The Jewish Problem in U.S. Medical 0 0 ~ Education, 1920-1955 ::, 0 OJ C. (1) EDWARD C. HALPERIN C. g 3 N 1959 Saul Jarcho conceded: "it must be admitted ~it-----~u that the evidence of d1scrimmatory admission prac­ tice by medical schools [directed against ] is not of the precision or concreteness which the historian requrres." 1 In this essay I argue that, on the contrary, the nature and extent of U.S. medical school adm1s- s10n quotas during the first half of the twentieth century can be thoroughly documented. Leaders of U.S. medical schools rationalized their objections to the adnuss1on ofJewish students on the grounds of proportional representation as well as the classic anti-Semitic ca­ nards of Jewish defensiveness, bookishness, poor manual dexterity, and avarice. The Jewish community, in response, was divided between those who accepted the quota and those who vigorously fought back. Here I examine the historical evidence concerrung the quota, how it was justified, and the nature of the Jewish community's response.

A QUOTA IS PUT IN PLACE Twentieth-century United States quotas restricting the access ofJew­ ish students and physicians to medical school and postgraduate training

1. Saul Jarcho, "Medical educanon m the Uruted Stace.s- 1910-1956," J Mount Sinai Hosp ., 1959, z6, 339-85, p 358

Th1S project was supported by a grant from the Josiah Charles Trent Foundanon Suzanne Porter of the Trent Library, Duke Uruversity Medical Center, rruide many helpful sugges­ noru. Rabbi John Fnedman helped clanfy my understanding of Rabbi Moms Lazeron and the non-Zmmst movement. The staffi of the Amencan Jewish Archives m Cmcmnan, Oh.10; the Archives of the JeW1Sh H1Stoncal Soaety of Metrowest, Whippany, New Jersey, the SpeCJal Collecooru Secooru of the library of the Uruversity of Medicine and Dennstry of New Jersey, Newark, New Jersey; Southern H1Stoncal CoUecnon, Chapel Hill, North Carolina; and the H1Stoncal Center for the Health Sciences of the Uruversity of Mlclugan, Ann Arbor, M1ch1gan, were very helpful.

C 200 I OXFORD UNIVERSITY PRESS ISSN 0022-5045 VOLUME 56 PAGES 140 TO 167

[ 140 ] Halpen'n : Jews in U.S. Medical Education 141 were a response to the massive wave of Russian Jewish immigrants at the beginrung of the twentieth century and the interest of these munigrants and their children in medical education. From r 880 to 0 the begrnning of the First World War in 1914, two million Russian 0 ~ Jews immigrated to the United States, joining about 400,000 Jews :::, 0 OJ already in the country. Following World War I and the , C. Cl) the United States saw a rise in nativist feeling and a growth in C. 0 organizations hke the Ku Klux Klan that targeted popula• on groups ""3 2 ::,- with foreign roots. Overt anti-Jewish in the academic -ff community in the United States reached its zeruth when the children g:(/) of these eastern European Jewish immigrants began to enter college £ C. in large numbers. By 1902, for example, 90% of the undergraduates Cl) 3 at City College of New York were Jewish. 3 i:i" 0 C From 1900 to 1922 the proportion of Jewish students at Harvard ""O (") College rose from 7 percent to 21 percent. President A. Lawrence 0 3 Lowell, along with some members of Harvard's governing boards, "§; 3 OJ alumni, and faculty, noted this increase with grave concern. Lowell (/) Ql disapproved of unnugrants who fatled to merge into his image of ;l. o· mainstream America. Lowell had been an officer of the Boston-based io Immigration Restricoon League and was concerned that superior e:ui ~ Anglo-Saxon culture nught be undermined by excessive Jewish repre­ .i,. 0 sentation in the college.4 In 1922 Lowell told Harvard's graduates that ::;j .i,. 0-, "if every college in the country would take a linuted proportion of 0-, u, CD O" '< 2 Ceo) Roth, A Short H1Jtory of the Jewish people (Hartford, U.K : Harttnorc House, z Cl) 1969) pp 386-89; Abraham Leon Sachar, A H1Jtory of the Jews , 5th ed (New York. Al&-ed ~ A Knopf, 1967), Bernard Maron, A Hutory of Juda1Jm, 2 vols (New Yorlc· BasJc Books, -< Q 1974), II , 319-48; Seymour Rossel, joumry tlzrough J=h Hwory The Age of Fa,th and the 7'" Age of Freedom (New Yorlc Berman House, 1983), pp. 95-97; Rufus Lcam (pscud for s: Cl) Israel Goldberg] , 771e]ews m Ammca A H1Jtory (Cleveland World Pubwhmg Co, 1954), C. p 125 ; Paul Borchsemus, 77u History of the Jews, 5 vols (New York. Simon and Schuster, o· Q!. 1965) IV, 149-76 0 3. Sheny Gorelick , Cay College and the Jewislz Poor (New BrunsWick, NJ Rutgers Q_ io Umvers1ty Press, 1981) , p. 85, Heywood Broun and George Bntt, Christians Only A Study co m fujudlle (New Yorlc: Vanguard Press, 1931), p 72; Kenneth CoU1ns, Go and uam The Cl) C lntemat1otu1/ Story of Jews and Med1e1tll'. m Scotland (Aberdeen: Aberdeen Umvers1ty Press, (/) 1988) , p. 100 ~ 0 4 Seymour Mamn L1psct and Everett Carl Ladd, Jr. , "JeWJSh academics m the Uruted :::, N States," m MarshaU Sklare, ed , The Jew m Ammcan Socuty (New Yorlc Berman House, co 1974), pp. 255-89, M:ucu G Synott, "Ano-Senunsm wd Amencan uruversines: did quotas L C foUow the Jews' " m DaVId A Gerber, cd Ant1-Scm1t1sm in Ammcan History (Urbana­ '< Champa1gn Uruvemty of lllinoJS Press, 1986), pp. 233-70, Henry Aaron Yeomans, Abbott N 0 unvrrna Lowd/ 1856-1943 (Cambndge, Mass Harvard Umversity Press, 1948), p 209; N ~ Leonard Dmnerstem, Ant1Jmlll1Jm m America (New York: Oxford University Press, 1994), p 85 . ..

