‘I could not imagine any decent woman wishing to study medicine – as for any lady, that is out of the question.’

Statement attributed to a professor of medicine (anonymous), Edinburgh 1869 quoted in An Illustrated History of the Royal Free Hospital Lynne A L Amidon

MUST A WOMAN PRETEND TO BE A MAN TO QUALIFY AS A DOCTOR?

The medical-profession was men-only for most of the nineteenth century. Women adopting male names, and sometimes wearing men’s clothes, subverted this prejudice.  The most famous case is that of Mary Ann Buckley who qualified as Dr James Barry in 1812 . She presented as a man throughout her life to study and practice as a surgeon.  

WOMEN WHO BROKE THROUGH THE CONCRETE WALLS

The first recognised women doctors, Elizabeth Blackwell and Elizabeth Garrrett Anderson, entered the profession and joined the register of medical doctors in 1859 and in 1865/6 respectively.  They got in through legal loopholes which were subsequently closed to prevent other women for applying and being granted a medical degree. 

By 1869, Sophia Jex-Blake, and several of her peers, successfully lobbied for admission to a recognised medical degree at the University of Edinburgh. However, rioting by male students, furious at their admission, meant that the women  were denied the right to graduate. They obtained their degrees abroad.

THE STEREOTYPE  OF THE FEMALE AS ‘UNSTABLE’

Doctors writing in medical journals debated the merits of female entry from early 1870 to late 1880.  Arguments against equality stated that women’s biology made them mentally and physically unsuitable as doctors and surgeons. It was declared that menstruation would ‘make them unstable and diminish their mental acuity.’  Women entering professional life were castigated as traitors to their gender and to the ‘civilised social order’.  Opponents to equality said that women wanting entry were threatening the proscribed female life of matrimony and motherhood.  A woman with a career could harm the national birth rate. Some argued that perhaps women should be allowed to pursue their education but, given their presumed smaller brain size and inferior intellect, it was doubtful that they could succeed as doctors.

Patriarchal attitudes labelled them as too hysterical ‘to be trusted in the operating theatre and ‘too weak’ to perform specific operations.  Male opposition declared that exposure to blood and bodily fluids might be upsetting and unhygienic and that dissecting rooms would be dangerous for women’s ‘delicate health’.  Medicine and surgery were seen as too dangerous, vulgar and demanding a profession for women.’ 

LEGAL IMPEDIMENTS TO WOMEN’S ENTRY

The process becoming a doctor or surgeon was structurally hostile to women’s entry.  In 1838 surgical training comprised three years’ course work in a recognised school of surgery, twenty one months of hospital fieldwork, complete courses in dissection and the attendance of lectures.  Since women could not secure apprenticeships, and were not allowed entry into medical school, to sit for examinations, nor work on hospital wards, they were excluded from the surgical profession.

When it was suggested that perhaps women patients might prefer to be seen by a female professional, especially when dealing with female sexuality, an article in the Lancet countered that, while women’s and children’s health might be the most appropriate field for female practitioners, there would be no demand for women doctors by female patients because women “hate one-another.” (7 May 1870, p. 673).

SUBVERTING SYSTEMS OF EXCLUSION

Women pioneers countered their exclusion by practical means. They established medical schools for female students. Notable trailblazers include Elizabeth Garrett Anderson and Sophie Jex-Blake. Anderson founded St. Mary’s Dispensary for Women in 1866 and Jex-Blake the London School of Medicine for Women and Edinburgh School of Medicine for Women which opened in 1874 and 1886 respectively. 

Legislative reforms in 1876 authorised universities to award degrees to women but it was not mandatory.  A year later King’s and Queen’s College of Physicians of Ireland—one of Britain’s 19 medical licensing bodies—allowed women to sit for final examinations.  Also in 1877 London’s Royal Free Hospital, agreed to allow students from the London School of Medicine for Women to train on its wards in preparation for medical and surgical degrees. These measures increased the number of women in training.  

THE SUCCESS OF SUBVERSION

By the 1890s The British Medical Association voted to admit women but neither the Royal College of Surgeons nor the Royal College of Physicians did so until 1908. However, by 1892, the numbers of women medical practitioners on the register had grown to 135 and their written contributions to the debates, as well as to clinical findings, were occasionally published in contemporary journals.

