History of Women’s Medical Education 1846 - 1864
“The female population of this country is destroyed to about two and three quarters times as great an extent by cancer as the male.”
Pre 1846
Elizabeth Blackwell sits with her friend Mary as she suffers through what is likely advanced uterine cancer. “The worst part of my illness is that I am being treated by a rough unfeeling man. If I could have been treated by a lady doctor, most of my worst sufferings would have been spared me.” She confessed to her friend, then asked young Elizabeth:
“Why Not Study Medicine?”
1847
In Philadelphia, Elizabeth applied to the local medical colleges for admission.
Jefferson College - Dr. Samuel Jackson said he did his best but all the professors opposed the entrance of Elizabeth
Pennsylvania Medical College - Prof. William Darrach stumbled over himself making no answers “I have nothing to say either for or against it…I cannot express my opinion to you either one way or another. I have not expressed any opinion.
Temporarily sidetracked, Elizabeth began study on her own, through textbooks. When she was first exposed to a human corpse, she was not disgusted as she thought she might be. After dissecting a human wrist she remarked:
“The beauty of the tendons and exquisite arrangement of this part of the body struck my artistic sense. I begin to think there is more love of science in me than I have hitherto suspected.”
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The social stigma around cancer was significant. Knowing many cancers were hereditary, many women avoided early treatment to maintain their privacy and to protect the future prospects of sons and daughters. [WIWC, 18]. After the loss of her friend, Elizabeth could not get this question out of her mind and she was ready to take on a new challenge. She had already resigned herself to a life without love, though she wished for it, it never lived up to her expectations. She needed a path that could help secure her financial future and keep her mind occupied.
She needed to raise money for school, at least $3000, which in today’s money would be $100,000 - $120,000.
Money raised, she looked to Philadelphia, birthplace of American medical education with the establishment of is now the University of Pennsylvania (Then the College of Philadelphia, founded by two men who had trained at the University of Edinburgh).
In an attempt to dissuade Elizabeth from attending medical school, Dr. Joseph Warrington a Philadelphia doctor who founded the Philadelphia Lying-in Charity for Attending Indigent Women in Their Own Home and created the Philadelphia Nurse Society which provided training in obstetrics. It was his goal to convince Elizabeth that:
“Woman was designed to be the helpmeet for man”
Everyone was convinced of the proper positions within society, but Elizabeth was not content to be subornment, with nothing but respect for nurses, she saw no reason why she could not be a woman and also a doctor with a complete medical education. After some convincing, Dr. Warrington would go on to be one of Elizabeth’s loudest champions writing letter after letter on her behalf. [WIWC, 26]
Ether had just been introduced as a surgical anesthetic, prior to that heroic surgeons were prized for their speed over accuracy while removing as much malignant tissue as possible from a patient in agony while held down and restrained. The transition to an unconscious patient must have been a relief to operating rooms everywhere [WIWC,63]
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Twenty-nine rejections from medical schools small and large. It turns out the real fear wasn’t that women weren’t capable of being doctors, it was that the male doctors were afraid of losing their jobs. One rejection letter responded with:
“You cannot expect us to furnish you with a stick to break our heads with?”
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NEW PLAN: go to Paris, don masculine attire to gain the necessary knowledge… this was a suggestion she heard many times, who knows how many woman took this invisible route. Elizabeth didn’t want to be invisible, she wanted to make a statement.
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NEW NEW PLAN: October letter from Geneva Medical College, an invitation to start right away! The invitation was extended under slightly false pretenses. The faculty, not wanting to offend Dr. Warrington in Philadelphia opted to pass the decision of accepting a women student onto the ranks of the student body. It was put to a vote, but no one believed a woman would actually want to attend medical school, they believed it was more likely to be a prank by a rival school. It wasn’t a joke.
“The Female Student has arrived - This is Miss Elizabeth Blackwell”
The professor had her wait in the hall so he could prepare the students before she entered, the only official woman medical student in the world. The room was packed, the dean admitted the attention a woman student brought would be an advantage.
1848
The American Medical Education Society is formed in Boston by Samuel Gregory to promote the medical education of women because he believed it to be immoral for men to deliver babies [WIWC, 95]. It’s name was changed to:
the Female Medical Education Society and by 1857 will be formally recognized as:
the New England Female Medical College, finally merging with Boston University in 1874 to become:
the Boston University School of Medicine.