I 42 Journal of the History of Medicine Vol . 56, April 2001 Jews we should go a long way toward elirrunating race feelings among students and, as these students passed out into the world, eliminatmg 1t in the community."5 Lowell suggested a quota and rationalized his 0 views by arguing that a large Jewish presence on the campus would 0 ~ increase anti-Semitism in the student body and cause Genttle students :J 0 Ill not to attend Harvard.6 a. (I) a. Harvard's Board of Overseers appointed a committee to consider a the quota proposal. A faculty committee recommended that "in the 3 admirustration of rules for admiss10n Harvard College maintains its -s:::r traditional policy of freedom from on grounds of race g:en 7 C) or religion." The faculty committee voted against a formal quota, Ill a. 8 (I) as did the board. An unofficial program of educational access restnc­ 3 o· tion was, however, adopted and spread to many colleges, uruversities, 0 C and professional schools. Nicholas Murray Butler, president of Co­ 'O 8 lumbia Uruversity, also supported a policy of "selective adnussions" 3 to limit the admission of Jews m favor of his perception of an elite ~ 3 9 Ill "natural consti tuency." Butler said that he had "not elirrunated boys en CJ because they were Jews and do not propose to do so. We have honestly ~ ff CD attempted to elimmate the lowest grade of applicant and it turns out c:;; that a good many of the low grade men are New York Jews." 10 ~ ~ The pressure of Jewish applicants was particularly strong among .j:,. £2 potential medical students. In 1927 Dean Hugh Cabot of the Univer­ ---J .j:,. 0) sity ofMidugan advised Uruvers1ty President C.C. Little that, because 0) U1

York, Denver, or Los Angeles. 11 This personal interview was used at Michigan and other schools to exclude Jews on the basis of their havmg an unacceptable personality. One medical school dean con­ 0 0 curred on the usefulness of this technique in Justifying Jewish exclu­ :;: sion: "It is a fairly tenable fact that . . . personal acceptability and :::, 0a, C. magnetism . . . 1s less prevalent among the Jewish class, from which (1) by far the large number ofJewish applicants is bemg recruited, than C. 0--- among the entire list of applicants as a whole." 12 3 Cabot's new policy included the addition of an admissions test as ::::r -sen well as a short essay on a nonmedical subJect along with the interview. g: (") In the first year of the new policy, 49 percent of Michigan's initial a, C. (1) applicants did not present themselves for mterv1ew and examination. 3 c;· The .reduction was particularly noticeable m New York, the major 0 C source ofJewish applicants.13 A 1946 review of thirty-nine U.S. medi­ -0 8 cal school application forms showed that all asked the applicant's 3 religious preference or affiliation, ten asked for the religion of the "§: 3 a, applicant's parents, fifteen asked the parents' race, and eleven inquired en o, if the family name had ever been changed. Similar questions were ;:I, ff ro also used on college applications to screen for Jews, Catholics, and u'i African Americans.14 Ernest Hopkins, president of Dartmouth Col­ ~ ~ lege, summed up the reason for these questions: "Any college which .j>. e -..J is going to base its admissions wholly on scholastic standing will find .j>. Ol itself with an mfinitesimal propomon of anything else than Jews Ol Ul 15

