The Massachusetts State Board of Insanity began selecting patients from the several thousand metropolitan area residents who had been committed to other hospitals by 1929. The first ever patients to arrive were 36 men from the Grafton State Hospital who arrived on December 26, 1930. Others, from the hospitals at Westborough, Danvers, Worcester and Medfield soon followed. Within a year of opening, Metropolitan State Hospital accommodated 1,150 patients in the continuing treatment class. By the end of 1932, the number of patients totaled 1,230. With completion of the Medical/Surgical Building in August of 1934, the capacity reached 1,560. The 1945 Governor and Council's Report cited a population of 1,995 with an additional 281 patients "out on parole" which was 410 over capacity of 1,585. The staff numbered at 234. The Medical/Surgical Building not only served inpatients, but also was accepting patients from the neighboring Fernald State School.