Introduction: In this class, the stories of women physicians show diversity in the challenges they faced. The ways that different writers represent the challenges and benefits of women's medical education and professional practice reveal a deep need to demonstrate women's fitness as professionals. The barriers that they overcame demonstrate not only their skills as doctors, but also their ability to face financial and social hardship because of gender and race. In Pioneer Work, Blackwell recounts her struggle to earn money for medical school, gain preparatory education, and secure admittance to a medical college. In A Country Doctor, Sarah Orne Jewett's fictional character Nan Prince demonstrates a natural aptitude for medical study while being mentored by an ideal father-figure physician; still, her decision about whether to pursue medicine is difficult. Regina Morantz-Sanchez's brief essay gives an overview of women's entrance to medical education starting with Elizabeth Blackwell. The treatise "Letter to Ladies" by Dr. Samuel Gregory presents encouragement for women who could medically benefit other women. Finally, the biographies under "Opening Doors" and "Challenging Racial Barriers" in Changing the Face of Medicine, reveal the diverse obstacles that the first generation of women faced in obtaining medical education and establishing practices, and highlight their remarkable successes. Women's combined efforts in writing both professionally and literarily contributed to their success in entering the profession and beginning to change cultural attitudes toward women.

Primary:

• Blackwell, Elizabeth. Pioneer Work in Opening the Medical Profession to Women. London and New York: Longmans, Green, and Co., 1895, Chap. 2 and 3. Available online at http://archive.org/stream/pioneerworkinop00blacgoog#page/n43/mode/2up Available online (accessed 11/26/2012).
• Jewett, Sarah Orne. A Country Doctor. New York: Bantam, 1999, Chap. 9-12. Available online at http://www.public.coe.edu/~theller/soj/acd/acd-cont.html (accessed11/26/2012).
• Gregory, Samuel, AM, MD. "Letter to Ladies, in Favor of Female Physicians for Their Own Sex." Boston: Female Medical Education Society, 2nd ed., 1854, 3-23. Available online at http://resource.nlm.nih.gov/101183083 (accessed 11/26/2012).

Secondary:

• Morantz-Sanchez, Regina. "The Female Student Has Arrived: The Rise of the Women's Medical Movement." In "Send Us a Lady Physician": Women Doctors in America, 1835-1920. Edited by Ruth J. Abram. New York and London: W.W. Norton and Co., 1985, 59-69.
• National Library of Medicine. 2003. "Dr. Marie E. Zakrzewska." In Changing the Face of Medicine's Opening Doors. Available online at http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_338.html (accessed 11/26/2012).
• ___. "Dr. Mary Amanda Dixon Jones." In Changing the Face of Medicine's Opening s Doors. Available online at http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_338.html (accessed 11/26/2012).
• ___. "Dr. Rebecca Lee Crumpler." In Changing the Face of Medicine's Challenging Racial Barriers. Available online at http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_73.html (accessed 11/26/2012).
• ___. "Dr. Susan La Flesche Picotte." In Changing the Face of Medicine's Challenging Racial Barriers. Available online at http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_253.html (accessed 11/26/2012).
• ___. "Dr. Helen Octavia Dickens" In Changing the Face of Medicine's Challenging Racial Barriers. Available online at http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_82.html (accessed 11/26/2012).

1. For Blackwell and Morantz-Sanchez: How does Dr. Stephen Smith's account of Elizabeth Blackwell's acceptance at Geneva Medical College compare with Blackwell's own? After considering the climate in which Blackwell is writing her account of her medical school years, why do you think she chooses to emphasize certain events and downplay or ignore others?
2. For Blackwell, Jewett, and Gregory: Who are Blackwell and Gregory addressing? What is the main argument that Blackwell and Gregory share for women entering the profession? What does this argument tell us about gender behaviors and sexual propriety in middle-class America in the nineteenth century? How do these behaviors and sexual prescriptions impact women's health? Why do you think that neither Blackwell nor Gregory favors the possibility of women physicians treating male patients? What patterns emerge in women's medical education? What about in opportunities for clinical work? How do these women's educations compare with Nan Prince's experiences with gaining medical knowledge? What is Jewett's political purpose in representing Nan's experiences and abilities outside the university? How does Dr. Gregory's support of women compare with the fictional Dr. Leslie's support of Nan?
3. For the biographies under "Opening Doors" and "Challenging Racial Barriers": What are the kinds of backgrounds of the first women to enter the medical profession? How do women advance educational and career opportunities for other women? What challenges do African American and American Indian women face? How does race compound the social strictures imposed by gender? What kinds of writing do these physicians produce (fiction, medical documents, political documents)? What is the relationship of writing to their medical studies and careers?

Students read primary source materials in the archive, paying attention to their research questions. They use a table with columns with headings that read "observation," "inference," and "relevance" to a research question in order to organize and capture their research notes. Students are encouraged to write down miscellaneous and interesting information as well as full and complete notes that address the research questions to help with writing their assigned segment of the physician's biography. They produce full citations for sources used—i.e., bibliography.