In March 1881 the Seventeenth Texas Legislature authorized the establishment of the University of Texas and decided that Texans would determine its location by popular referendum. Moreover, Texans could locate the medical school of the new university in a city that was not the same as the one selected for the main campus. Between 1865 and 1881 Galveston doctors had organized medical societies, taught medical students in two colleges, examined candidates for licensure in Galveston County, participated actively on a board of health, treated indigent patients at local hospitals, and edited the state's only three medical journals. Proud of this cultural legacy, Galvestonians lobbied fiercely for their city as the site for the new medical school. In September of 1881, 70 percent of the voters chose Galveston over Houston. After ten years of political and economic struggles, the Medical Department of the University of Texas opened for instruction in October 1891 with thirteen faculty members and twenty-three students. The UT regents added a School of Pharmacy in 1893 and assumed responsibility for the John Sealy Hospital Training School for Nurses in 1896. By 1900 the institution had graduated 259 men and six women as physicians, seventy-six men and six women as pharmacists, and fifty-four women as nurses. In 1919 it was renamed the University of Texas Medical Branch. In a classic study of all American medical schools published in 1910, Abraham Flexner concluded that UTMB was the only school in Texas "fit to continue in the work of training physicians." Displaying their esteem for both Carter and UTMB, the Association of American Colleges elected the UTMB dean, William S. Carter, as its president in 1917.
Throughout its existence UTMB's faculty and staff have remained dedicated to the service ideals associated with patient care, teaching, and research. Expansion of the campus has accompanied expansion of programs for care of the sick, instruction of students, and technologically sophisticated scientific research. State, federal, and private dollars have enabled the addition of major clinical facilities, including Negro Hospital (1902, 1937), Children's Hospital (1912, 1937, 1978), Woman's Hospital (1915), a psychiatric hospital (1931, 1982), a new John Sealy Hospital (1954) and John Sealy Hospital Towers (1978), ambulatory care facilities (1930, 1966, 1983), Shriners Burns Institute (1966, 1992), Jennie Sealy Hospital (1968), the Texas Department of Corrections Hospital (1983), and a vastly expanded Emergency Trauma Center (1992). As the major statewide multicategorical referral medical center, UTMB has treated a steadily increasing number of inpatients and outpatients; about 18,000 came annually during the late 1930s, and more than 350,000 by the late 1980s.
A variety of educational programs evolved at UTMB. Although the School of Pharmacy was moved to Austin in 1927, the training of physicians, nurses, and other health professionals remained as central missions. By the seventy-fifth anniversary year (1965–66) 3,000 of UTMB's 5,000 physician graduates still practiced in Texas. By 1991 UTMB had conferred more than 9,000 medical degrees, 4,000 nursing diplomas or degrees, 800 master's or doctor's degrees in the biomedical sciences, and 3,000 diplomas or degrees in such allied fields as physical therapy, occupational therapy, and medical technology. The UT regents administratively centralized the latter programs into a School of Allied Health Sciences in 1968. They organized the biomedical science graduate programs into a Graduate School of Biomedical Sciences in 1979 and established two unique institutes—the Marine Biomedical Institute (1969) and the Institute for the Medical Humanities (1973). To provide support for teaching and research programs, several buildings have been added, including the Keiller Building (1925, 1932), the Gail Borden Building (1953), the Surgical Research Laboratories (1964), the Libbie Moody Thompson Basic Sciences Building (1971), the Moody Medical Library (1972), and the Medical Research Building (1991).
During UTMB's first fifty years several faculty members engaged in experimental and clinical research projects. These professors included Oscar Plant in physiology, William Rose and Meyer Bodansky in biochemistry, Wilfred Dawson in pharmacology, Donald Duncan in anatomy, George R. Herrmann in internal medicine, and Robert Moore and James E. Thompson in surgery. Research activities increased dramatically after World War II, mostly because of increased federal funding. Between 1946 and 1966 UTMB faculty received more than $8 million from research grants and contracts with United States Public Health Service agencies. These agencies provided more than $96 million between 1982 and 1988. The Hogg Foundation for Mental Health, the Harris and Eliza Kempner Fund, and the Moody Foundation, among others, have also contributed private dollars in support of numerous research projects. Approximately 700 full-time faculty members and 1,900 students participated in the instructional and research programs of UTMB's four schools and two institutes during the institution's centennial year (1990–91). UTMB faculty received more than $36 million in research grants. About 27,000 inpatients and 350,000 outpatients received diagnostic and therapeutic services in 1991.
