The Rise of Specialties
In learning about the history of black health professionals over the past several weeks I have inquired much about the history of black specialist, and more specifically the rise in black neurosurgeons. I hope to one-day find myself practicing in the neurosurgery department; hence my curiosity which stimulated my interest in the experiences of my predecessors. How did they develop this expertise during a time of extreme racial discrimination and segregation? What obstacles did they overcome and what contributions have they made? All things I discovered in my research.
I must start off by appreciating Dr. W. Montague Cobb for if it were not for his exhaustive documentation and many contributions there would be virtually no record of the tremendous progress made by early black physicians in the certification process. The articles I examined by Cobb were published in A Century of Black Surgeons: The U.S.A. Experience V.II, but he was also the editor for the Journal of the National Medical Association, which was especially critical in helping to verify the certification of the earliest surgical specialists.
The rise in surgery, and other medical specialties in the black community, was greatly hindered by the societal forces of institutionalized racism, limiting blacks’ access to certification. In his article titled Medical Care and the Plight of the Negro, Cobb quotes, “Certification for specialties was extremely slow at first.” Medical residency was a “rare privilege”—only about fifty internships were given out for the 113 annual Negro graduates in medicine. This meant that most black physicians would settle for becoming general practitioners. Not to say that there was anything necessarily wrong with being a general practitioner, but what was wrong was the fact that blacks felt that there was nothing beyond that for them while there were endless opportunities for their white counterparts. Even once a black physician received their certification, boards would claim that there were no records of such certifications, thereupon diminishing the progress rising black physicians had made. Take for example the case of Peter Murray, the first black man to be certified in obstetrics and gynecology. When researchers went to verify his certification, the ABMS Directory of Certified Surgeons claimed that there were no records of it. Luckily Dr. Montague Cobb had documented it and so it was verified. Moreover, there was simply a lot of paranoia circling around black communities that specializing was something only whites were qualified for. Dr. William Harry Barnes once said:
… Although specialization had been gaining ground in American medicine for some years, the first specialty board was not organized until 1916 in ophthalmology and otolaryngology. Negro physicians, however, considered specialization impossible for them and many openly claimed that anyone so foolish as to attempt it would starve.
I presume Dr. William Harry Barnes did not have a heavy appetite for he soon thereafter became the first certified Negro specialist in the United States. In 1924, Dr. Barnes received board approval from the otorhinolaryngology department, and three years later on May 16th, 1927 he received his certification.
Dr. Barnes started his medical career back in the University of Pennsylvania Medical School, graduating in 1912 and then taking on an internship in the otorhinolaryngology field. After completing the internship he was appointed Assistant otolaryngologist at the Philadelphia Fredrick Douglas Hospital. It was not long before he became the Chief of the Department of Otolaryngology. He also is known for giving birth to the Society for the Promotion of Negro Specialist in Medicine (S.P.N.S.M), whose mission was to stimulate, encourage, assist and promote the development of specialists among the Negro medical profession. They had a charter detailing the qualifications for membership and the requirements associated with being a member. One of the key elements of S.P.N.S.M was that it offered seminars free of charge led by faculty for each respective specialty: surgery, internal medicine, neurology, psychiatry, gynecology, etc. Clearly this was a huge contribution made by Dr. Harry Barnes.
Cobb also wrote on the first black male neurosurgeon, Clarence Sumner Greene, and his many contributions. Greene received his education from the north also, attending both University of Pennsylvania and Harvard College, and later received his M.D. degree from Howard University. When it became apparent that Howard needed a division of neurosurgery, Greene decided to travel to Europe to receive even more schooling at the Montreal Neurological Institute of McGill University. He was giving excellent reviews after his two-year residency in Montreal and returned to Howard as the chief of its newly established Division of Neurosurgery with the rank of assistant professor. His major contribution was pioneering many of Freedmen’s Hospital’s surgical procedures: intracranial aneurysms, brain tumors, herniated intervertebral discs and sympathectomies for hypertension as well as other routine diagnostic procedures. Greene believed that education would take him farther than most during his time would ever dare to go, and it sure enough did.
The common observation is that most of the early specialist sprouted from black medical schools, such as Howard or Meharry, but as mentioned this is not the case for everyone. I believe Cobb put it nicely when he said:
I agree wholeheartedly, that our goal should be total integration. However, until such time as our men are afforded more opportunities in white hospitals, Negro hospitals that provide recognized training must prove beyond the shadow of doubt, to individuals in our respective communities that we are interested in graduate medical education, investigative work and are willing to maintain standards equal to or above those of the other group…
I believe Cobb was saying that even though hospitals are segregated, the black hospitals must be high-status, not lacking anything that white hospitals had. The fight to eliminate the disparities of black health professionals starts by empowering them and giving them a platform in which to succeed and practice medicine as they wish, and that is what the early pioneer specialist did.