1849
Geneva Medical College: January 23, 1849 in a black brocaded silk gown and cape, tripped with black silk fringe and accented with lace collar and cuffs she remarked “I can neither disgrace womankind, the college, nor the Blackwell’s by presenting myself in a shabby gown.” After graduation, the university slammed it’s doors shut to other woman saying: “Miss Blackwell’s admission was an experiment, not intended as a precedent.”
Elizabeth heads to Europe to acquire some much needed practical experience. Dr. Elizabeth Blackwell begins interning at a hospital which will give her the important experience she will need when the governing bodies start changing the rules for being a doctor in the UK. It’s here she meets who will become her lifelong friend Florence Nightingale [WIWC, 51], [TCOTP, 33]. Elizabeth laments about the role of women in London “Prejudice is more violent the blinder it is, and I think that Englishwomen seem wonderfully shut up in their habitual views.” A life changing event would change the path of her life and impact the lives an unknown number of woman doctors who followed her route. Learn more about the event HERE
1850
It was important for women to have access to the best schools the country had to offer so they couldn’t be lumped into the mix of “bone-setters, hypnotists, hydropaths and unqualified midwives” found practicing medicine. It was important for them to have MDs after their names to help establish their professional status. There was also a growing demand for woman to have access to information about their own bodies or “to fully understand the physical laws which govern their own organisation.” [TCOTP, 30] There was growing demand for woman to take on more obstetric cases.
The Female Medical College of Pennsylvania was founded in Philadelphia by a group of Quakers who believed in women’s right to education. In 1867 the name would change to The Women’s Medical College of Pennsylvania. One of the first graduates was Hannah Longshore. She had a difficult time establishing a practice since the leading pharmacists refused to sell her drugs. She was told “you are out of your sphere! Go home and darn your husband’s stockings! Housekeeping is the business for women.”
Nancy Talbot Clark quietly begins studies at Western Reserve University. After losing her young daughter and then her husband to typhoid fever, the young widow made her way to Cleveland (not sure how or why - haven’t found any records or controversy of her starting classes (UNSOLVED MYSTERY). Keep reading to learn more or visit THIS LINK for additional background.
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Interest in alternative medicine was growing and since traditional medical school was closed to women, some chose to train in irregular methods. Harriot Hunt was a well know practitioner, offering her patients counseling, herbs and rest. [WIWC, 31]
Her practice was well established.
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After 12 years of practice, she was encouraged to apply to Harvard after hearing of Elizabeth Blackwell's graduation from Geneva College. Harvard responded it would be "inexpedient" to accept her.
What did that even mean? She described it as "so shuffling, so shifting, so mean, so evasive." [TCOTP, 29]
Harvard won't accept a woman student for 94 years (June 5, 1944). [TCOTP, 34]
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"The debate over coeducation in Cleveland was begun in February, 1850, instigated, as in so many schools of the era, by Blackwell's graduation from Geneva Institute. Jared Potter Kirtland, professor of Physical Diagnosis and the Theory and Practice of Physic, a man esteemed nationally for his leadership in the natural sciences as well as in medicine, moved in a faculty meeting that year that "respectable ladies who were fitting for the practice of medicine be admitted to attend all the lectures of the School on the same footing as gentlemen." When a vote was called, Horace Ackley, professor of Surgery, shrewdly burdened the motion by introducing another that asked that "respectable Negroes be admitted to the same privileges," effectively silencing the discussion and tabling both motions."
1851
Dr. Elizabeth Blackwell returned to America and rejected for a position within a large dispensary in New York. Frustrated, she set up her own practice. She described it as a very lonely route with very little help but plenty of criticism and antagonism. She describes the time filled with loneliness, financial anxiety, professional insecurity and fear of male violence.
In Akron (not far from Western Reserve University) Sojourner Truth gives a famous speech at the Ohio Women’s Right’s Convention titled “Ain’t I a Woman?”
Dr. Nancy Talbot Clark
1852
Dr. Nancy Talbot Clark graduated from Western Reserve University (Case Western Reserve presently) the second lady doctor after Dr. Elizabeth Blackwell. Clark's graduation thesis: on the interdependence of the body's vital organs in the pursuit of harmony and balance.
She returned to Boston and attempted to practice medicine for two years. She attempted to gain acceptance into the Massachusetts Medical Society, but they rejected her application asserting that it was their duty to only examine male candidates for membership.
