Despite intimidation from male peers and powerful institutions, a group of 19th-century women led the charge for gender equality in medicine education.
In March 1869, Sophia Jex-Blake had just been rejected from medical school, and not because her grades weren’t good enough or because she stumbled through her interview. Jex-Blake had been rejected from the University of Edinburgh for a reason she found morally outrageous: because she was a woman.
She could have accepted the rejection and moved on, but Jex-Blake fought back — and turned the tides for women in medicine for decades to come.
Born in England in 1840, Jex-Blake had a comfortable upbringing, attended private schools, and eventually enrolled at Queen’s College in London despite her parents’ protests. At 21, she travelled to the US and worked for a time as an assistant at the New England Hospital for Women and Children in Boston, where she met a woman who changed the course of her life: Dr Lucy Ellen Sewall. A pioneering female physician, Sewall inspired Jex-Blake to pursue a career in medicine. But when Jex-Blake moved back to the UK, she found that no English medical school would admit her, so she journeyed north across the rolling border to try her luck in rugged Scotland.
Scotland was no more accommodating than England. Jex-Blake wrote to Professor J.J. Balfour, Dean of the Medical Faculty at the University of Edinburgh, for permission to attend medical lectures during the summer. Her request went to a vote. Many members of the faculty supported her — some, it must be noted, stipulating that they would only support her to study obstetrics and gynaecology. Others, like Professor of Materia Medica and Therapeutics, Robert Christison, stated that professional standards would be lowered if the university were to train women, who he believed had naturally poor intellectual ability and stamina. Surgeon William Walker thought a co-ed class would be “repugnant to patients” and argued that “many examinations and operations are offensive in nature and could not be undertaken before a mixed class without violating the feelings of propriety and decorum.” This opposition was bolstered by a petition signed by 200 male students.
The University Court finally declared that the university could not possibly change their teaching practices “in the interest of one lady”; they assumed that Jex-Blake must, of course, be taught anatomy and surgery separately to male students.
The genesis of the Seven
Jex-Blake took the rejection as a challenge. With the support of with her friend and professor of literature at Edinburgh, David Masson, Jex-Blake approached The Scotsman and other newspapers to encourage more women to join her petition. If enough were interested, she figured, the university would run out of arguments.
One of the first women to respond was Edith Pechey, who wrote humbly to Jex-Blake:
“Do you think anything more is requisite to ensure success than moderate abilities and a good share of perseverance? I believe I may lay claim to these, together with a real love of the subjects of study, but as regards any thorough knowledge of these subjects at present, I fear I am deficient in most. I am afraid I should not without a good deal of previous study be able to pass the preliminary exam.”
In fact, when she took the entrance exam in 1869, Edith Pechey achieved the highest mark of students sitting the exam for the first time. She was among five women who took the exam, including Jex-Blake, along with 145 male candidates. These five women were the first members of the Edinburgh Seven: Sophia Jex-Blake, Isabel Thorne, Edith Pechey, Matilda Chaplin and Helen Evans. Mary Anderson and Emily Bovell joined shortly afterwards. The Seven didn’t know it at the time — or perhaps they suspected — but they were trailblazers for the equal education of women. Together, they were the first women to matriculate at a British university.
In a letter to Lucy Sewall, Jex-Blake wrote:
“It is a grand thing to enter the very first British University ever opened to women, isn't it?”
Unfortunately it wasn’t smooth sailing from then on. The university was adamant that the women had to be taught in separate, smaller classes, and must therefore pay higher tuition fees. Moreover, teachers were permitted — but not required — to teach women, so the Edinburgh Seven had to arrange lectures for themselves.
Jex-Blake took up the mantle of ringleader, organising lectures and tutoring the other women in mathematics. The Seven proved to be personally and intellectually matched to the discipline of a medical degree, and conducted themselves professionally even in the face of hurdles. Their classes were graded differently, even though the Seven frequently outperformed the men in open exams, which meant that their scholarship opportunities were severely depleted and they were ineligible for academic prizes.
Their exemplary grades also led to overt tensions with their male counterparts. A growing pack of male students — likely goaded by professors — began to act “markedly offensive and insolent” in a growing campaign of intimidation, as Jex-Blake later wrote. Their aggressive behaviour included “shutting doors in our faces, ostentatiously crowding into the seats we usually occupied, bursting into horse-laughs and howls when we approached — as if a conspiracy had been formed to make our position as uncomfortable as might be.”
The insolent students regularly followed the women home, wrenched off Jex-Blake’s doorbell, damaged her nameplate, attached a firework to her door, and sent the women filthy letters. In a letter to The Scotsman, Edith Pechey wrote of having “the foulest epithets” like whore shouted at her in the streets. The women took precautions; they stayed home at night and did not go onto campus alone.
On one horrific occasion in 1870, the Seven attempted to attend an anatomy exam at Surgeons’ Hall on Nicolson Street and found the road blocked by over 200 male students and locals, hurling insults, handfuls of mud and bits of rubbish at them. But these women were nothing if not stubborn, and they struggled through the mayhem only to find that the gate to the examination hall was locked. Eventually, a sympathetic fellow student hurried to unbolt the gate for them. The disruption didn’t end there; chaos reigned when the rioters threw a live sheep from the medical faculty into the exam hall.
