Residency Training in Black Hospitals

Presented by: Maya Wright

Major Setbacks

Race Relations White hospitals did not take on

Black residentso In 1930 no residencies available to

African Americans in any specialty field (60)

o 1939 - fewer than 25 Black specialists Most Blacks excluded from

residency programs before the 1950s (72)o 1947 - 18 out of 18,000 board certified

specialists were Blacko In many hospitals in the north, Black

nurses and patients were allowed, but not doctors

o People did not want Black men working over white nurses or operating on white people especially white women

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Race Relations Inability to take boards

o Blacks especially in the South not able to become members of American Medical Association

Limitations on residency optionso Some hospitals only offered

certain specialties to Blacks that were sufficient for Black people

Distrust in Medical Communityo Because of lack of opportunities to

continued education patients and white physicians believed Black physicians were not as qualified as white physicians

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Financial Support By 1958 there were adequate number of

residencies available for Black physicians predominantly at white hospitals but Blacks chose not to attend because not paid enougho Many Blacks incurred debt during college and medical

school and low paying residency was not a viable option Not financially viable in Jim Crow South

o Many specialists denied hospital accesso Tension with Black general practitioners who felt

threatened and would not refer patients, would send them to white physicians

o Potential patients could not afford specialty fees

Influential Hospitals

Important Hospitals Freedmens Hospital, Washington DC

o Daniel Hale Williams pioneered an internship program

Kate B. Reynolds Hospital Winston-Salem North Carolinao Built from funds from Reynolds and Duke

tobacco familieso Provided internships for white and black

physicians Harlem Hospital, New York Meharry Medical School Lincoln Hospital Durham North Carolina

o Began training residents in surgery in 1948-close association with Duke medical school

Homer G Phillips, St. Louis Missourio 500 bed, staffed entirely by black

physicians St. Mary’s Infirmary, St. Louis, Missouri

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Freedmen’s Hospital

Influential Hospitals Wheatley-Provident Kansas

City, Missouri Hubbard Hospital, Nashville

Tennessee, Taborian Hospital Mound

Bayou, Mississippi Harlem Hospital Harlem

New York US Marine Hospital , Boston

Massachusetts Provident Hospital, Chicago

o One of the First hospitals to provide intern training for blacks

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Taborian Hospital

Influential People

Pioneers Dr. Daniel Hale Williams

o Pioneered intern program at Freedmen’s hospital which served as a model for other hospitals and helped to establish Washington DC as the center of the Black medical profession

Dr. Matthew Walker of Meharryo Asked to be chief surgeon of Taborian

hospital, turned the position down but implemented a plan that provided the hospital with surgical residents and interns from Meharry at a rotating basis

o 2 residents served four to six months stints as chief surgeon and assistant and 24 meharry seniors served 2 week shifts as interns

o Also trained locals to become medical technicians

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Pioneers Dr. John J Mullowne Meharry

Presidento Proposed idea of selection one or

two outstanding students to receive special training at a premier medical school or hospital under the understanding that they came back to teach at Meharry

Dr. Numa P. Adams dean of Howard Medical Schoolo Made a great effort to secure

clinical specialists for Howard’s faculty

o Helped to make Washington DC center of black medical community

o Also sparked national desire for more Black physicians to seek residency training

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Institution Changers Dr. George Thorne

o Sought admittance to the American College of Surgeons (ACS) did not put race on application but when the board found out he was black denied his application on grounds that that they were not conferring black members at that time

o Caused a firestorm, prompted New York governor Thomas Dewy to investigate ACS’s refusal to admit black surgeons

o ACS quickly amended the policy, and stated black physicians did not need to be members of AMA if the region where the practiced excluded them

o 14 black surgeons were soon after elected to the fellowship

Institution Changers Dr. Hubert Eaton

o In 1957 rejected from American Academy of General Practice because he was black and not a member of AMA or its local chapter in North Carolina

o Applied again in 1971 was again denied because he was not a part of AMA even though AMA now dropped racial bars• Did not want to join because of the past discrimination he had

experiencedo Wrote to the American Academy of General Practice

questioning is ethics and legality in denying southern black physicians

o Soon after Academy amended to accept those who were members of NMA

o Finally joined in 1972, 15 years later

Important Institutions

Federal Government Intervention

Hill-Burton (1946)o Legislation that provided

millions of dollars in federal grants to states to build and improve hospitals on the condition that hospitals provided service without discrimination account to race creed or color