Following the route of Elizabeth Blackwell, Nancy went to Paris (“with her physician brother” who is he? UNSOLVED MYSTERY - SOLVED Israel Tisdale Talbog, he was inspired by his sister Grad of Homeopathic Medical College of Pennsylvania in 1853 & Harvard Medical School in 1854) Nancy studied in Paris, on her return voyage she met a wealthy, recently widowed gentlemen Amos Binney of Boston. Nancy would go on to have 6 children, her medical practice would take a back seat seat for a while, until she opens a free dispensary for women in 1874.
“Today the diploma of the College was conferred upon her, an honor which she has faithfully earned, for she has been a faithful student, and I am told by the Professors that she stands One of the first, if not the very first in medical knowledge in a class of more than fifty graduates. She has won the esteem and respect of all the Professors and students, and many have been the tokens of respect bestowed.”
In Cleveland, The Ohio Female Medical Education Society was formed for the medical education for women found by Caroline Severance, Martha J. Tilden along with eight others. At the same time Elizabeth Blackwell created a series of six lectures on the physical education of girls, promoting exercise and education. The courses were well attended by the Quaker community [TCOTP, 35]
Emily Blackwell (The Younger)
1853
In Cleveland, the success of Dr. Nancy Talbot Clark’s graduation left an uneasy but positive atmosphere in the city. The dean held a request from Emily Blackwell, she was admitted in November
1854
Through the Home for the Friendless, a support group for immigrants the sisters met Elizabeth Blackwell who invited the women to join the staff of the dispensary ran by the Blackwell Sisters. They arranged for entry into Western Reserve University’s medical program which was about the only school in America accepting women medical students. She was joining a small number of women students in a sea of 200 men.
Dr. Cordelia A. Green
Dr. Elizabeth Griselle
Dr. Emily Blackwell graduates from Western Reserve University
Marie Elizabeth Zakrezewska
Marie Elizabeth Zakrezewska was born in 1829 Berlin to Polish parents after feeling Russian occupied land. Marie’s formal schooling was done at 13, so accompanied her mother who was enrolled in the school for midwives in Berlin. She visited patients with her mother and would read any medical book she could get her hands on. Hoping to become a midwife, Marie Elizabeth applied to the Royal Hospital in Berlin twice and rejected twice at the ages of 19 and 20.
She was finally accepted a spot after gaining the attention of Dr. Joseph Schmidt. She graduated with top honors in 1851 and was appointed to a rank as professor at the college, a completely unheard of appointment - no women held positions at this rank. Dr Schmidt, her supporter died a few hours after she assumed the position.
(Dr. Schmidt quarreled with Ignaz Semmelweis in Vienna about puerperal fever and it’s causes in 1850s - great quote about the birth process being slow, so it’s helpful to be close to other wards so the doctors can go into the morgue)
1853
Marie Elizabeth and her sister Anna set sail to New York hoping to find a world of opportunities, she was greatly disappointed. She wasn’t able to start her own practice or find a physician to assist. The sisters were left to hand embroider worsted fabrics to sell at the marketplace to make ends meet.
1854
Through the Home for the Friendless, a support group for immigrants the sisters met Elizabeth Blackwell who invited the women to join the staff of the dispensary ran by the Blackwell Sisters. They arranged for entry into Western Reserve University’s medical program which was about the only school in America accepting women medical students. She was joining a small number of women students in a sea of 200 men.
Dr. Cordelia A. Green
Dr. Elizabeth Griselle
Dr. Emily Blackwell graduates from Western Reserve University
Women in America seemed to have broken into the medical field with relative ease compared to the rest of the world. The success of the first wave of women working as doctors can be contributed partly to the wild nature of medicine in America. With no formal requirements to the profession, any individual could set up a practice and often they did under the names of Doctor no mater how non traditional their practice [TCOTP, 28].
…meanwhile in England
The 1858 Medical Act
At the time, the world of medicine in England mirrored that of society. Physicians treated the Gentlemen and their families, only the fellows, members and licentiates of the Royal College of Physicians held this status within society. Surgeons were seen more like skilled craftsmen, though often as well trained and able as any physician. At the bottom of the hierarchy were apothecaries, viewed on level with tradesmen [TCOTP, 22]. A physician, though maybe ranked higher among his medical peers, was not a highly sought out position at the time. A successful doctor would send his son into the church or the army to have the most success in life. The low wages for the average medical man made them especially weary of anyone else entering the field, especially women, fearing they would gain an advantage in the growing field of obstetrics.
