The College of Physicians of Philadelphia Digital Library

Challenging the Status Quo

Surgical Amphitheater

J. Chalmers DaCosta, a member of the Philadelphia General Hospital surgical staff, operating in front of a class. Nurses and physicians present.

The predominantly male domain of 19th century medical education was challenged by Elizabeth Blackwell, the first woman to graduate from a medical school in the United States. Blackwell attended Geneva Medical College only because the faculty assumed that the male students would never agree to have a woman amongst their ranks, and allowed the student body to vote on her entry.  The students voted “yes,” but as a joke.  Blackwell graduated in 1849.

Blackwell’s successful graduation did not open the doors to coeducational medical schools.  On the contrary, segregated education became the norm, beginning with the Female Medical College of Pennsylvania, which opened in 1850.  Eminent physicians such as William Henry Welch, the first Dean of Johns Hopkins University School of Medicine, expressed embarrassment at the idea of discussing “medical matters” with women in the classroom.

Johns Hopkins was fortunate to escape the embarrassment that characterized the critique of medical education in the early 20th century with the publication of Abraham Flexner’s Medical Education in the United States and Canada (1910).  Flexner examined nearly every extant medical school not from the point of view of a medical practitioner, but from the viewpoint of an educator.  Flexner’s scathing reviews revealed a frightening inconsistency not only in medical education, but also in the prerequisites required for entry into medical school.

How anatomy was taught was not just challenged by courageous female medical students, or the lack of adequate dissection facilities in some medical schools, but also by the development of medical ethics regarding the treatment of patients, and the provenance of bodies and specimens obtained for medical research.