American medical students frequently trained through an apprenticeship to an older practicing physician, who passed along his own fund of knowledge, good and bad. Sometimes the mentor, or preceptor, sponsored the student’s admission to a formal medical college.
The country had more than 80 medical schools that operated independently. Most hospitals were institutions that had evolved from almshouse infirmaries. Very little surgery was performed.
The average medical student in the United States trained for two years rather than the European requisite of four, and received little clinical and laboratory experience. In 1861, several states still prohibited dissection by medical students.
American medical schools weren’t prepared to take an organized part in the war effort. Most schools were merely faculties of professors who delivered lectures for which they sold tickets. Fees ranged from $10 to $25 per course, and a popular professor could earn several thousand dollars a semester.
Most medical schools conducted lectures for only four to five months of the year. Second-semester lectures were a repeat of the first semester. Courses in anatomy, surgery, midwifery and other subjects were available, but optional.
Many independent schools had sprung up in the United States, and the mere possession of a diploma conferred the right to practice. Even medical schools like those at Harvard and Dartmouth relied solely on the personal standards and experience of the physicians who made up the faculty. State licensing could be brought about only by public action through state legislatures, and reform of the licensing system occurred many years after the war.
Although women were barred admission to most medical schools, by 1859 an estimated 200-300 American women possessed diplomas in medicine. Some were graduates of The Female Medical College of Pennsylvania, the world’s first medical school for women, founded in 1850.
America’s first Medical School at the University of Pennsylvania sent more surgeons to both the Union and Confederate armies than any other collegiate institution in the country. It was typical of other teaching facilities: there were no laboratories in which to conduct tests or prepare medications. The School had no hospital of its own, but it did conduct a dissecting room and gave clinical instruction in a neighboring hospital.
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