Women in White Coats

For centuries, women delivered healthcare across the globe as herbalists, midwives, and healers, but the professionalization of medicine in medieval Europe, which required university training barred to women, steadily pushed them out of the field. Between 1400 and 1700, the Catholic and Lutheran churches executed a campaign against women healers, branding them as witches and burning more than 100,000 at the stake. By the Victorian era, women could practice medicine only as nurses or midwives. Journalist Olivia Campbell traces how three women challenged this exclusion, fought for medical degrees, and reshaped the profession.

In the mid-1840s, Elizabeth Blackwell, a young teacher in Cincinnati, visited her dying neighbor Mary Donaldson, who likely had advanced uterine cancer. Mary told Elizabeth that her worst suffering came from being treated by a rough male doctor and urged her to study medicine. Elizabeth was initially repulsed by the idea but eventually embraced it, motivated by a desire to spare other women similar ordeals and to expand women's professional opportunities. She spent years teaching to save money and studying medical texts under two former doctors in the Carolinas, then moved to Philadelphia, where she applied to 29 medical schools. All rejected her. Finally, in October 1847, Geneva Medical College in western New York accepted her, though only by accident: The faculty let students vote on her admission expecting a refusal, but the students treated the application as a prank and unanimously approved it. Elizabeth enrolled at age 26, weathered gossip and hostility, and insisted on attending every class, including reproductive anatomy. She graduated on January 23, 1849, at the top of her class, becoming the first woman in the United States to earn an MD. Geneva immediately barred future women applicants.

Elizabeth continued her training in Paris at La Maternité, a maternity hospital, where she contracted an eye infection from a newborn and permanently lost sight in her left eye, ending any hope of becoming a surgeon. She returned to New York in 1851 and struggled to find work or rent office space, as landlords assumed "female physician" meant abortionist. She opened a private practice and in 1854 founded the New York Dispensary for Poor Women and Children, one of the first dispensaries to employ women practitioners. Her sister Emily Blackwell followed her into medicine, earning an MD from Western Reserve College in Cleveland in 1854 and gaining surgical training in Europe. Together with Marie Zakrzewska, a German-born midwife Elizabeth mentored, the Blackwell sisters opened the New York Infirmary for Women and Children in May 1857, staffed entirely by women physicians and serving impoverished neighborhoods. The infirmary quickly became overcrowded, treating thousands of patients annually.

Across the Atlantic in 1858, 21-year-old Elizabeth Garrett, known as Lizzie, read about Blackwell's achievements in the English Woman's Journal, a feminist periodical, while restlessly managing her family's household in the coastal English town of Aldeburgh. In January 1859, she attended Blackwell's London lecture on medicine as a profession for women. After conversations with Blackwell and her friend Emily Davies, a fellow feminist campaigner, Lizzie decided to pursue medicine. Her father, Newson Garrett, initially called the idea "disgusting," but he gradually became her strongest ally after witnessing the opposition she faced. In August 1860, Lizzie entered Middlesex Hospital in London as a nurse to prove her fitness. She thrived, impressing surgeons and studying privately with tutors, but after she outperformed male students on exams, 40 students petitioned for her dismissal and the school expelled her. Every London hospital and the Universities of Edinburgh and St. Andrews similarly rejected her. Lizzie discovered that the Society of Apothecaries, a medical licensing body, was required by its royal charter to examine "all persons," not just men. She spent years assembling a private education: training in midwifery in Edinburgh, serving as a nurse at the London Hospital, and completing courses with private tutors, often at 10 times the cost men paid. On September 28, 1865, she took the Apothecaries' exam, scored highest among all eight candidates, and became the first UK-trained woman placed on the British medical register, the official list of licensed practitioners. The Society immediately changed its rules to prevent other women from following her path.

Lizzie then earned her MD from the Sorbonne in Paris in June 1870, opened a private practice and dispensary in London, and expanded the dispensary into the New Hospital for Women in 1872. In 1873, she became the first female surgeon to successfully perform an ovariotomy, the surgical removal of an ovarian tumor, and was elected to the British Medical Association, where she remained the sole female member until 1892.

Sophia Jex-Blake, born in 1840 in Hastings, England, was a brash, energetic reformer who had been expelled from multiple schools for insubordination. After a painful end to her relationship with social reformer Octavia Hill, Sophia traveled to America in 1865 and began working alongside Dr. Lucy Sewall at the New England Hospital for Women and Children in Boston. Watching patients explain they had delayed treatment because they could not consult a male doctor, Sophia fell in love with medicine. She applied twice to Harvard, which rejected her both times. She briefly enrolled at the Blackwells' newly opened Woman's Medical College of the New York Infirmary in 1868 but returned to England after her father's death.

In autumn 1869, after Sophia recruited four other women to justify separate instruction, the five became the first women accepted into a degree program at a British university, the University of Edinburgh. They were charged higher fees, taught separately, and graded more harshly. Two more women joined, forming a group remembered as the Edinburgh Seven. As their academic success became undeniable—one of the most brilliant students, Edith Pechey, was denied a prestigious scholarship despite earning top marks—hostility escalated. On November 18, 1870, as the women approached Surgeons' Hall for an exam, a mob of over 200 men blocked their path, hurling mud and rotten eggs. Sympathetic male classmates forced the gates open and began escorting the women to and from classes. The riot prompted widespread newspaper condemnation and public testimony from women about their need for female doctors. Despite completing all required coursework over four years, the Edinburgh Seven were denied degrees. A court ruled that the university had overstepped its authority in admitting them, and the women left Edinburgh in March 1874 with nothing.

The three pioneers disagreed sharply about next steps. Lizzie argued women should study abroad rather than fight hostile British institutions. Sophia countered that Edinburgh had shifted public opinion and that sending women abroad excluded those without means. Taking action, Sophia founded the London School of Medicine for Women, persuading both Blackwell and Lizzie to join the school's council despite their reservations. The school opened on October 12, 1874, with 14 students but lacked affiliation with a large hospital for clinical training, threatening its survival.

The critical breakthrough came in August 1876, when parliament passed the Enabling Bill, granting all British examining bodies permission to admit women to exams regardless of gender. The Royal College of Physicians of Ireland agreed to examine students from Sophia's school, and in 1877, Sophia, Edith Pechey, and others passed the Dublin MD exam. For the first time in 12 years, women's names were added to the British medical register. James Stansfeld, the school's honorary treasurer, then secured an affiliation with London's Royal Free Hospital, meaning British women could finally achieve an MD entirely within their own country.

In their later years, the three women pursued separate paths. Sophia moved to Edinburgh, opened Scotland's first woman-run medical practice, and found personal happiness with Margaret Todd, a medical student who became her partner and biographer. Elizabeth settled in Hastings, England; when she died on May 31, 1910, nearly 7,400 women were licensed physicians and surgeons in the United States. Lizzie served as dean of the London School until 1903 and in 1908 became Britain's first woman mayor. Emily Blackwell ran the Woman's Medical College for 30 years, graduating 364 women. In 2017, for the first time, more women than men entered US medical schools. Two years later, the University of Edinburgh posthumously awarded honorary degrees to all seven members of the Edinburgh Seven.