From its founding, UTMB has been actively committed to infectious disease research. Within hospitals and laboratories, early physicians explored the effects of yellow fever, pandemic influenza, bubonic plague, and poliomyelitis and searched for cures. These efforts served to build a solid reputation for scientific research at UTMB. The steady recruitment of world leaders in tropical and infectious disease research over the decades enabled UTMB to become a global leader in the field. UTMB built specialized facilities and created resources and programs to further develop these initiatives. These included the establishment of the UTMB Center for Tropical Diseases (1994), and the acquisition from Yale University of the World Reference Center for Emerging Viruses and Arboviruses (WRCEVA) (1995)—an extensive collection of virus strains procured throughout the world and freeze dried for storage. By 2019 the WRCEVA contained more than 6,200 virus strains, including every strain of the Ebola and Zika viruses.
In 1997 UTMB built the Robert Shope MD laboratory, the first maximum containment (BSL4) lab established on a university campus. Other important facilities and programs established during this period included the John Sealy Pavilion for Infectious Disease Research (which houses the Shope laboratory) (2003), the Sealy Center for Vaccine Development (2001), the Center for Biodefense and Emerging Infectious Diseases (2003), and the Institute for Human Infections and Immunity (2004). In 2014 UTMB was named a World Health Organization Collaborating Center for Vaccine Research, Evaluation and Training on Emerging Diseases—only the second university given this designation in the Western Hemisphere.
In 2001 the September 11th and subsequent anthrax attacks further stimulated UTMB’s prominence on the world stage. In 2003 the National Institutes for Health (NIH) selected UTMB as the future site of one of only two National Laboratories with Biosafety Level 4 (BSL4) capabilities located on a university campus. The $174 million Galveston National Laboratory (GNL) opened in 2008 and became fully operational in 2010. The eight-story structure, containing more than 80,000 feet of laboratory space, is designed to withstand a Category 5 hurricane. Under its roof, scientists at the GNL study some of the most dangerous pathogens known to medical science. These include Ebola, anthrax, SARS/MERS, West Nile encephalitis, and drug-resistant tuberculosis. In 2020 faculty throughout the UTMB enterprise shifted their research focus to address the deadly coronavirus (COVID-19) pandemic. Laboratory teams quickly initiated numerous projects designed to study the virus and assist in the creation of vaccines and therapies. For instance, starting in the early phase of the pandemic, the WRCEVA became one of only two global repositories to supply COVID-19 RNA for diagnostic testing and development in laboratories around the world.
The academic enterprise at UTMB continued to flourish as it approached a new century. In 1995 the medical school began implementing an experimental curricular track in which students took all their courses in small classes rather than large lecture halls and, during their first two years, spent half a day each week off-campus in a primary-care clinic or private practice. The School of Allied Health Sciences initiated cooperative programs in Edinburg with the University of Texas–Pan American (now part of the University of Texas Rio Grande Valley) to train physician assistants and with Galveston College to offer an associate degree in radiologic health sciences. In addition, as the major health-care provider for the Texas Department of Criminal Justice, UTMB became the first health sciences university in the country to offer degree programs and residencies in correctional health care.
Beginning in 2007 UTMB expanded to a comprehensive health system with hospitals on four campuses and a network of clinics. In 2019 UTMB boasted an annual budget of $2.25 billion and employed a workforce of 13,629, including 968 faculty. Student enrollment increased by nearly 40 percent across the four schools over a ten-year period and totaled more than 3, 300 students in 2019. UTMB patient totals for that year included 1.2 million outpatient visits, nearly 6,400 births, and more than 88,000 visits to UTMB emergency rooms.
The institution's chief administrative officers have included John Fannin Young Paine (1891–97), Allen John Smith (1897–98, 1901–03), William Keiller (1922–26), George Emmett Bethel (1928–35), and Truman G. Blocker, Jr. (1955–56, 1964–74), William C. Levin (1974–1987), Thomas N. James (1987–1997), John D. Stobo (1997–2007), David L. Callender (2007–2019), and Benjamin G. Raimer, Interim (2019–).