Similar, though more frequent, opportunities for clinical instruction had been previously secured for women at the city hospitals of New York (Bellevue), Philadelphia (Blockley), and Chicago (Cook County). At the Pennsylvania Hospital in Philadelphia, moreover, the women from the Medical School had been admitted to lectures on special days, when no male students were present. These scanty privileges (for not much can be learned about a patient by spectators seated on the benches of an amphitheatre) were only obtained after a series of collisions with the men students, occasionally rising to the dignity of a row, as upon one memorable occasion at the Pennsylvania Hospital;[[122]] more often consisting in petty teasings and annoyances, which bore considerable resemblance to the pranks of schoolboys. To students habituated to the daily visits in the wards of the vast European hospitals, this form of clinical instruction, where the patient studied is seen but once, and then at a distance, must seem ludicrously inadequate.[[123]] From these defects, however, the male and female students suffer alike. But the former have, until recently, retained the monopoly of the hospital appointments, whereby a certain number of graduates are enabled to acquire real clinical instruction. This monopoly is only just beginning to break down.
Apparently the first general hospital in the country to confer a hospital appointment on a woman, was the Mt. Sinai Hospital of New York. Here, in 1874, Dr. Annie Angell, a graduate of the Infirmary School, was made one of the resident physicians, at the instance of several members of the medical staff.[[124]]
In 1884 Dr. Josephine Walter, another graduate of the Infirmary School, was admitted as interne after a severe competitive examination, among nineteen candidates, of which only two could be appointed. She also served three years in the hospital, and then spent two years in Europe in medical study.
Since her appointment, none others have been made, or indeed applied for, in this or any other hospital in the city. Even in the Woman’s Hospital, with exclusively female patients, and a host of female nurses, the medical staff have repeatedly expressed their formal opposition to the admission of female internes; and the Board of Lady Managers, oblivious of the first resolution of the first founders of the hospital, have so far remained indifferent to the anomalous injustice of the situation.[[125]]
Among dispensary services, however, many women have found places. Dr. Angell and Dr. Putnam Jacobi founded a dispensary at the Mt. Sinai Hospital, and for a year conducted it exclusively themselves. It was then systematically organized by the directors of the hospital, and has since always had women on the staff. In 1882, a school was open for post-graduate instruction in New York, and Dr. Putnam Jacobi was invited to a place in its faculty, as the clinical lecturer on children’s diseases, the first time a lectureship in a masculine school was ever, in this country, filled by a woman. In the same school, another woman, Dr. Sarah McNutt, was also appointed as lecturer, and founded a children’s hospital ward in connection with the school. The positions at present held by women physicians in New York dispensaries may be thus summarized, exclusive of the dispensary of the Infirmary:
Demilt Hospital, 3; Mt. Sinai Hospital, 2; St. Mary’s Hospital for Children, 1; Hospital for Ruptured and Crippled, 4; Manhattan Eye and Ear Infirmary, 1; Foundling Hospital, 1 (resident physician); Nursery and Child’s Hospital, 1 (resident at country branch); Babies’ Hospital, 1.
In Philadelphia, the Blockley Hospital, the first in the United States to allow a woman to visit its wards,[[126]] appointed a female interne upon competitive examination, in 1883.[[127]] Since this date, eleven other women have received such appointments,—of whom four in 1889. Dr. Clara Marshall and Dr. Hannah Croasdale were put on the visiting staff in 1882. Chicago, however, is the city where the hospital privileges have been most equitably distributed, though the opportunity has been obtained by a struggle rendered severe, not from the opposition of those adverse to women physicians, but from the inadequate instruction given by those who had professed to be their friends.
In 1877, an invitation was sent to the senior class to take part in the examination for internes at the Cook County Hospital. “To go meant to fail. We decided to go, if only to show how little we had been taught in surgery.” This was really an heroic determination; and the ordeal was severe. “The students and other spectators received us with deafening shouts and hisses The gynæcological and obstetrical examiners made vulgar jokes. The surgeon tried to wreck us. We forced things as best we could, but of course no one received an appointment.”[[128]] As a rather unusual result of this trial, the professor of surgery at the Woman’s College was roused to exertion, and for two years taught so well, that on another competitive examination the Woman’s College was said to have stood first. However, no woman was appointed, but a relative of the commissioners, without an examination. Still the women’s pluck and determination held out; they came up a third time,—and then, in 1881,—the coveted position was gained, and a young woman only twenty-one years of age was nominated as interne. Since then, appointments have multiplied, thus:
| Name of Hospital. | Date of Appointment. | No. of Women Physicians. |
| Cook County Hospital | 1881 | 1 |
| 1888 | 2 | |
| 1889 | 2 | |
| Illinois Woman’s Hospital | 1882 | 1 |
| 1887 | 1 | |
| 1888 | 1 | |
| 1889 | 1 | |
| Wesley Hospital | 1889 | 1 |
| State Insane Asylum | Unknown | 2 |
Finally, it is noteworthy that Dr. Sarah Hackett Stevenson holds an appointment to the Cook County Hospital as visiting physician, and Dr. Marie Mergler a similar appointment to the Woman’s Hospital.