only two Italian Cathohcs and take no blacks at all." 16 A letter of rejecnon to a Jewish applicant to the medical school ofLoyola Univer­ sity in Chicago read simply: "I am sorry to have to inform you that your application for admission to the School of Medicme cannot be acted upon favorably because the quota for Jewish students has been filled." 17 Additional confirmation of the implementation of Jewish quotas can be found m documented events at other medical schools. In the early 1930s Arthur Bernstein, an undergraduate at the University of Pennsylvarua, applied for adnussion to the university's medical school. He described his meeting with Dean William Pepper: The dean said to me: "[ nught as well tell you nght now that you do not have a chance here because we took m the ten Jewish boys that we always take m and that is our quota. We also take ten Cathohcs and the rest are Protestants." I said, "That's not fau," and we got mto an argument and he said: "Why 1s 1t that JeWISh mothers always want their sons to be doctors?" I said: " Dr. Pepper, you're wrong. That's not true. My father wants me to be a cantor, my mother wants me to be a rabbi. I want to be a doctor." Finally, after about forty nunutes, he said, "My God, tlus was supposed to be a fifteen nunute mterview. Get out and don't ever come back." 18 Berrutem did not give up Without a fight, however. He took his case to the president of the alumni association, a non-Jewish physician, who said, "'What! With these grades they didn't take you?' He sat down and dictated a letter in wluch he said, among other dungs: 'I had no grades anywhere near th.ts good when you took me in. I can assure you that if you don't take him in, you will never get another penny from the alumnae of the Newark area.'" Bernstein was adrrut­ 19 s:: ted, and attended the school. (1) Q. Among the most dramatic demorutratioru of the quota occurred o· ~ at the University of North Carolma at Chapel Hill (UNC). The 0 Q. ro UNC Medical School was a two-year program under the direction co (1) of Dean Isaac Hall Manning from 1905 to 1933 . Manning faced C (/) constant difficulty sustaining UNC's two-year medical college. The ~ 0 ::, N co 16 Dm A Orcn,Jommg 1/u: Club. A H,story ofJews and Yale (New Haven, Conn Yale '­ c Uruvemty Press, 1985), pp 136-58, 249-57, p. 148 '< N 17. Quoted m Broun and Bntt (n 3), p. 130 0 18 . Quoted m William B Helmreich. 771e Endunng Communuy Tiu:jnvs of Newark and N Mnrowest (New Brunswick, NJ. Transacoon Publishers, 1999), p 92. 19. Ibid. Halperin : Jews in U.S. Medical Education 145 tightening of standards for medical education substantially reduced the total number of medical schools m the United States between 1906 and 193r. By the 1930s, the eleven remaining two-year medical colleges m the United States found it difficult to attract and hold 0 ~ faculty. 20 With no hospital facilit1es or sites for clinical training, the :::, 0 Ql two-year schools were dependent upon four-year medical schools to 0. (1) 0. accept their students for the final two years of cltmcal training. Man­ a rung labored hard to place his graduates. For Manning, the success 3 of his transferred students was a measure of the success of his school.2 1 .g::;,- "It is vital to the existence of this school to transfer only such students tCJ> (') that can and will hold their own in the schools to which they are Ql 0. transferred," he wrote.22 The problem of the Jewish student was, in (1) 3 Manrung's view, serious: ff 0 C 'O Shortly after the World War large numbers were applying for admiss10n - 8 enough as a matter of fact to pracncally swamp the schools. Many were 3 =::;,- exceedingly objecnonable students. Very few were North Carolm1ans and 3 Ql m no instance had a North Carolina JeWJsh student been refused admission CJ> tu to the Medical School 1f he met' the entrance requirements. There is no ;::i. ff prejudice against Jews as such in a medical school. A number had been ro ui admitted and on the whole were acceptable students. Nevertheless, they (]) had to be admitted m couples as m several of the laboratories the students § +>- 0 worked together in couples and only rarely would a Jew and a Gentile ~ 23 +>­ work at the same table. (]) (]) c.n Cha~/ Hill . 1/1e First Hundred Yean (Chapel Hill Uruverstty of North Carolma School of ~ 0 Med1ane, 1979), p 28, Edward C. Halpenn, "Frank Poner Graham, Isaac Hall Mannmg, :::, at N and the jeWISh quot.a the Umvemty of North Carolma Medical School," N C Hist CXl Rev, 1990, 67, 385-410 '-­ c 22 Isaac Hall Manning, "HIStory of the UNC School ofMedtcme, 1879-1937," unpub­ '< lIShed 1TUJ1uscnpt (ca. 1940), Isaac Hall M:mrung Papers, 1866-1946, Southern HIStoncal N 0 Collecoon, Uruverstty of North Carolina at Chapel Hill, Clupel Hill, North Carolma N 23 Ibid. 24 rbtd. 146 Journal of the History of Medidne Vol . 56, April 2001 applied for adnussion to the medical school and was refused by Manrung. Manning wrote that "the refusal was entirely on the ground that 4 Jewish boys had already been adrmtted, and in the judgment of the Dean, this was as many as he could hope to transfer."25 Krasney's attorney contacted the president of UNC, Frank Porter Graham. Graham was a man of strong character with an uncompromising belief in democratic and Christian ideals and a strong commitment to .26 He reviewed Manning's pohcy and decided It was a matter of institutionalized anti-Semitism which could not be tolerated at UNC. He felt that any state citizen who was qualified for adrmssion to medical school was entitled to a place irrespective of his religion. When Manrung refused to admit Krasney, Graham ordered Krasney's adrrussion and accepted Manning's resignation. This appears to have been the only episode of a U.S. med.teal school Dean losmg his job over the issue of Jewish quotas.2 7 By 1941 the medical historian Henry Sigenst concluded thatjeWish medical school applicants were subject to an effective quota. Sigenst noted that the medical faculties of European universities adnutted all students who could satisfy the entrance requirements. If the number ofstudents increased, then the medical school was supposed to respond by enlargmg its faculty and facilities. In contrast, according to Sigenst, U.S. schools limited the number of students accordmg to the facilities available.

While there undoubtedly are advantages m havmg a small, carefully selected body of students instructed m small groups by a large faculty, the system has led to senous discmninations, and has provided an easy pretext for racial and other preJud1ces .... colored students are segregated mto two s:: colored schools (Howard, Meharry) and only very few of them are adnutted (I) a. incidentally to northern schools where their position 1s far from enviable. o· ~ .. . Jewish students are subject to a tacit, but nevertheless highly effective, () Q_ quota-system and m most schools the number ofJewish students admitted iD cc rarely exceeds 10 per cent of the total enrolment [s1c] .28 (I) C: (/) ~ 0 ::, 25 . Ibid N 26. Warren Ashby, Frank Porta Graham A Southmi ubaal (Winston-Salem, NC : John 00 '­ F. BL=, 1980). c: '< 27 Halpenn (n. 21) N 0 28 . Henry E. S1gcrut, "Trends m medical eduol:lon. a program for a new medical school," N Bull Hw Med , 1941, 9, pp 177- 198 , p 181 ~ Halpen·n : Jews in U.S. Medic.al Education 147 Women suffered d1scrim.ination as well. S1genst did not conunent on the obvious exception to European hberalism, the absence of Jewish students in German medical schools. A long essay on "Jews in America" appeared m the January 1936 0 ~ issue of Fortune magazme that summed up the situation in the Uruted ::, 0 States. The unsigned article observed that m medicine Qln. (ll n. Jews do not occupy a pos1t1on of power correspondmg to their abilities or a their numbers in the profession. Hospital med1Cal boards and the hke are 3 apt to be controlled by non-JeW1sh doctors . ... of apprmamately 14,000 young men and women attemptmg annually to enter the seventy-SI)( reputa­ ble U.S. medical schools 50 percent are Jews whtle of the 6,000 more or less who get m only 17 percent are Jews.29 The article cited opposmg explanations for tlus phenomenon: Non-Jewish doctors cite these figures as proof of the danger of JeW1sh aggressiveness and commerc1ahsm m the profession while Jewish doctors cite them as proof of d1scnnunat1on, argumg that 1f there are a disproport10nate number ofJews m medJCal schools the reason may be that Jews are brighter than non Jews 30 The article's author doubted this latter assessment. The truth seems to be that medicine is merely the most obv10us pomt of collmon between forces set m motton by the peculiar development of Jewish life in Amenca. Given the desire of Jews to see their sons m the learned profess10ns, and given their urbaruzation and hence their access to free college education, and given the assiduity of Jewish children, a clash was mev1table. There 1s no occas10n to explam It by an alleged Jewish mtellectual supenonty.31 We may conclude from contemporary accounts that there is strong anecdotal evidence for the existence ofJewish medical school adrrus­ s10n quotas.

