Wednesday, May 26, 2010

Part 4: MD with an LLD Degree or Is It LLD with an MD Degree?

I made an javascript:void(0)error in my last post. Maryland was not the location of one of the first four medical colleges in the United States.

The Medical College of Philadelphia (now the medical school of the University of Pennsylvania) was established in 1765. King's College (now Columbia University) in New York City established a medical school in 1768. Philadelphia and New York for many years were the centers of medicine in the American colonies.

Harvard College added a medical curriculum in 1782 followed by Dartmouth Medical College in 1797. The creation of medical schools in the United States in the first 75 years of the 19th century was rather slow. Between 1801 and 1825 only 12 more medical colleges were established. Over the next 25 years 22 more schools were established followed by 33 between 1851 and 1875. However, the pace accelerated in the last 25 years of the 19th century with the addition of 86 new medical colleges. According to page 13 of The Standard Medical Directory of North America 1902, as of 1899, there were 156 medical schools in the US with 24,119 students enrolled.

This book, as well as others, claimed that during the Revolutionary War, nearly 3500 people were medical practitioners but only about 400 had medical degrees. So with only four medical schools founded between 1765 and 1797, how were most medical practitioners trained?

A few went to Europe to study. Dr. Francis Packard writes in his book that from 1758 through 1788, 63 Americans graduated with a medical degree from the University of Edinburgh in Scotland (page 156). During this period, if you had the funds, you went abroad to study in London, Edinburgh, Paris and Leiden. Unfortunately, most colonists did not have the means, thus most medical practitioners were trained through an apprenticeship.

I found that there were no standards regarding what constituted proper medical training. The following quotations taken from or about the time clearly illustrates the point:

God heals and the doctor takes the fee. - Benjamin Franklin
Few physicians amongst us are eminent for their skill. Quacks abound like locusts in Egypt, and too many have recommended themselves to a full practice and profitable subsistence. This is the less to be wondered at, as the profession is under no kind of regulation. - William Smith (1732)
The Chicago Medical College (Northwestern University) by 1859 had introduced a more rigorous curriculum and graded courses, compulsory clinical and laboratory work and lengthened the duration of the program. In 1871, Harvard Medical School adopted a similar program followed by Syracuse Medical School. However, the problem continued throughout the greater part of the 19th century at which time medical societies such as the American Institute of Homeopathy (organized 1844), Association of American Medical Colleges (1890), National Confederation of Eclectic Medical Colleges (1871) and the Southern Medical College Association (1892) pushed for the establishments of higher standards.

To be continued in my next blog: American Medical Training before the 20th Century.

History of New York, from the First Discovery to the Year MDCCXXXII by William Smith. Albany, NY: Printed by Ryer Schermerhorn, 1814.
The History of Medicine in the United States by Francis Randolph Packard, MD. Philadelphia: J. B. Lippincott Company, 1901.
The Standard Medical Directory of North American 1902
. Chicago: G. P. Englehard & Company, 1902.

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