The British Gynaecological Society did not admit women until 1901 and Louisa Aldrich Blake, the first woman surgeon, did not appear in the List of the Royal College of Surgeons of England until 1910.  Women as nurses and medical auxiliaries, even if qualified doctors, still did not have equal standing as surgeons. The presence of women as medics became more apparent in World War One as thousands of men were sent to the Front. When spaces were empty in the profession, women filled them but as soon as peace came, women were told to return to their ‘proper position’ in the home.

We shan’t admit you,, Mistress Fell –
The reason why we cannot tell;
But this we all know very well,
We shan’t admit you, Mistress Fell!      

Dr Johnson

3 March 1857 Jessie White wrote to Barbara Leigh Smith Bodichon regarding her attempts to obtain a medical education in England.

Listen to her letter to Barbara summarising her attempts:

Listen to her correspondence with different hospitals:

Listen to her letters to and from the University of London asking to be admitted as a candidate to the Matriculation Examination:

Read by Julia Pascal

Letters quoted from Barbara Leigh Smith Bodichon and the Langham Place Group edited by Candida Ann Lacey; Women’s Source Library; Routledge & Kegan Paul, N.Y. and London 1987

1878 ELIZABETH GARRETT ANDERSON –ADVICE TO WOMEN MEDICAL STUDENTS 

covering aspects such as education, costs, wellbeing, training and practice in medicine.

A Special Chapter for Ladies who Propose to Study Medicine by Mrs Garrett-Andreson, M.D in The student’s guide to the medical profession by Charles Bell Keetley 

excerpts show some of the issues women faced entering the career:

At this time, “there is but one school of medicine for women in the United Kingdom.  It is located at 30 Henrietta Street, Brunswick Square. W.C.”

She warns: ‘that the standard of professional attainment expected to be reached by women, will for some years be higher than that expected in the case of the ordinary male practitioner.  Women can less easily afford to be second-rate, their professional work will be more closely scrutinised; mistakes will ruin them more quickly than they will men.”

Regarding lodging, she advises that there a comfortable board and lodging homes in Bedford & Russell Squares. “The great desideratum for a student is to live where she can work without interruption, and the next point of importance is for her home to be near her work. I would therefore strongly urge students never to make their home with relatives (where interruption is inevitable); never to attempt, if boarding with a family, to do without a separate sitting-room; and never to be more than fifteen minutes’ walk from the school.” 

Regarding health: she stresses the importance of good food, sleep and breaks: Where she has witnessed problems ‘the annual spring and autumn holidays have been sacrificed, either to work or to nursing relatives.”

Regarding dress: “The less conspicuous medical women make themselves in their dress the better.”

Regarding future lines of practice open to a medial woman who has obtained her diploma:  “every medical woman will do well to prepare herself specifically for those lines of practice in which she is sure to be chiefly consulted.  These are medicine proper, midwifery, the diseases of women and children, diseases of the skin, and of the rectum.”

“If a student proposed to take up midwifery on at all a large scale, she should go to Vienna….” “In like manner the diseases of women, those of children, and of the skin demand special study in the Continental and English hospitals…”

She concludes: “ I would beg female students of medicine not to be discouraged either by the magnitude of the work to which they have put their hands, or by the disapproval of many of their friends and acquaintance.” 

“It may not be useless to remind female medical students of the immense value of good temper. The power to meet disapproval and even hostility good-humouredly, of being able to ignore and to go on one’s way cheerfully and calmly in spite of it, is a precious weapon to those who are working for a cause still regarded by many with prejudiced disapproval.

The student’s guide to the medical profession by Charles Bell Keetley London: Macmillan and Co. 1878  

The student’s guide to the medical profession / by Charles Bell Keetley. | Wellcome Collection

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Original drawings by Anne Sassoon

references:

https://www.researchgate.net/publication/318082735_Medical_women_Perspective_from_the_victorian_medical_profession

https://publishing.rcseng.ac.uk/doi/full/10.1308/rcsbull.2020.202