AAMC Reporter: February 2008

Echoes of Leonard Medical School Still Heard Today

Class of 1889, Leonard Medical School of Shaw University

Parking lots, construction sites, and office complex after office complex dot the landscape around South Street in Raleigh, N.C. But there's a tiny new piece of the landscape amid the whirlwind of humanity: a new, solitary sign sits beside a sidewalk, carrying a little history for anyone who cares to stop and read. It is the story of Leonard Medical School, which was once housed on this site.

One of 14 black medical schools to open after the Civil War, Leonard is distinctive in many ways. Emancipated slaves risked their lives to learn how to practice medicine here. The medical school buildings are long gone, but state historians recently planted the historical marker on South Street to commemorate the location and the school's lasting contributions to health care and medical education in North Carolina and beyond. Not only was it once part of the South's oldest historically black college, Shaw University, but it was also the first black medical school in the deep South and the only one in North Carolina. Its existence opened the door for many young black men to earn a medical education, and it gave them the opportunity to improve life for their community by treating those who previously had little or no access to medical care. The late 1800s were heady times for blacks in the United States in general and the South in particular, and Leonard Medical School and its more than 400 graduates went on to play important societal roles by leading hospitals, opening libraries, and starting businesses in the health care field.

"The Colored Christian Physician"

Black medical schools began popping up in the eastern United States in the 1880s, including the still-operating Meharry Medical College and Howard University College of Medicine. Leonard joined this group in 1882 as the brainchild of Shaw University's first president, the Rev. Henry Tupper, a white Baptist minister.

According to "The Anatomy of Failure: Medical Education Reform and the Leonard Medical School of Shaw University, 1882-1920," an article published in The Journal of Negro Education, Tupper believed strongly in a moral connection between faith and medicine. However, he faced resistance from the Shaw Board of Trustees, the majority of whom claimed to be wary of the expenses related to building a medical school. Their reluctance mirrored the hesitance in many segments of the local population, which expressed no interest in funding a school for black doctors.

Undeterred, Tupper pledged to recruit students and raise funds himself. He leveraged his belief about the medicine-ministry bond to finance the school and persuaded benefactors that the "colored Christian physician" would be the highest accomplishment of the black community and must be nurtured "In a time when there was so much animosity toward blacks in the South, black men who got through medical school were instant representatives of African Americans in the community," said Todd L. Savitt, Ph.D., professor of medical history at East Carolina University Brody School of Medicine. "Tupper believed, as he said it, that black doctors could 'do good for their race.'"

In 1882, Tupper finally raised the capital he needed, receiving a $6,000 donation from his brother-in-law Judson Wade Leonard, whose name would eventually grace the school. A few other, smaller donations and a land earmark from the North Carolina legislature helped to establish the school later that year. So, without money for adequate classroom equipment, faculty salaries, scholarships, or other resources, the first class at Leonard Medical School was in session.

Life at Leonard and Beyond

Leonard Medical School students built their own medical dormitory by hand.

From the beginning, Leonard was different from most medical schools. It was the first school, for blacks or whites, to require students to complete a four-year graded curriculum. (At the time, the unprecedented four years of training compensated for the fact that black students did not generally have the same preparatory education as white students.) Students were required to attend weekly church services, and the school put as much emphasis on how the students lived as it did on how well they learned medical tenets.

"Medical students were expected to set an example for other students on campus," Savitt said. "They had to conduct themselves as gentlemen. They had to live with integrity."

Leonard students made great sacrifices to earn their medical education. They built their own dormitories by hand, even making the bricks themselves. Families struggled to raise the $60 annual tuition. Men pored over dilapidated, books and timeworn charts and skeletons. But they studied relentlessly under their white physician professors, and many passed their board exams with higher scores than their white counterparts, according to the Journal of Negro Education article. And when they went out into their communities to practice, their doors were open to all comers.

"These men answered a call of duty. They studied to become the doctors who would treat underserved populations in both rural and urban settings," said Elvatrice Belsches, an independent researcher working on a documentary about Leonard and its graduates. "These doctors saw both black and white patients, often helping patients who had no way to pay for their services." Leonard students and officials had a watershed year in 1885, when the school opened the 25-bed Leonard Hospital. Students and their professors treated patients from across North Carolina and surrounding states, who traveled long distances for access to the care they provided.

Making Their Mark

Several Leonard students went on to make major contributions to health care in North Carolina and beyond. Leonard alumnus Aaron Moore became the first black physician in Durham, N.C., and later cofounded North Carolina Mutual Life Insurance Company, the country's largest and oldest black-owned insurance company. Lawson Andrew Scruggs, a member of the first Leonard graduating class, started a tuberculosis sanatorium in Southern Pines, N.C. Belsches said his efforts prompted the Raleigh superintendent of health to proclaim Scruggs largely responsible for decreasing the death rate in Raleigh's black community.

L.P. Armstrong graduated from Leonard a few years before it closed. He became a general practitioner for Rocky Mount, N.C., along with every other town within a 50-mile radius. He and his brother, who attended Meharry, were the only physicians treating the black population in that area.

"It didn't matter if patients could pay, my uncle saw them all and treated them with respect," said Brenda Armstrong, M.D., L.P.'s niece and associate dean for medical education and director of admissions for the Duke University School of Medicine.

Brenda Armstrong said L.P. often compared his Leonard experience to that of being in an army regiment. "He would often tell me that being a Leonard graduate— being in medicine—meant accepting the onus of leadership," Armstrong said. "He knew he was providing a service to the community that not only kept the community together, but kept them whole and moved them ahead."

Leonard's Downfall and Demise

Inadequate funding plagued Leonard from its inception. Shaw's president Tupper tried desperately to keep the school afloat, using bank loans and university coffers to cover tuition payments and faculty salaries. Tupper died without untangling the school's finances, and the school eventually closed its doors forever in 1920. Monetary troubles spelled its ultimate undoing, but Leonard historians say the decline may have been hastened by the Flexner Report, the 1910 report that called on medical schools to enact higher admissions and graduation standards while staying true to science in their teachings. The report meant medical schools would be required to incorporate more lab science into the curricula, including chemistry, pathology, and germ theory—subjects Leonard Medical School simply could not afford to teach.

"With its limited endowment and financial disarray, Leonard couldn't move past the public perception that it was an inferior medical school that should be closed down," Belsches said. "Leonard couldn't make the leap to more laboratory-based medicine, and an insufficient endowment meant the school couldn't update necessary equipment or facilities."

In a last-ditch effort, Leonard's second president, Charles Meserve, tried to secure Leonard's survival as a two-year preparatory school for students who desired to attend Meharry or Howard. Although all the schools agreed, the final needed funding fell through, and Leonard's fate was sealed.

"In its brief existence, Leonard graduated more than 400 well-trained black physicians who made a positive impact on their communities," Savitt said. "They had a major impact on health care in the South and paved the way for other black men and women who wanted to enter medicine in the future."

Leonard graduates transformed the black community in ways that transcended simply increasing the number of black physicians in the postwar South, according to research from the Virginia Center for Digital History. Local white citizens developed new respect for the students and for the black community in general, seeing them as contributing members of society. According to Brenda Armstrong, many young black men and women did the same, taking notice of the impact Leonard doctors made and went on to answer the call of medicine and healing, reviving the ongoing push to increase diversity in medical education.

—By Madeleine Evans, special to the Reporter

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