STATISTICAL STUDIES OF MEDICINE'S "JEWISH PROBLEM" Jarcho argued that documentation of anti-Semitic medical school quotas in the 1930s was difficult.32 He was probably unaware of

29. "Jews m Amenca," Fortune, February 1936, pp 79-85, 128-130, 133-14-4; pp 136- 141 30. Ibid , p 141. 3 I Ibid ' p 141. 32 Jarcho (n. 1) . 148 Journal of the History of Medicine Vol . 56, April 2001 contemporary statistical studies of medical student ethnicity that con­ clusively established systemic rejection ofJewish medical school appli­ cants. In the early 193os Harold Rypms, M.D., secretary of the New 0 York State Board of Medical Examiners, calculated that there were 0 :;: approximately 6,000 new medical students per year who were selected ::, 0 ru from 12,000 applicants. He estlmated that about 3.5 percent of the a. (1) U.S. populanon was Jewish and about 17 percent of U.S. medical a. 33 a students were Jewish. Rypins's calculations were consistent with 3 ::,- studies conducted at about the same tim,e by Fred C. Zapffe, M .D., .g secretary of the Association of American Medical Colleges, William g:(/) () Pepper, M.D., dean of the Medical School of the Uruversity of ru a. Pennsylvarua, Dr. Max Dar121s of Newark, New Jersey, and Dr. A. (1) 3 Rongy of New York City. 34 ('i" 0 C Rypms's data showed that the probability of a Jewish applicant -0 (") gaimng admission to a New York City medical school was I 5 percent 0 3 versus 63 percent for a Gentile. In spite of this data, Ryp1ns argued ~ 3 ru that there was no against Jews. He felt that, (/) OJ insofar as Jews were admitted to medical school at a rate higher than ;:i. ff their representation in the population (17 percent of U.S. medical iii ai students vs. 3.5 percent of the U.S. population and 43 percent of New a, ~ York City medical students vs. 30 percent of the city's population), any +> 0 assertion that there was a restricnve Jewish quota fell short. The ~ a,+> essence of the problem, he concluded, was that "Jews were concen­ a, 01 co tt:ated m New York City, that New York City's medical schools could cr '< not accommodate all of the Jewish applicants, and that those students z (1) :;: -< 0 ;;,. s:: (1) a. 33 Harold Rypms, "The JeWJSh Medical Student," undated typescnpt, m the Moms S <'i. u.uron Papers [hereafter Lazaron Papers), Arnencan JeWISh Archives, Cmcmnao, Oluo ~ () 34 Max Danzis, "The Jew m medicine," Am Htbrw ]tw1sh Tnbunt, 23 March 1934, Q. pp 372-401 ; Fred C Zaplfe, "Report of applic:mts and applicants made for admission to iii cQ the 1933 freshman class of seventy-nine medical schools," J. Assoc. Am. Mtd. Coll, 1934, (1) C 9, 93 - 106 Dr F A Mass , Secretary of the Comrruttee on Apotude Tests for Students of (/) the AssOC1:itlon of Amencan Medical Colleges made "as careful a count as we can of the ~ 0 JeWISh students who took the Aparudes Test " (Mass to Lazaron, 1 March 1934, Lazaron ::, N Papers, [n . 33)) Rongy's work IS quoted m Broun and Bntt, (n . 4) Chnstians Only, pp ex, 147-50 See also A M K.:iplan , "Are medical colleges unfair toJeW1Sh students?" ThtJ=h c... C Tribune, 1 August 1930; "Medical schools fair to Jews," Tht L.ituary Digfit, 13 September '< 1930 Both araclcs may be found m the Laz.aron papers (n 33) Willian1 Pepper extensively N 0 studiedJeWJSh adnuss1on rates to meche2l schools See Pepper to Laz.aron, 13 February 1934; N ~ Pepper to Dr. Alfred Stengel, 13 February 1934, Lazaron to Pepper, 15 and 16 February 1934, Pepper to Lazaron, 30January and 16 February 1934, Lazaron Papers, (n. JJ). Halperin : Jews in U.S. Medical Education 149 who were not accepted in N ew York City rarely found a place elsewhere in the United States." 35 The most detailed study of the quota was performed in 1934 by Rabbi Morris S. Lazaron of Baltimore (1888-1979).36 Concerned 0 ~ about the allegation of excessive JeW1Sh medical school applicants and ::::, 0 Ill an oversupply of Jewish physicians, Lazaron wrote to the deans of a. (D U.S. medical schools and directors of residency programs. His letters aa. asked the deans to provide data concerning the proportion ofJewish 3 ::::,- students in their schools and their assessment ofJewish medical stu­ -6' dents. Lazaron surularly asked residency program directors to supply (/)g: (') information on the number and quality ofJewish house officers. This Ill a. extraordinary survey was never pubhshed.37 (D 3 Lazaron surveyed the deans of sixty-five medical schools. He re­ ff 0 C ceived fifty-seven responses including thirty-four with defirute data, 'O () ten with approximate data, and thirteen which he discounted because 0 3 they came from two-year basic science schools or the dean was unable -§; 3 to provide sufficient data. Lazaron calculated that, m 1924, about 11 Ill !!'.. Ill percent of U.S. medical students were Jewish. By 1933 that number ~ had risen to 20 percent, consistent with the calculations of Rypins, ro(') ui Pepper, Zappfe, and Rongy. Reviewing the last names of students (j) takmg the medical college admissions test, Lazaron calculated that ~... 0 about 32 percent of applicants to medical school in 1933.:....1934 had ...::::i (j) 'JewISh" names. Pepper did a similar revtew of names at the same (j) (11 time. His estimate was 50 percent.38 to ro percent ofJews m the class. Other schools, which had a more £ C. CD liberal policy concerning the acceptance of Jews, such as Chicago 3 ff Medical School, New York Uruversity, New York Homeopathic 0 C Medical College, the University of Illmois, and Wayne Uruvers1ty­ "O () 0 Detroit College of Medicine and Surgery, had student bodies in 3 which 50 to 60 percent of the class were Jewish. There can be no =:::r 3 Ol doubt that Jewish medical school applicants faced discrirrunation m !!!.. 