For centuries in this country, White-only medical schools, with exclusionary policies and practices, made it virtually impossible for Black people to receive medical training. It was only after the Civil War, with thousands of injured veterans in desperate need of medical care, that a small handful of Black trainees began to be admitted to White medical schools in the North. And it wasn’t until Reconstruction that a number of Black medical schools sprang up in the South, enabling Black people to finally have access to medical training in greater numbers.
These schools were Howard University College of Medicine, established in D.C. in 1868; Meharry Medical College, established in Nashville in 1876; Leonard Medical School, established in Raleigh, N.C., in 1882; New Orleans University Medical College, founded in 1887; Knoxville College Medical Department, founded in 1895; Chattanooga National Medical College, founded in 1902; and the University of West Tennessee College of Physicians and Surgeons, founded in Memphis in 1904. By 1905, those Black medical schools had trained 1,465 doctors. Each of those doctors was poised to train a new generation of physicians, who would have gone on to train a generation of their own.
And then, that promising legacy was abruptly extinguished.
The reason was the publication of the Flexner Report — a landmark document in U.S. medical history that had a devastating effect on the number of Black physicians in this country.
Abraham Flexner, the White author of the report, was an education specialist who at the turn of the 20th century was employed by the Carnegie Foundation and the American Medical Association to travel to all 155 medical schools in the United States and Canada to assess the state of medical education. His report, published in 1910, led to broad standardization of medical schools, with the top school in the country at the time — Johns Hopkins — held up as the example for all others to follow.
The new standards did go some way toward elevating the quality of U.S. medical care. Flexner’s recommendations included more-stringent admissions criteria; well-equipped laboratories and facilities; and a higher level of instruction by physician scientists, resembling the model found in Western European medical schools. The problem was that smaller Black institutions simply did not have the resources or endowments to implement the more rigorous instruction the new standards required.
Flexner had strongly racist opinions on the role of Black people in medicine. He wrote that Black students should be trained in “hygiene rather than surgery” and were best employed as “sanitarians” who could help protect White people from common diseases such as tuberculosis.