Fedunkiw focuses on three recipients - the University of Toronto (the leading Ontario medical school), McGill University ( Canada's medical school ), and Dalhousie University (the struggling Maritime school) - to demonstrate how the money made possible the introduction of full-time clinical teaching and encouraged greater public and private support for medical education. The shift to full time, although advocated by progressive educators, also led to a backlash in Toronto resulting in a provincial inquiry in Ontario that threatened to return the University of Toronto to government control. Her book not only provides a history of Canadian medical education and large-scale philanthropy in North America but also analyses the effects of philanthropic giving, the practice of matching fund gifts, and accountability.