44 Ol their attempts to gam a medical education. ;:i ff ro ui WHAT'S WRONG WITH JEWS? Ol ~ We find a window mto the thmkmg of medical school deans in the ~ 0 ::j wntten comments that accompanied their responses to Lazaron's ~ Ol Ol survey. Many of the responses decried discrirrunation. For example, <.n CD Dean G. E. Bethes of the medical branch of the University of Texas c:r '< at Galveston wrote, "I feel that the Jewish medical students in the z CD University of Texas are no different from the Chnstian medical stu­ ::E "c} dents so far as scholastic ratings are concerned, so far as their ability ~ s: to do work is concerned, so far as failing students are concerned, CD C. and so far as other conditions are concerned."45 0 · Q!_ Dean Frank Vincenhaler of the University of Arkansas School of 0 Q. Medicme agreed: ro co CD C CJ> 41 . Broun and Bntt, (n 3) C/mst,ans 011/y, pp. 143-47, New York T11nl!S , 28 August 1946, ~ 0 p 29 ; 23 JanlUJY 1946, p. I. :::, N .p. F Kingdom, " D1scnn11naaon m medical colleges " Am Mercury, 1945 , 56, 394 0, 43. "D1.1cnnunanon charged," Nw York T11111!S, 15 March 1956, p 23 , " at Columbia '­ c derued at heanng," Nnv York T1ml!S , 18 May 1946, p. 39, Nacahe Berger, ed ,Jews and '< Re/1g1011 , Cu/111rr, (Pluladelph1a: The JewISh Publ,canon Society, 1997), p. N Medrane Soma 0 225 N 44 Lazaron (n. 37) 45 Bethes to Lazaron , 23 February 1934, Lazaron Papers (n 33) . Halpen·n : Jews in U.S. Medical Education I 5 I I do not believe chat any restncnon should be placed on any man regardmg his religious beliefs. The field of practice 1s and ought to be open and restriction should only be placed to the degree that men are sufficiently prepared in their premedical studies to enable them to appreciate and take 0 0 :E advantage of theu meilical studies. My observaaon after a long life of ::::, 0 medical pracnce has been that the Jewish physicians as a rule are high grade Q) 46 0.. men. ct> a0.. The nuJonty of deans, however, were opposed to an increase in 3 :;r Jewish admissions. This opposition was couched, by some, as a ques­ ~ -0 u, tion of proport10nal representauon. Many state-supported medical g: (') schools, particularly those in the South, Midwest, and West, based Q) 0.. their discrimination against Jews on the low proportion of Jews in ct> 3 the local populauon. These schools often I.muted the number of out­ ?i 0 C of-state applicants accepted. If a disproportionate number of out-of­ l:) (') state applicants were Jews, then 1t followed that few of them were 0 3 accepted. This was not, these schools argued, the result of ant1- =:;r 3 Q) Senut:1sm but rather the result of a desire to serve the state's taxpayers. u, Were a Jewish state resident to apply, the deans of these schools ii, ;:io· claimed, he would have every reason to expect adrrussion 1f qualified. ro ui The dean of the University of Alabama School of Medicine stated !2: ~ in 1934, for example, "If we should accept all the Jewish applicants .;. 0 from the Nqrtheast who offer three or four years of preparation and ~ .;. cr, whose references as to character, etc., seem satisfactory, we should cr, CJ1 fill up our freshman class twice over and exclude all our own native state university."-4 :E -< A large proportion of the letters objected to JeWish medical students 0 ~ on the grounds that they were more suited for book work than for ~ ct> working with their hands and thus did not do well at clinical work. 0.. i'i' This objection hearkens back to the restrictions directed against Euro­ ~ () pean Jews, from the Middle Ages on, regarding membership in trade Q. ro co gutlds. Jews were restricted from participatmg in skilled trades, were ct> C confined to money lending and dealing in used clothes, and then u, 48 ~ 0 were criticized for not being good at work.mg with their hands. ::::, N This anti-Semitic characterization is typified by the comments of Dr. CD '­ J. T. McLintock of the State Uruversity of Iowa College of Medicine, c '< N 0 46 Vmchenhaler to Lazaron, 30 Janu:i.ry 1934, Lu.aron Papers (n 33) N ~ 47 J N . Simpson to Lu.aron, 22 February 1934 Lu.aron Papers (n 33) 48 Sachar, (n. 2) A Hutory, pp 255-58. I 5 2 Journal of the History of Medidne Vol. 56, April 2001 who wrote that the Jewish students "have difficulty in handling the practical angle of the medical course, but they do very well on the didactic or so-called book work which 1s required." 49 McLintock's views were echoed by Dean C. R. Bardeen of the University of Wisconsin Medical School who stated that "the chief weakness of the majority of them Uews) seems to be a tendency to memorize than show the ability for practical work in the laboratory and wards." 50 There were an equal number of letters complammg that some Jewish students were unethical or generally ill suited for medicine. Some letters hinted at Jews being politically radical or overly interested m money. Some deans merged their VIews of Jews mto a general concern about immigration. Dr. A. C. Curtis, secretary of the Uruver­ sity of Midugan Medical School, believed, Those Jewish students who come from fanuhes m the Uruted States for two or more generanons are usually well bred, well cultured, and disnnctly high class people .... Those students who are born in Europe, or whose parents have recently nugrated from Europe, are apt to be an entirely different type, sometimes radical, somenmes asocial, often unstable. I do not feel that they can compare with the American born Jew any more than the native Pole can compare with the Pole who has lived m this country for three or four generanons.51 Dr. H. R. Wall of the Uruversity of Kansas School of Medicine felt that "the Jewish student does not have as high ethical standard as the average Christian student that is, he is more apt to be commercially inclmed, and yet we have had exceptions to this general impression." These views were supported by Dr. Worth Hale, Assistant Dean of the Harvard Medical School who felt that "as a member of the conuruttee of admission I am inclined to believe that it is more difficult to be sure what the Jewish applicant will develop into than the average Christian applicant." Dr. H . G. Whitecotton of the College of Medicine at Syracuse University likewise felt that "a proportionately large number of students who we find generally unfitted for the practice of medicine are Jewish rather than Genttle."52 Some of the deans thought that the problem of the Jewish medical

