At the time of America’s Centennial celebration, Philadelphia was home to eight medical colleges:
- University of Pennsylvania’s Department of Medicine
- Jefferson Medical College (JMC)
- Woman’s Medical College of Philadelphia
- Hahnemann Medical College of Philadelphia
- Medico-Chirurgical College of Philadelphia
- Penn Medical University
- Eclectic Medical College of Pennsylvania
- Philadelphia University of Medicine and Surgery
The city had, by 1876, also witnessed the extinction of such institutions as the Medical Department of Pennsylvania College, Philadelphia College of Medicine, and Franklin Medical College. A few colleges of pharmacy and dental colleges were also represented in the Quaker City.
In the early part of the nineteenth century Federal influence had swept away states’ regulations governing medical education, which resulted in a proliferation of schools throughout the U.S. Not all of these “temples of education” were “diploma mills,” but the requirements for establishing medical colleges were virtually non-existent. At a time when “science” itself was being defined and explored, traditional or “allopathic” medicine was being challenged by sectarianism (water-cure, Thomsonianism, homeopathy, etc.) with its own established schools. With no requirement for state licensing, practitioners could and did treat (or mistreat) patients without their having an M.D. or a recognized course of training.
After the Civil War, improved pre-med education (with the establishment of public high schools) coincided with a wave of reform in medical education. In the Centennial year, JMC administrators took efforts to improve educational standards from within, such as the construction of a modern teaching hospital connected to the college. This would provide Jefferson medical students with a wider clinical experience and Jefferson patients with a longer recovery period under medical supervision. This attached structure was the second of its kind in the U.S. On a national level, one of the most important efforts was the establishment of a policymaking body which would become the Association of American Medical Colleges (AAMC).
In a letter postmarked Louisville, Kentucky and dated May 15, 1876, various medical schools were invited to attend a national convention, “to consider all matters relating to reform in medical college work.” The letter was signed by doctors J.B. Biddle, Jefferson Medical College; William H. Mussey, Miami Medical College, Cincinnati; John T. Hodgen, St. Louis Medical College; J. Adams Allen, Rush Medical College, Chicago; W.T. Briggs, Medical Department of the University of Nashville; J.M. Bodine, Medical Department, University of Louisville. Representatives of 22 medical colleges convened at the hosting institution, Jefferson Medical College in Philadelphia on June 2 and 3, 1876. The nascent organization’s first act was to elect John Barclay Biddle, the letter’s primary signatory, as its president. Biddle held the deanship of JMC from 1873-1878 and was Chair of Materia Medica (1865-1878). The actions from that founding meeting of the “Provisional Association of American Medical Colleges” included the following:
- “A resolution was passed expressing the opinion that the completion of two consecutive courses of lectures in one year should not entitle students to become candidates for graduation.
- It was resolved that no medical faculty should issue a diploma not bearing the graduate’s name.
- It was recommended that all medical colleges offer three courses of lectures (presumably of 20 weeks each).”
Biddle served as president for two more years at annual conventions until ill health kept him at home. His Jefferson colleague, Samuel David Gross, Professor of Surgery (1856-1882), became president of the “American Medical College Association” until 1881. The following year the association collapsed when eleven member colleges withdrew.
It was the insistence of mandating a three year coursework that derailed this engine of change. Oddly enough, many of the founding members signed the letter of resignation; Jefferson Medical College was included in that august list. (JMC established a three-year course of instruction for its own students in the fall of 1884.)
The group reformed in 1890 under the name of the Association of American Medical Colleges with nearly all of the original members signing on. The agenda included:
- Three years course of six-months sessions.
- Graded curriculum.
- Written and oral examinations.
The reconstituted organization learned that slow and deliberate change was the preferred method to consensus in reforming and establishing standards.
Jeffersonians were in the vanguard of the early AAMC; besides Drs. Biddle and Gross serving as AAMC presidents, JMC Dean James W. Holland served in that office (1897-1898), followed by JMC Dean Ross V. Patterson (1933-1935).
Further Reading:
"Extinct Medical Schools of Nineteenth Century Philadelphia," Harold J. Abrahams, University of Pennsylvania Press, 1966.
"American Medicine in Transition 1840-1910," John S. Haller, Jr., University of Illinois Press, 1981.
"Abraham Flexner in Perspective: American Medical Education 1865-1910," Robert P. Hudson, in "Sickness & Health in America," ed. Judith Walzer Leavitt, University of Wisconsin Press, 1978.
"History of the Association of American Medical College 1876-1956," Dean F. Smiley, Journal of Medical Education, vol. XXXII, no. 7, p.512-525, 1957.
