Doctor of medicine profession (MD)

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Types of health care providers

To address numerous abuses within medical education, a national convention was held in May 1846. Proposals from that convention included the following:

• The creation of a national medical association
• The adoption of uniform higher educational standards for MDs, including suitable courses of premedical education
• A standard code of ethics for the profession

On May 5, 1847, nearly 200 delegates representing 40 medical societies and 28 colleges within 22 states and the District of Columbia convened and resolved themselves into the first session of the American Medical Association (AMA). Nathaniel Chapman (1780-1853) was elected as the first president of the association. The AMA was maintained and has grown to become a formidable organization capable of exerting a great deal of influence on issues related to health care within the United States.

Initial educational standards for MDs, set by the AMA, included the following:

• A liberal education in the arts and sciences
• A certificate of training completion from the preceptor over apprenticeship prior to medical-college entrance
• An MD degree that encompassed 3 years of study, including two 6-month lecture sessions, 3 months devoted to dissection, and a minimum of one 6-month session of hospital attendance

In 1852 the standards were revised to incorporate additional requirements:

• Medical schools had to provide a 16-week course of instruction that included anatomy, medicine, surgery, midwifery, and chemistry.
• Graduates had to be at least 21 years of age.
• Students had to complete a minimum of 3 years of study, 2 of which were under an acceptable practitioner.

Between 1802 and 1876, 62 fairly stable medical schools were established. In 1810, there were 650 students enrolled and 100 graduates from medical schools in the United States. By 1900, these numbers had risen to 25,000 students and 5,200 graduates. Nearly all of these graduates were white males.

Daniel Hale Williams (1856-1931) was one of the first black MDs. After graduating from Northwestern University in 1883, Dr. Williams practiced in Chicago and was later a primary force in establishing Provident Hospital, which still serves Chicago's South Side.