A widening circle
Turns out having trash chucked at you has a silver lining: people begin to take notice. Many male students were horrified with the way the women were treated and began to act as informal bodyguards, escorting them to classes and walking them home. The riot against the Seven was also covered by Edinburgh newspapers and drew much public attention — and support. The Scotsman urged all men to come forward and express “their detestation of the proceedings which have characterised and dishonoured the opposition to ladies pursuing the study of medicine in Edinburgh”. And people did. Supporters founded a General Committee for Securing a Complete Medical Education for Women; among its 300 influential members was Charles Darwin himself. The committee helped to plan the women’s campaign and fundraise for it.
Then in 1873, after having passed all of their final exams — and paid their extravagant tuition fees — the university ultimately denied the Edinburgh Seven their degrees. Apparently, regulations prevented women from serving in wards. The Seven and their supporters fought this, appealing to higher courts, but the decision was upheld. The University Court, in fact, rather belatedly decided that the women should not have been admitted to the university at all.
After all this time and effort, the Seven refused to be thwarted. “I believe that it was the seed sown in tears in Edinburgh that was reaped in joy elsewhere,” Jex-Blake declared later in her 1886 book Medical Women, and indeed their accomplishments at Edinburgh served to rebuke assumptions about women’s intelligence and show that women are more than competent to work in medicine. After this loss in Edinburgh, the Seven took the battle elsewhere, helping to pave the way for women in medicine around the world.
Jex-Blake moved to London in 1874 to help set up the London School of Medicine for Women, alongside Elizabeth Garret Anderson and Elizabeth Blackwell, who was the first woman to achieve a medical degree in the US. While continuing to campaign and study herself, Jex-Blake began to train the next generation of female doctors. But although the school provided classes, there was still nowhere in the UK that allowed women to sit their exams for their medical licence.
Then came a breakthrough: the UK Medical Act of 1876 was passed, allowing all qualified applicants — regardless of gender — to obtain a medical licence in the UK. The College of Physicians of Ireland was the first organisation to take advantage of this new law, but before she applied to them, Jex-Blake went with Pechey to complete her MD in Bern, Switzerland in 1877. They finally sat exams four months later in Dublin, Ireland, and became recognised throughout Britain as registered doctors.
Shortly after, Jex-Blake left the London School of Medicine for Women in the capable hands of Isabel Thorne, another member of the Edinburgh Seven, and returned to New Town in Edinburgh to become the city’s first female doctor. Jex-Blake set up a clinic for poor patients, and eventually — once women were legally allowed to obtain a medical licence in Edinburgh — was integral in founding the Edinburgh School of Medicine for Women. She also established the Edinburgh Hospital and Dispensary for Women: Scotland's first hospital for women that was entirely staffed by women.
The other members of the Edinburgh Seven also went on to do great things in their beloved profession. Edith Pechey practiced in Leeds before moving to Mumbai to become a senior medical officer at the new Cama Women and Children’s Hospital, where she also started a training programme for female nurses, campaigned for equal pay for women in medical professions, and sponsored one of the first female doctors to practice in India, Rukhmabai. Upon Pechey’s death in 1908, after her decades of campaigning for social causes, her husband set up a scholarship at the London School of Medicine for Women, which was granted regularly for the next 40 years.
Bovell and Anderson worked at London’s New Hospital for Women, and after founding a midwifery school in Tokyo Chaplin gained her MD in Paris, sat exams in Ireland, and set up at a private practice in London. Neither Thorne nor Evans were able to complete their studies, but they worked in administration roles at the London and Edinburgh Schools of Medicine for Women respectively, continuing to oversee new generations of female doctors for years to come — including two of Thorne’s own daughters.
Persistence, bravery, passion and undeniable stubbornness were the traits that carried the Edinburgh Seven through. Their unyielding struggle focused attention on the plight of women in education at the time, and set the wheels of progress in motion to pass legislation not only to allow women to obtain degrees from UK universities, but also to obtain medical licenses. These effects weren’t localised to the UK — the campaigning and educational experience gained by the Seven at Edinburgh gave them the tools to directly take the fight across the world to places like India and Japan, parallel to other changes in society that were occurring as a result of first-wave feminism that secured women the right to vote.
Labour shortages during the first and second world wars meant that the number of women studying medicine grew by necessity, but restrictions — such as limits on the number of women allowed in courses and marriage bars preventing women from pursuing a career once married — still meant that female doctors were by far the minority for most of the twentieth century. Today, the old medical patriarchy is dissolving and the proportion of women entering medical schools is higher than ever before — Australia reached gender parity in medical schools in the year 2000. However, the percentage of women and men practising medicine is only just becoming equal, and men are still holding onto the top jobs.
As for the University of Edinburgh? Well, it resisted the waves of change. It began to allow women to graduate — 25 years after Jex-Blake’s initial application — and its first female doctors graduated in 1896. One last kick to the teeth, though: they still had to organise their own classes.
Edited by Nathan Mifsud and Diana Crow