History is recorded by those who have been in power; because of this, it should not be surprising that few data exist on the engagement of significant minorities in the medical field. According to Dr. Donald Wilson, writing in Lucas Patersthe Journal of the National Medical Association, the first African physician in the colonies was probably a Dutch-educated man named Lucas Santomee Peters, who practiced under special dispensation in New York in the 17th century.
Although other non-whites offered important medical insight and advice, such as Onesimus, the slave who taught Cotton Mather about smallpox vaccination based on the methods utilized by his tribe in Africa, the existence of the first recognized black physician is not recorded until the late 18th century. James Derham, who is thought to have lived between 1762 and 1802, was born a slave in Philadelphia, but his early masters taught him the fundamentals of reading and writing. After passing through ownership of a number of physicians, Derham ultimately found himself owned by a Scottish physician, who hired him in 1783 to perform medical services. At the age of 21, Derham bought his freedom and moved to New Orleans to establish his own medical practice. His most notable medical accomplishments took place during the yellow fever epidemic around 1789-90, during which he saved more yellow fever victims than any other physician in colonial Philadelphia. During an outbreak in which thousands fell victim to the plague, Derham lost only 11 of 64 patients. After 1802, history loses track of James Derham.
The first African American to earn a formal medical degree didn’t graduate until 1837. Dr. James McCune Smith (1813-1865) was not only an outspoken abolitionist and suffragist, he was also the first African American to earn a medical degree. As American Universities would not admit non-whites, Dr. Smith attended the University of Glasgow, Scotland. Upon returning to New York City after completing his education, Smith became the first black physician to publish articles in United States medical journals. He loaned invaluable credibility to the fight against slavery in the American South, personally collaborating with John Brown, Gerrit Smith, and Frederick Douglass.
Dr. David Jones Peck (1826-1855) earned the distinction of being the first black man to graduate from an American medical school when he earned his medical degree from Rush Medical College in Chicago in 1847. After graduating from medical school, Peck toured Ohio with William Lloyd Garrison and Frederick Douglass, speaking out on behalf of abolition. Although his status as an educated man gave immeasurable credence to the arguments of abolition, Peck’s medical practice was unsuccessful as the prevailing racism of the time kept other doctors from consulting with him or referring patients to him.
Dr. Rebecca Lee Crumpler faced dual obstacles in her path to a medical career: not only was she African American, but she was a woman – and either of these facts alone would have been enough to discredit her in the eyes of the white establishment of the 19th century. Nonetheless, after working for 8 years as a nurse in Massachusetts, she was admitted to the New England Female Medical College in 1860. When she graduated in 1864, she was the first African American woman in the United States to earn a medical degree, and the only African American woman to graduate from the New England Female Medical College, which closed in 1873. When the Civil War ended in 1865, Dr. Crumpler moved to Richmond Virginia, to join with other physicians in caring for freed slaves who would otherwise not have had access to medical care. The environment was hostile toward black physicians, yet Dr. Crumpler continued her work in the postwar South until roughly 1880, when she returned to Boston to practice medicine there. Her 1883 book, Book of Medical Discourses, is an account of her career path and her observations of that journey.
The end of the American Civil War saw a quick and vicious embrace of segregation in the South. One of many horrifying implications of this reality was that nonwhites were often denied access to even basic medical care, as the best (and sometimes the only) medical facilities were “white-only.” In response to this reality, Howard University opened its medical school in 1868, minority doctors and nurses to train, and Meharry Medical College, which began to function in 1876, followed suit. In 1869, three of the Howard faculty members were denied membership in the American Medical Association’s local branch in Washington, DC. Their continual attempts through 1884 were unsuccessful; finally, in 1884, an all-black medical society, the National Medical Association, was formed.
In spite of the fact that black physicians had clearly proved their capabilities by the turn of the 20th century, the prevailing wisdom still held that non-whites were incapable of matching their white counterparts in terms of medical knowledge and capability. As of 1950, “white” medical schools had graduated less than 15 percent of black physicians, and there were fewer than 100 black specialists throughout the country. The years between 1868 and 1904 saw the establishment of 7 medical schools for black students; however, most of these did not survive even to the landmark Flexnor report of 1910.
Perhaps more telling was the fact that overcoming previous obstacles was not an indication that future attempts to break through cultural prejudices against racial minorities in medicine would be successful. Levi Watkins, Jr., was denied admittance to the University of Alabama School of Medicine in 1966 in spite of his exceptional academic credentials from Tennessee State University and the fact that the Supreme Court decision of Brown vs. The Board of Education had ruled 12 years before that requiring non-whites to attend separate schools unconstitutional. As a result, Watkins completed his medical degree at Vanderbilt’s School of Medicine, becoming the first African American to graduate from that medical school.
Dr. Watkins subsequently became the first black intern at Johns Hopkins University Medical School, after which he studied at Harvard Medical School’s Department of Physiology. He returned to Johns Hopkins in 1975 as the first black chief resident in heart surgery. In this capacity, he was the first surgeon to implant an automatic heart defibrillator in February 1980. Since that operation, the defibrillator has saved more than one million lives. In 2010, Dr. Watkins received the Thurgood Marshall College Fund Award for excellence in medicine.
Racial and ethnic minorities have made tremendous strides toward equality in the medical professions; however, current data show that the playing field is far from equal, and the numbers of minorities working as physicians and faculty at medical schools is far from representative. According to the American Medical Student Association in 2015, although racial and ethnic minorities comprise 26 percent of the total population of the United States, only roughly 6 percent of practicing physicians are Latino, African American and Native American. Moreover, minorities account for only 4 percent of U.S. medical school faculty members, and approximately 20 percent of these are concentrated at 6 schools – Howard University, Meharry Medical College, Morehouse School of Medicine, and 3 Puerto Rican medical schools.
Given that diversity among medical faculty is essential if the best ideas, research endeavors and innovations are to be achieved, it is imperative that the medical schools of today build on the successes of the trailblazers of the past, and embrace policies and cultures which will lead to representative inclusion in the future.