49 McLmtock to Lazaron, 7 February 1934, La.zaron Papers (n. 33) 50 Budeen to La.zaron, 23 February 1934, Lazaron Papers (n. 29). 51 CurtlS to Lazaron, 6 M.irch 1934, Lazaron Papers (n 33) . 52 Wall co Lazaron, 27 February 1934, Hale co Lazaron, 30 January 1934, Wh1tecorcon to Lazaron, 29 January 1934, Lazaron Papers, (n. 33) . Halpen·n : Jews in U.S. Medical Education I 53 student rrught be attnbuted to psychopathology. Illustrative are the comments ofDr. WJ. Moss, dean of the University ofGeorgia School of Medicine: "My general impression is that the Jewish students, who are admitted to th.is and other schools with which I have been 0 :::,~ connected, stand high on scholarship. I believe that relatively a high 0 Q) 53 Cl. percentage of Jewish students are of a neurotic temperament." (1) Cl. Others criticized the Jewish students for their alleged arrogance. a A. R . Loraine, actmg dean of the Chicago Medical School, reported, 3 ::r .§' It has been my experience that JeW1sh students, on the average, compare (/) favorably with the Nordic type. The only criticism I have 1s their tendency g: () Q) to develop a superiority complex which at times make them appear to be Cl. (1) disrespectful to theu superiors. On the average, I may say that ten per cent 3 54 o' of the Jewish students m tlu.s college suffer from the above anach.romsm. i::, C -0 But he was less worried about Jews than about other undes1rable 8 3 groups. "Certamly from a social and political point of view we have '§: 3 far greater problems to contend with in the immediate future, such Q) (/) as the procreation and education of the biologically unassirrulable OJ ;:::i. 55 ci' races such as the Negro and Asiatic." ro ui THE QUOTA AND RESIDENCY TRAINING 0:, ~ .j>. Discnrrunation m obtaining internship and residency posinons was 0 ~ .j>. also widespread. An early incident occurred m Brooklyn, New York, 0:, 0:, c.r, at the Kmgs County Hospital. In 1916 a Jewish intern was overpow­ CD c:r ered in lus room, bound, gagged, and taken by force to a tram statlon '< z and told not to return. That same mtern became an Army medical (1) ~ officer in the first World War and died m the line of duty.56 In 1927, 0-< at the same hospital, an estimated twenty Gentile interns kidnapped, ~ physically intinudated, and warned three Jewish interns to leave the "Christian 1nst1tut1on." Jewish interns were subjected to other insults including segregation from the dirung hall and at the tennis courts. A subsequent invesngation resulted in the temporary suspension of six Gentile mterns and the hospital superintendent. All were eventually reinstated. 57 Jewish medical school graduates had considerable difficulty during

53 Moss to Lazaron, 2 February 1934, Laz:iron Papei. (n. 33) 54 Lor.une to Lazaron, 7 March 1934, Laz:iron Papers (n. 33) 55 Ibid. 56 Bruno usker, ed.,jewuh Expmfnm m Ammca (New York Inquiry, 1930), pp. 72-75. 57 N= York Timl1, 21-30 June 1927, 1-3 July 1927, 5-8 July 1927 154 Journal of the History of Medicine Vol . 56, April 2001 the mterwar period acquiring internship and residency positions. In 1923 Dr. B.E. Greenberg of Boston noted that

Out of the twenty-five to thirty LJew1Sh] men who graduate from medical 0 0 :;; schools [m Boston] each year, practically all of them are compelled to go :J mto general pracace, to become the sort of pracnnoner who does not carry 0 Cl.. "'Cl) much weight, who is not considered at the head of his profession, because Cl.. they are not given the opportunity to get mto hospitals to procure hospital a 58 3 expenence. :::,­ :::: -a u, Others found a less pessimistic situat10n, but emphasized the concen­ g: tration of Jewish house officers withm Jewish institutions. Lazaron () "'Cl.. surveyed 1000 U.S. hospitals with roe beds or more m 1934, receiving Cl) 3 421 responses. He found that, consistent with the fact that approxi­ o· 0 C: mately 20 percent of medical students were Jews, approximately 22 -a percent of interns in the United States were Jewish. The majority of 8 3 these Jewish interns were concentrated at Jewish hospitals, however, ~ 3 where 90 percent of the mterns were Jews. 59 "'u, ii, Responding to Lazaron's survey, many directors of medical educa­ ;:::i. ff tion and teaching hospitals were as frank as the deans. Dr. William ro G. Turnbill, superintendent of the Philadelphia General Hospital, ui reported -1:>~ 0 I find rather a large number of Jewish boys graduated from Philadelphia ~ Ol Ol schools this year who have not been able to secure an mternsh1p. Some of CJ1 (0 these boys are splendid students who undoubtedly will make excellent O' '< phys1C1ans . . . I have not the least doubt that Jewish boys are docked on z Cl) account of unacknowledged on the exammanon.60 :;; -< Turnbill believed this was neither due to "antagonism to the individual :x­0 ~ or antagorusms to the Jews as it is to the fear and feeling that the Cl) Cl.. 61 o· Jew is beginning to dominate the profession." Q!_ Harry G. Dunham, superintendent of the Newport Hospital, 0 2. ro Newport, Rhode Island, had other grounds for explairung his hospi­ co Cl) tal's discriminatory practices. He adrmtted that "there are three appli­ C: u, cants &om Jewish doctors to every one Gentile doctor that we receive. ~ 0 :J Whether this is due to the fact that Jewish young men find difficulty N ex, '­c: 58 Quoted m Arthur J. Lmenthal, First a Dream . Th~ History of &ston's Jrunsh Hospitals , '< N 1896-1928 (Boston: Franm A Countway Library of Medicine, 1990), p 211 0 N 59 Lauron, " The JeW1Sh Student m Mec!Jcrne," p. J, chart rv, Lazaron Papers (n 33) ~ 6o Turnbull to Lauron, 10 February 1934, Lazaron Papers (n 33) 61 Ib,d. Halpen·n : Jews in U.S. Medical Eduwtion 155 m securing internships m the larger hospitals I do not know." Dunham commented that physicians on the intern selection committee "have found by past experience that the average Jewish mterne is so zealous in his desire to learn, and so aggressive m his demands for hospital opportunities to learn, that they have been prejudiced with the prefer­ ence to engage a Gentile interne whenever possible." 62 Dr. Lloyd Nolan, the chief surgeon of the Tennessee Coal, Iron & Railroad Company, Birmingham, Alabama, responded to Lazaron that the patient population he served was generally not smtable for Jewish physicians:

