The 12 students who entered the classroom at Boston’s newest medical school on Nov. 9, 1848 were unlike any others in the history of Western medicine—they were all women.

In the mid-1800’s, educational opportunities for women were beginning to open up, albeit slowly. There were a handful of new women’s colleges. And women could train as midwifes or nurses. But medical school? Forget it. That all changed on the heels of the historic 1848 women’s rights convention at Seneca Falls. And ground zero for that change was right here in Boston.

Launched as the Boston Female Medical College, and later called the New England Female Medical College, it was the first female medical school in the United States—and in the world.

"It’s seen as this sort of Utopia of women doctors, women nurses, a hospital for women," said Doug Hughes, associate Dean for academic affairs at the Boston University School of Medicine. "So that’s sort of the way it’s envisioned as it starts."

The two-year program required that students have some previous schooling and—crucially—included OBGYN training, something few, if any, other medical schools were teaching at the time.  

"They graduate and they don’t know what to call them, so they call them Doctresses of Medicine,'" Hughes said. "The women resent that title and they feel it’s second rate. And 12 years later they finally start graduating women with Doctor of Medicine."

The battle for the proper title was no means the only fight for respect these trailblazing doctors would have to endure. For decades, they were not exactly openly embraced by the establishment. 

"Our medical students were not allowed to go to other hospitals to train. Our graduates were often denied jobs at sort of established hospitals," said Hughes.           

Still the New England Female Medical College continued to train new female doctors – and break new ground. In 1860, with the country hurtling toward Civil War, the medical school became the first in the nation to admit an African-American woman, Rebecca Lee Crumpler.

"There is this trepidation about accepting her," Hughes said. "Is this needlessly provoking the South or is this wise to do? They consider it wise and they admit her."

Upon graduation, she traveled south to post-Civil War Richmond, to care for some 10,000 freed slaves who were living in tent cities on the outskirts of the city.   

"She sets up a tent hospital and is taking care of these 10,000 slaves," Hughes said. "They’re having babies and dealing with illnesses. She gets typhoid, she gets malaria."

Hospitals would not admit her patients; druggists would not fill her prescriptions or sell her supplies. She was that her M.D. title stood for nothing but "mule driver."

"She gets the school to send medicine and bandages down by train to Richmond," explained Hughes. "And for four or five years she takes care of these freed slaves under deplorable conditions."

She returned to Boston, where she practiced medicine from her home in Beacon Hill, and later—after moving to Hyde Park—turned to writing. 

"She writes a textbook. The first [medical] textbook by a black physician. The first [medical] textbook by a woman. And it's sort of a combination of pediatrics and OB," Hughes said. 

On the heels of the devastating Boston fire in 1870, with many of its benefactors in financial ruins, and millions of dollars in debt, the New England Female Medical College nearly folded. They declared bankruptcy—and needed a bail out.

"Harvard is willing to take the school over," Hughes said. "It won’t take the debt over and it won’t allow minorities or women into the school."

But a new school in town, Boston University, had a better offer. They would assume the debt, and continue to admit women and minorities, but also add men to the mix.

"We become the third co-ed medical school at that point—around 1872," said Hughes.

The newly named Boston University School of Medicine would lose none of its progressive spirit, and continue to push the envelope. In the late 1880s, they trained one of the country’s first Native American doctors: A Santee Dakota Indian named Ohiyesa, who had endured intense racism during his years at Dartmouth College. 

"He feels like he’s come home," said Hughes. "He feels he’s treated with respect. He’s given a full scholarship. He excels. He becomes the orator and valedictorian of his class."

Not long after graduating, Ohiyesa went to work as a physician for the Federal Bureau of Indian Affairs, caring for Native Americans on reservations in South Dakota. He was there in December of 1889, when a scuffle over a rifle between the U.S. Army and Lakota Indians turned violent – an incident remembered today as the massacre at Wounded Knee.

"There are 326 women and children and old men that are killed," Hughes said. "Their teepees are burnt so there are no shelters for the survivors."

Ohiyesa appealed to his supervisors to allow him to retrieve the survivors. When they denied him, he took matters into his own hands.

"So he and a group of fellow men with white flags go to the massacre site," Hughes explained. "They find 51 survivors in very bad shape. They drag them back on sticks. They put them in a church, they make that into a hospital. They do amputations, there’s no antibiotics. And of the 51, 47 survive. A phenomenal feat."

Hughes says that the pioneering spirit and commitment to social justice that first spawned the school is not just a thing of the past, pointing to programs that today care for the poor, the homeless, refugees and the LGBT community.

"The school has always been a champion of social equality and social justice," he said. "The mission is very much alive. We want students who will be great doctors but will champion equality."

And it all began with 12 women—the world’s first class of prospective female doctors—whose training began at the Boston Female Medical College, 168 years ago this week.