Office of Economic Opportunity o helped to fund and Support

Taborian Hospital and its residency and internship program in Mound Bayou Mississippi

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Philanthropy Rosenwald Fund

o Helped fund countless black students, nurses, physicians, dentists, pharmacists through fellowships

o More specifically provided the first 6 fellowships for Dr. Mullowney of Meharry’s specialty training program

Duke Endowmento Provided money to build black

hospitals Rockefeller Foundation

o Provided money to build black hospitals, and train black professions so that black community could be attended to and kept healthy and separated from white community

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Harlem Hospital

General Timeline 1919 Louis T Wright first

black physician appointed to the medical staff

1926 First Black interns appointed

1934 Department of Surgery offers one-year surgical residency after externshipo 1943 Louis T Wright appointed

Director of Surgeryo 1952 Aubrey de L. Maynard

appointed Director of Surgery 1965 Urology Residency

Training Program approved 1966 Orthopedic Residency

Program approved

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Louis T Wright served as the crack in the door appointment through who other blacks were given a chance

After appointment of black interns in 1926 racial tensions rose for the next several yearso As a result of protest and persistent pressure from black physicians

like Louis T wright the entire medical board and staff of Harlem Hospital was fired and new one appointed to replace them• firing 23 white doctors and 2 black

o 12 black doctors, 7 black in patient staff• Physicians were assigned according to qualifications therefore making its

mark in history as being the first American hospital to function with a racially integrated professional staff

o As a result other hospitals in the area began to follow Harlem's example

In 1934 the first residency program was a one year program following and internship

In 1945 Louis T Wright directed the new four year surgical residency program

Later in 1953 the surgical residency program was increased to five yearso In combination with New

York University Postgraduate Medical school, residents would enroll annually in the post graduate course in surgery

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Homer G Phillips

General Timeline 1919 City Hospital

No. 2 opens 1927 City Hospital

No. 2 receives approval for a surgery program from AMA

1937 New City Hospital N. 2 Opens and renamed Homer G Phillips

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When City Hospital No. 2 opened, dedicated to the care of indigent black patientso Also an institution where black physicians

could receive formal accredited postgraduate training,• The only others during this time were

Howard, Meharry, Harlem Hospital, and Provident Hospital

Supervised by a white mano Black staff occupied associate staff

members, functioned under the attending white staff no matter their qualifications

The Peoples Hospital and St. Mary’s infirmary were institutions that worked in conjunction with City Hospital No.2 and Homer G Phillipso People's Hospital would also take part in

the surgical program in Homer Phillips Hospital • Was integrated from it’s inception, but

predominantly black• For many years the only place where black

physicians ad surgeons could treat private patients in St. Louis

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Homer G Phillips Hospital's conception was a result of the dismal conditions of City Hospital No.2o Opponents mainly white did not

want the hospital to be built but instead wanted the money to be used to build an annex to City Hospital No.1 which was the white hospital

o The argument being that annex would “serve” black patients

o Homer Phillips the young black lawyer leading the drive for the establishment of the hospital wouldn’t budge understanding that if the annex was created instead black physicians would not have the opportunity to practice or pursue post graduate education

o Homer G Phillips Hospital was successfully opened in 1937

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Homer G Phillips Hospitalo Physicians were able to treat

patients regardless of the race and supervision of white physicians was no longer required

Residencies offered included gynecology and obstetrics, orthopedics, urology, otolaryngology, internal medicine, pediatrics, and surgeryo Training in surgical subspecialties

were part of general surgery service

o General surgical residents were responsible for the care of patients who needed subspecialty surgical care

Homer G Phillips also worked closely with Washing University Hospital

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Reference Ward, Thomas J. "Post Graduate Education." Black

Physicians in the Jim Crow South. Fayetteville: University of Arkansas, 2003. 59-93. Print.

Organ, Claude H., and Margaret M. Kosiba. A Century of Black Surgeons: The U.S.A. Experience. Norman, OK: Transcript, 1987. Print.