Because of the fact that we handle a large proportion of nanve whites of the laboring class and Negroes, we have made special effort to select mterns from this particular part of the world, and consequently we have had few applications from jeW1sh medical students. As a matter of fact, we have not had an mtem of the Jewish fa1th for a number of years, although we have appointed one for work to begm July r, 1934,63 Other physicians observed no difficulty m placement of Jewish house staff Dr. John O'Hanlon, medical director of the Jersey City Hospital, Jersey City, New Jersey wrote that: "Individual aptitude for the practice of Medicine should ... be a deternunmg factor for the practice of the profession, rather than whether one is or is not Jew­ ish."64 Dr. A. A. Herald, president of the North Louisiana Sanitarium, Shreveport, Louisiana, expressed lus humble opinion (that) there 1s no cause for alarm m the fact that so many Jewish boys wish to study medICme; we certamly have no surplus here, for m our Parish (county), out of about 175 doctors there are only three Jews in practice; I note also that m the large cities, especially m the East, a large ~ (1) a. percentage of the leaders are Jews and there can certamly be no objection o· 65 to a surplus of them m the profession 1f they continue to excel. ~ 0 Q. RATIONALIZATION, ACCOMMODATION, ASSIMILATION, AND ro

It is quite commonly known th.at the facts of medicine make 1t an intunate profess10n. Doctors are particularly aware that the lines of practice are sharply divided. Seldom does a Jewish physician acquire a clientele among non-Jews while the number of non-JeWJSh patients who consult the average Jewish physician 1s so small that-allowmg for the meV1tably rare exceptions they must be discounted entirely as a source of professional revenue. Natu­ rally if the supply of Jewish doctors were to increase too far m excess of the demand, an econonuc problem would arise not dissimilar to the problem of thousands of Jewish lawyers. We shall not touch upon the question of educs here, but experience has taught us-too often to pardon any further nsk m this direction - that a condition of severe competition [between physicians) IS conducive to a lowermg of ethical standards.66 Other pronunent Jewish physicians argued that there were no anti-Sermnc Jewish quotas. They said, instead, that Jews, being a predominantly urban population in the United States, were disin­ clined to become country doctors and therefore were not being. selected for medical school because they would not improve medical care in rural areas. 67 In this way, they echoed the proportional repre­ sentation argument of some of the medical school deans. Danzis, a Jewish surgeon practicing in Newark, New Jersey, argued that a tendency for Jewish physicians to gravitate to urban centers contrib­ uted to Jewish physicians serving a largely Jewish clientele: The tendency of the medical graduate is to graVItate to the large centers s: of population, where the educational and clmical facilities for practice are (I) o0.· better th.an those m the smaller cities . . . The Jew, being a city dweller Q!_ . .. 1s most likely to continue his practice there for the same reason as the () Q. ro non-Jew does, and also because of the JeW1sh commuruty group hfe which (Q 68 (I) he may lack in the small town or rural d1Strict. C: (/) ~ Rabbi Lazaron and some other Jewish leaders thought that an 0 :::, N appropriate response to discriminatory quotas was accommodation ex, L to their existence and improved vocational counseling for youngJews. C: '< N 0 66 Rogny, quoted m Kaplan (n 30) . N 67. Kaplan (n. 34) 68. Danns (n . 34) Halperin : Jews in U.S. Medical Education 157 They hoped that students would select alternative careers. In fact, Lazaron never published his data which illustrated discrimination against Jewish students so clearly. In a letter to magazine publisher 0 0 Morris A. Beale dated 21 May 1936, Lazaron explained his reluctance :;: ::, to allow Beale to publish the report. 0 a, a. Cl) Pubhaty to the facts m the article has already been given through a number a. of the medical colleges in the country, and It is an open question whether it would be adVJsable at the present ti.me to make the material m the arncle a matter of public discussion. Difficulties of the sort considered m the article can be much better solved through education m those quarters where educa• on 1s necessary. 69 Lazaron was proud of lus Sephardic Jewish heritage and felt very much a part of American culture. He was at home in the upper levels of Gentt.le and Jewish society and counted Irving Berlin, Eddie Cantor, the Schulzbergers of the New York Times, and actress Irene Dunn among his friends. His brother-in-law was the famous Ziorust Abba Hillel Silver. Lazeron "did not want to upset the apple cart" within his perceived social circle by making a public protest. He counseled Jewish students to do the same.70 But many Jews were not persuaded by calls for accommodation. Unable to obtain places in U.S. medical schools, they matriculated in European schools. By 1932-1933 the Council of Medical Educa­ tion and Hospitals of the American Medical Association reported that r9u Americans were studying medicine in Europe. The most popular sites were Great Britain (452), Italy (222), Germany (337), and Switzerland (403). By the rmd-193os it was estimated that 95 71 percent of Americans studying medicine in Europe were Jews. s:: (1) In February 1933 the Federation of State Medical Boards of the a. n· Uruted States began to reqmre that Americans matriculating in Euro­ Q!_ 0 pean medical schools obtain a license to practice medicine in the Q. ro

88 Kenneth M . Ludmerer, "The ongms of Mount Smai School of Medicine," J Hut Med All1td Sci , 1990, 45, 469-89. For a general h1Story of the Mount Smai Hospital and the other Jewish hospitals of New York City, see TU13 LeVJun, fs/,inds of Compassion A History ojthe}twrsh Hosp1"2/ of New York (New York Tw:iyne Publishers, Inc, 1964). 89. Turner to Lizaron, 16 March 1934, Lazaron Papers {n 33) . 90. Ludrnerer {n. 88) 162 Journal of the History of Medicine Vol . 561 April 2001