In Theory, the 1858 Medical Act was designed to ensure the professional quality of all medical practitioners, but in practice it acted to exclude women from the official registry of Great Britain and Ireland. Possession of one or various qualities could qualify an individual to be on the registry. One main problem was that the 19 different licensing bodies had wildly different standards of examinations so the resulting registry lacked no uniformity in expertise as expected.
The act did not make it a crime to practice medicine for those names not included on the registry, only those individuals were not protected legally the way a “doctor” was.
Elizabeth Garrett Anderson in London
1858
The April issue of English Woman’s Journal was the first suggestion to Elizabeth Garrett Anderson that she could be a doctor. In that issue was an article about Florence Nightingale and her impacts during the Crimean War where her influence on unsanitary conditions lead to immediate positive changed in the number of sick and wounded. The second article was written by about another Elizabeth, The Lady Doctor Elizabeth Blackwell, written by her sister Anna. [WIWC, 47]
1859
Elizabeth Blackwell returns to London to be placed on the List of Registered Medical Practitioners. The law was changing so that if you received a degree from a foreign university you had to have practice in England prior to 1858. Thanks to Elizabeth Blackwell’s internship after graduation she was eligible. Letters of recommendation from Florence Nightingale surely helped. [WIWC, 52]
Elizabeth Blackwell gave lectures across London, Elizabeth Garrett Anderson attended at least two of them and continued corresponding with the first lady doctor about the process of becoming a doctor.
1860
Elizabeth Blackwell publishes another piece, “Letter to Young Ladies Desirous of Studying Medicine” which outlined the guidelines a young woman should consider. Elizabeth Garrett Anderson fit the description: between 20-30 and in good health, a liberal English education, French, Latin and Greek. Year one consists of studying at home or under the direction of a physician. Then move on to work as a nurse in a hospital, then train in a laboratory, then girls most travel to America to attend of the few medical schools open to women. [WIWC, 58]
By this time Elizabeth Garrett Anderson had started attending lectures at Middlesex Hospital’s surgical ward, she supplemented this time with tutoring, but was frustrated at her lack of access to the dissection room. She eventually gained admittance to more lectures, but she insulted the boys by doing better than them. At the time, medicine was not a highly sought profession, so the students tended to be rather wild and roguish group. They petitioned to have Elizabeth removed from the dissection room, and it worked. The school kicked her out. [WIWC, 77]
1862
The New England Hospital for Women and Children (The Dimock Center) was opened on July 1st by Dr. Marie Zakrezewska. It was opened and operated by women for women.
Dr. Lucy Ellen Sewall
graduated from the New England Female Medical College. She went on to London, Paris, Zurich, Munich, Vienna and Edinburgh for additional clinical experience.
Upon her return, she became a physician for the New England Hospital For Women and Children, eventually becoming a director.
1863
Graduated from the New York College of Pharmacy
1864
Doctor of Medicine from the Female Medical College of Pennsylvania (AKA The Women’s Medical College
Mary Corinna Putnam Jacobi
1865
Sophia Jex-Blake sails from England to Boston with her friend Isabel Bain. They stay with Ralph Waldo Emerson [poet, lecturer & editor of The Dial a transcendentalist journal popular at the time]. Sophia and Isabel were not warmly greeted in the north. England had thrown quiet support behind the south in the Civil War by repairing damaged confederate ships, the New Englanders were resentful of the brits who were forced to keep their opinions quiet [WIWC, 94].
1870
Elizabeth Garrett Anderson get’s her degree in Paris while Frances Morgan get’s her degree in Zurich [LITL, 170].
1871
A LOT of Russian women were enrolled in medical school, the faculty was not likely to complain about the significant increase in funds that came with the increase in students, but the local community had concerns about the newcomers.
1873
June, Russia bans all further study by women in Zurich, proclaiming no degrees will be recognized. Bakunin and his rival Pyotr Lavrov were “luring” impressionable medical women into their net.
“All degrees obtained by women in Zurich after 1 January 1874 would be invalid in Russia.”
men, carry on as usual if you want.
22 students were arrested and sentenced to prison
3 died in prison
4 committed suicide
1881
Dr. Sewall along with 8 women offer Harvard $50,000 (1.6 Million in today’s dollars) to allow a woman to enter the medical school.
Selected References
[WIWC] Campbell, O. (2021). Women in White Coats: How the First Women Doctors Changed the World of Medicine. Park Row.
LOOKING FOR:
Goldstein LL. Roses bloomed in winter: Women medical graduates of Western Reserve College, 1852-1856. Dissertation Abstracts International. A. 1990;50:2951.