The Johns Hopkins Medical School was the first of its kind on two counts.
First, unlike the nation’s existing medical colleges, it was a
strictly graduate-level medical institution. Second, it was the first
such graduate institution to admit men and women on the same terms. While
these characteristics can be directly traced to the conditions imposed
by Mary Elizabeth Garrett and the Women’s Medical School Fund,
the women were not the only ones to express concern about the state of
American medical education.
Before the Johns Hopkins School of Medicine opened its doors, medical
education in the United States occurred either through a loose apprenticeship
system, at medical colleges, or in undergraduate programs at universities
such as the University of Iowa and the University of Michigan.. The kind
of standardized, graduate-level courses given in Europe had not migrated
across the Atlantic. Instead, students pursued medicine rather than an
undergraduate, liberal education. In his inaugural address as President
of the Johns Hopkins University on February 22, 1876, Daniel Coit Gilman
described the state of medical education in this way:
When we turn to the existing provisions for medical instruction
in this land and compare them to those of European universities;
when we
see what inadequate endowments have been provided for our medical
schools . . . when we see that in some of our very best colleges
the degree of Doctor of Medicine
can be obtained in half the time required to win the degree of Bachelor
of Arts; when we see the disposition of the laymen at home and the
profession abroad
to treat diplomas as blank paper, and the prevalence of the quackery
vaunting its diplomas . . . it is clear that something must be done.1
William Welch professed similar concerns that “at
present in this country no medical school requires for admission knowledge
approaching that necessary for entrance into the Freshman class of a
respectable college.”2 With medical education in this sad state,
reputable students and gentlemen stayed away from the field, preferring
more respectable professions.
The something that must be done, they decided, was to improve medical
education by raising it to the graduate level, including practical as
well as theoretical training, and adhering to strict admissions guidelines.
As with the rest of the university, the European schools served as models.
The connection between the medical school (a division of the University)
and the Hospital afforded opportunities for hands-on, clinical training.
This was unusual at the time. It was also insufficient. According to
Superintendent Henry M. Hurd, merely providing lectures
at the Hospital does “not meet the expectations of the country
and that the wonderful opportunity which is open to the University to
initiate medical teaching of the higher character is being allowed to
slip away . . . There is a universal demand for better medical education.”3
Gilman, the Trustees, and the Medical Faculty hoped to raise these standards
and the quality of medical students by requiring undergraduate education
in the natural sciences. Gilman developed a premedical course at the
college of Johns Hopkins, and they hoped that similar programs would
emerge elsewhere as students sought preparation for admission to the
School of Medicine.
This hope was soon realized. Correspondence between Gilman and John
Goucher, president of the Woman’s College of Baltimore (later Goucher
College), shows that once the medical school was established, the admission
standards had exactly their desired effect. Goucher wrote to Gilman that
the announcement that women and men would be accepted on the same terms
has been received with hearty approval . . . Women who propose to enter
the profession of medicine, and who are ambitious to avail themselves
of the most advanced training, are inquiring where they may take the
preliminary course most thoroughly . . . a quite a number have applied
to the Woman’s
College, enquiring as to our provisions to give the preliminary course.
The uniform answer of the Woman’s College is that we propose to
offer the prescribed work, at the required standard, whenever the schedule
of requirements shall be announced.4
Gilman replied with a proposed memorandum for inclusion in the Woman’s
College announcement, which reflects how closely those at Hopkins involved
themselves in improving medical preparation:
. . . The chief teachers of Chemistry and Biology have been nominated
to the Woman’s College by Professors in the Johns Hopkins University,
who have also visited the laboratories and given to the President
the benefit of their counsel. Students who graduate from the Woman’s
College after completing the courses in French, German, Physics,
Chemistry and Biology, as now
taught, may be assured of their admission to the Johns Hopkins Medical
School ...5
The ripple effect of the changes made in the framing of the Johns Hopkins
School of Medicine raised the level of both graduate and undergraduate
medical education. This success, however, cannot be allowed to cast its
shadow over the process of creating the school. That the Johns Hopkins
Medical School would exist in this model was not preordained. Between
the will of Johns Hopkins and the emergence of a first class medical
school first intervened severe financial difficulties, and disagreements
over the character of the school.
Enriching Bryn Mawr College