This represents the growth since 1857, when the only hospital conducted by women, in this country, was the lying-in ward of the New York Infirmary, containing twelve beds.
The foundation of these hospitals effected the transition for women physicians from the pre-medical period, when medical education was something attempted but not effected, to a truly medical epoch, when women could really have an opportunity to engage in actual medical work. Correlatively the theoretic education began to improve. In Boston, the Female Medical College was happily extinguished as an independent institution. In Philadelphia, the Faculty gradually struggled free of its inefficient or objectionable members, utilized its legacy of $100,000 to fully equip its beautiful college building, with amphitheatres, lecture rooms, and even embryo laboratories, museums, and libraries,—enlarged its corps of instructors until they numbered twenty-three, instead of the original and meagre seven,—and even, though more timidly, began to enforce something like a rigid discipline among its students, in regard to conditions of admission, examination, graduation, and terms of study. In 1885, Lawson Tait, the famous English surgeon, described the college building as “being very large and splendidly appointed. Last year twenty-six degrees of doctor of medicine were granted by the Faculty, and from the perusal of the curriculum, as well as from conversation with some of the graduates, and from discussion with both the friends and opponents of the school, I am quite satisfied that its graduates are quite as carefully trained as those in any other medical school. When I tell you that last winter 132 students matriculated in this school, that the amphitheatre in the hospital is large enough to seat 300 persons, and that every year about 4000 patients pass through this amphitheatre in the college clinics, I shall have said enough to prove to you that in the United States the practice of medicine by women has become an accomplished fact.”[[84]]
In New York, after much hesitation, a charter was obtained in 1865 for the establishment of a medical college in connection with the Infirmary. “This step was taken reluctantly, because the desire of the trustees of the Infirmary, of Drs. Elizabeth and Emily Blackwell, was not to found another medical school, but to secure the admission of women to the classes for instruction already organized in connection with the medical charities of the city, and to one at least of the New York medical colleges.... The demand of women for a medical education had resulted in the founding of small colleges in different places, all, with the exception of the Philadelphia School, limited to the narrow and cheap standard of legal requirements, and producing equally cheap and narrow results in the petty standard of medical education they were establishing among women students.[[85]] Application was made to the College of Physicians and Surgeons for advice, and the case was laid before the Faculty. It was stated that a sufficient number of women were studying medicine to show that there was a demand for instruction that must be satisfied; that the standard of education was so low that incompetent women were in possession of degrees, while competent women could not obtain the thorough instruction they desired, and those who were fitted to do good work had to contend, not only against popular and unjustified prejudice, but against the justified prejudices of those who saw the slipshod work of ignorant graduates from women’s medical colleges.”[[86]] The trustees proposed to the College of Physicians and Surgeons, the oldest and most reputable in New York, that they receive a limited number of female students on scholarships established by the Infirmary, to the amount of $2000 a year. This proposition was rejected, and the opinion expressed, in no unfriendly spirit, that the ends proposed were only to be obtained by establishing an independent school for women in connection with the Infirmary.
The establishment of such a school called for money,—but the money was forthcoming. A new building was purchased for the hospital; the old one, which had done such modest but effective work, was surrendered to the use of the college, and a prospectus issued announcing the requirements of the latter. In this prospectus a bold attempt was made to outline a scheme of education, which should not only satisfy the conventional existing standard, but improve upon this. It was realized, and, oddly enough, for the first time, that the best way to compensate the enormous disadvantages under which women physicians must enter upon their work, was to prepare them for it with peculiar thoroughness. Women students were almost universally deficient in preliminary intellectual training: their lesser physical strength rendered a cramming system more often dangerous to health, and more ineffective as a means of preparation; and the prejudices to be encountered in their medical career would subject them not only to just, but also to abundant unfair criticism. Instead, therefore, of the senseless official system which then everywhere prevailed, it was proposed to establish a three years graded course, with detailed laboratory work during the first years, and detailed clinical work during the last. A chair of hygiene was established for the first time in America, and an independent board of examiners was appointed consisting of professors from the different city schools. By this means the college voluntarily submitted itself to the external criticism of the highest local authorities. When the Infirmary put forth this prospectus, drawn up by the Drs. Blackwell, no college in the country required such a course: it was deemed Quixotic by many medical friends, and several of its features were for a time postponed. The independent board of examiners, however, was established from the beginning, and, little by little, the other parts of the scheme were realized. In 1876, the three years graded course, at first optional, was made obligatory. At this time no college but Harvard had taken this step. The next year the class fell off one-third,—a curious commentary on the character or circumstances of the students.[[87]] In 1881, the college year was lengthened to eight months, thus abandoning the time-honored division of a winter and spring course, the latter comparable to the Catholic works of supererogation, and equally neglected. At the same time entrance examinations were established. These moderate improvements upon the naïve barbarism of existing customs again reduced the classes one-half. When people first began to think of educating women in medicine, a general dread seemed to exist that, if any tests of capacity were applied, all women would be excluded. The profound skepticism felt about women’s abilities, was thus as much manifest in the action of the friends to their education as in that of its opponents. But by 1882, the friends dared to “call upon those who believe in the higher education of women, to help to set the highest possible standard for their medical education; and upon those who do not believe in such higher education to help in making such requirements as shall turn aside the incompetent,—not by an exercise of arbitrary power, but by a demonstration of incapacity, which is the only logical, manly reason for refusing to allow women to pursue an honorable calling in an honorable way.”[[88]]
“A career is open to women in the medical profession, a career in which they may earn a livelihood; a career in which they may do missionary work among the poor of our own country, and among their own sex in foreign lands; a career that is practical, that is useful, that is scientific.”[[89]]
Even when a theoretic demand is not entirely realized in the actual facts of the case, its distinct enunciation remains a great achievement; and, in an almost mysterious way, constantly tends to effect its own ultimate realization. And so it has been here.
During the current year, the college has emerged from its original chrysalis condition within the inconvenient precincts of a private house building, and entered upon a new phase of existence in a suitable building especially erected for its needs. The money for this building was collected from private subscriptions, by the indefatigable exertions of the friends of the college, and may be said to some extent to measure the growth of interest in the medical education of women, which had become diffused through the community.
In the West, two medical schools for women were opened in the same year, 1869; in Chicago a separate women’s school; in Michigan the medical department of the State University.
The State University was founded and controlled by the State Legislature. On this account, in accordance with a principle generally recognized in the West, the youth of both sexes are equally eligible to its schools, as being equally children of the citizens who support the schools by means of taxation.[[90]] The application of this simple principle to the medical school at once solved the question of “medical co-education of the sexes,” which had been such a bugbear in the East. The difficulties which had elsewhere been considered so insolvable, were arranged in the simplest manner. In regard to all subjects liable to create embarrassment, if discussed before a mixed audience of young students, the lectures were duplicated, and delivered to the male and female students separately. These were thus a double course for obstetrics, gynæcology, and some sections of internal medicine and surgery. The lectures, lecturers, and subsequent examinations of the students were, however, identical, and the clinics are held in common.
The value to women of this State recognition, and of opportunity to study at a university school, was immense. There were numerous disadvantages due to the youth and undeveloped character of the school, and still more to its control by a popular legislature, unversed in the requirements of learned professions. Yet there was promise of indefinite growth in the future, and in all the development of the future, women might hope to share.