouth College as a "literary institution" that would give status to his medical school and enhance his efforts to train physicians to care for rural patients. The College and the Medical School have followed intertwined paths ever since, as Constance Putnam shows in her account of the School's first two centuries. Like all medical schools, DMS has had to learn how to get along with its parent institution. At Dartmouth, this has meant repeatedly sorting out just how independent the "Medical Department" should be of Dartmouth College itself. Yet it is the strong personalities and the unique way Dartmouth responded to changes in medical education that sets the DMS story apart. Putnam brings to life the men who helped make Dartmouth Medical School important in the history of medical education. The unique path followed by Dartmouth Medical School in the aftermath of the Flexner Report is also thoroughly explored.