"as traditional physicians failed to demonstrate the ability to cure anyone, as democratic emotions and anti-elitism swept the nation with Andrew Jackson [1767–1845], American medicine became as wild and democratic as the frontier. (S)everal state legislatures did away with the licensing of physicians entirely. Why should there be any licensing requirements? Did physicians know anything? Could they heal anyone? As late as 1900, forty-one states licensed pharmacists, thirty-five licensed dentists, and only thirty-four licensed physicians."

"Still, by the 1870s, European medical schools required and gave rigorous scientific training and were generally subsidized by the state. In contrast, most American medical schools were owned by a faculty whose profits and salaries – even when they did not own the school – were paid by student fees, so the schools often had no admission standards other than the ability to pay tuition. No medical school in America allowed medical students to routinely either perform autopsies or see patients, and medical education often consisted of nothing more than two four-month terms of lectures. Few medical schools had any association with a university, and fewer still had ties to a hospital. In 1870 even at Harvard a medical student could fail four of nine courses and still get an M.D."

"It [the College of Physicians and Surgeons in New York City in the early 1870s] was a typical good American medical school, with no requirements for admission and no grades in any course. Instruction came almost entirely through lectures; the school offered no laboratory work of any kind. This, too, was typical. In no American school did students use a microscope. But unlike in many other schools, students at the College of Physicians and Surgeons could examine cadavers."