GOVERNMENT AND PRIVATE INVESTIGATIONS. OF THE QUOTA Leaders of medicine and the press took note of the quota soon after its introduction, although no effective action against quotas was taken until after World War II . Dean A. M. Schwitella of the St. Louis Uruversity School of Medicine expressed his concern about restncted Jewish access to medical schools at a meeting of the Amen can Associa­ tion of MedICal Colleges in 1928.91 In a 1932 speech to the National Conference ofJewish Social Service, Dr. Israel Strauss, a New York neurologist, told lus audience "we know that there is discnmination against the Jews because of their race or rehg10n. High [acadenuc] rank does not adnut them."92 A report in 1931 to the executive committee of the Amencan Jewish Committee observed that U.S. medical schools fatled to accept Jews in the same ratJ.o as their propor­ tion among the applicant pool. 93 At a 193 5 meeting of the National Conference ofJews and Christ1aru,Jew1sh quotas in colleges, uruvem­ ties, and medical schools were condemned as "un-Arnencan."94 In a 1940 amcle, two promment New York Jewish physicians, Nathan Ratnoff and Isidor Held, denounced the argument for proportional representation. One of the commonly advanced JUsoficauons for the small percentage of Jews admmed to medical schools . . 1s that Jews are already more than adequately represented in the medical profession according to their numeri­ cal proporaon in our populanon. Doubtless the latter statement 1s correct, but the argument 1s deplorable. Favoring a quota m med1cme or any other branch of education, according to nationality, seems to us a regress to med1evalism. 95

Near the end of World War II, Mayor Fiorello H. LaGuardia of s::: (l) New York City established a comnuttee to investigate racial and a. o· religious discnmination.96 Called the "Mayor's Unity Comnussion," ~ 0 the group received, in January 1946, a "Report on Discrimination 2.. co co (l) C: 91 "ReVJew of the Year 5690 " Am Jewul, Year Book, 1930-1931 , 32, p 78. (/) 92 "MecLcal school proposed for Jews," Nr:w York T1111es , 14 May 1932, p 4 ~ 0 93 "Medical school for Jews reJected." Nrw York Tim~, 7 December 1931, p 14 The :, report adVJsed , however, that thts was " not altogether traceable to ana-Jewuh dtscnmmanon, f\.) ex, as other factors are taken into account " L C: 94 " Faith parley bans athe1snc groups." New York Times, 31 August 1935 , p 11. '< 95 Nathan Ratnoff and Isidor W Held, "Some problems of the Je,VJSh medical student," f\.) 0 Mtd uavts, 1940, 4, 146-51 f\.) 96 B Fme, "Curb IS demanded on bias m colleges," New York T1mt5, 24January 1946, p. 18. Halperin : Jews in U.S. Medical Education 163 m Institut10ns of Higher Learnmg" authored by Dr. Dan W Dodson, an educator on leave from New York Uruvers1ty. Dodson's report described a fall in the average number ofJewish students in grade A medical schools from 12 . 16 percent of the student body in 1933 to 6.29 percent m 1938. From 1925 through 1943, the percentage of City University of New York graduates who applied for adrrussion to medical school and were admitted fell from 5 8 percent to 15 percent.97 The Unity Comrrussion was told that not only did local private colleges and professional schools linut the numbers of New Yorkers admitted, but that out-of-town schools "give pnonty to their local populations and that they believe that New York City institutions should proVIde for the educational requests of its student population. As a consequence, all New Yorkers and especially Jews, Catholics and Negroes, find themselves discnminated against both in the New York and out-of-town institutions."98 In March 1946 the noted Reform rabbi, social activist, and Zionist leader Stephen S. Wise (1874-1949) filed an application before the New York City Tax Commiss10n to cancel the tax exemption of Columbia Uruversity.99 Acting m lus capacity as president of the Amencan Jewish Congress and as an mdiVIdual taxpayer, Wise asked the commission co cancel Columbia's exemption for v10lating the antidiscrimmation clause of New York State tax law. Wise argued that Columbia's College of Physicians and Surgeons had discnminated against Jews and "betrayed the democratic purposes for which public subsidy for education is granted." 100 Wise showed data provided by Dr. Alexander H. Pekelis of the New School for Social Research documenting that, m 1920, 4 7 percent ofthe College ofPhysicians and Surgeons' newly admitted study body was Jewish versus 19 percent in s: CD 1924, 12 percent m 1938, and 6 percent in 1940. From 1941 to 1946 oC.· the number never exceeded 12 percent. 101 Julius L. Goldstein, an ~ 0 Q_ attorney, sued Columbia on similar grounds. New York State Attor­ ro

CONCLUSION Following a period of rapid immigration of eastern European Jews to the Umted States from 1880 to 1914, Jewish applications for admission to medical school increased sharply in the 1920s and 1930s. While the proportion of Jewish medical students rose, this was not commensurate with the increase in Jewish applicants. The discrepancy between the proportion of Jewish applicants and the propornon of Jewish matriculants was justified, at some medical schools, by a stated belief in proportional representation of m-state applicants. This pro­ pornonal representation, of course, was invoked only for Jews and not for women, African Amencans, or any other group that the medical schools wished to exclude. Many schools clearly established a "gentleman's agreement" of restrictive quotas. Many medical school deans and directors of post-graduate medical education programs harbored anti-Semitic views. s:: CD 0. Individual Jews and the Jewish community responded to discnrm­ ci" nation m a vanety of ways. Some urged assimilation, acceptance, and Q,_ 0 Q. accommodation. Others flocked to schools that did not discn.minate, ro <.O went abroad to medical school, or started their own medical schools CD and post-graduate programs. Ultimately, through political channels, C "'~ 0 particularly m New York state, pressure was brought to bear against ::, N discrimination. The quotas began to wane after World War II. ex, '­ c -<" I 18 Dmnerstem (n 4), pp 150-74. N 0 119 Quoted m Frank K. Shunleworth, "DtSCrurunaoon m college oppommines and N ~ adnuss1oru," Sdu>ol and Scatty, 1951, 74 , 398. 120 J:ucho (n 1), p. 371.