A.J. Wright
Birmingham, Alabama, United States

Alabama’s first operating medical school, the proprietary Graefenberg Medical Institute in the small town of Dadeville, opened in 1852. That school closed at the beginning of the Civil War. The Medical College of Alabama had been chartered by the state in 1856, but no funds provided; a charter from the city of Mobile and private fundraising followed in 1859. The state finally provided some funds, and the school opened in the port city in November 1859.

That school closed in 1861 and did not reopen until 1868. The two-year Medical College of Alabama in Mobile began a four-year expanded curriculum in 1899, and in 1907 the legislature changed the school’s charter to bring it under the University of Alabama’s trustees. The school’s name was also changed to the University of Alabama [UA] School of Medicine. During these decades various proprietary medical schools also opened in the state, but none survived more than a few years past the 1910 Flexner report.

In 1920 the UA School of Medicine was moved to the main campus in Tuscaloosa and reopened as a two-year basic science medical curriculum. Thus students had to leave the state to complete their M.D. training. By the mid-1930s serious efforts began to return the school to a four-year course of study. After much debate, the legislature created a four-year school in Birmingham, which had a large Jefferson-Hillman Hospital to offer as training ground for students. The first classes began in September 1945.

Today that school is known as the University of Alabama at Birmingham [UAB] School of Medicine. A University of Alabama Extension Center had opened in Birmingham in 1936, and in 1969 the two were merged to create UAB. The UAB School of Medicine also has branch campuses in Tuscaloosa and Huntsville.

The oldest building in the UAB Medical Center, now known as “Old Hillman,” is located on the block bounded by 19th and 20th Streets and 6th and 7th Avenues South. The four-story stone and brick structure was dedicated in July, 1903, and named Hillman Hospital after local benefactor Thomas Hillman, President of the Tennessee Coal, Iron and Railroad Company. The hospital was constructed on lots 1-6 of the block, purchased from John S. Cox. He had bought the land from the Elyton Land Company in 1877 for $250. A Victorian house on the property was used as the hospital’s first nursing dormitory.

Efforts to organize a charity hospital for the city had begun in 1884, and Hillman’s donations had helped fund several locations, including a 100-bed facility that burned in 1894. Hillman required that his support pay for wards for both white and black patients. Hillman Hospital was chartered by the state legislature in 1897 and operated by a Board of Lady Managers—wives of local businessmen, a group involved from the beginning as the Daughters of United Charity.

The four floors and basement were crowded with various facilities, including offices, reception rooms, a laundry, store rooms, and boiler and fuel room for the steam heat. Twelve private rooms as well as one child and four adult wards occupied most of the first and second floors. The third floor held a surgical amphitheater that could hold up to 80 students, sterilizing and ether rooms, two private operating rooms, and more private patient rooms. The fourth floor held the kitchen (with dumb waiter access to other floors), nurses’ dormitory rooms, a dining hall, and yet more private rooms.

By 1924 over 4600 patients a year were treated at Hillman. Financial difficulties had continued, and in 1907 the land and building were sold to the Jefferson County Board of Revenue. An annex built in 1913 failed to relieve the overcrowding of the 90 beds that Dr. Will Mayo had noted on his visit in 1911. Finally the “new” Hillman Building opened in 1928, followed the next year by a nurses’ home, which housed up to 100 nurses and fourteen interns. Eleven years later a five-story outpatient clinic was built.

Seats in the main surgical amphitheater of Hillman Hospital were filled by faculty and students from the Birmingham Medical College. The school was a proprietary college owned by nine prominent Birmingham physicians and opened in October 1894. The college and the Birmingham Dental College were first located in a five-story building on 21st Street North originally occupied by the Lunsford Hotel. The school had electric lighting, lecture rooms, several laboratories, and a free dispensary. Students were also exposed to patients at the city charity hospital, infirmaries owned by faculty members, and clinics in nearby towns.

In 1902 the college constructed its new home next to Hillman Hospital and a two-story autopsy house behind it. By that time the school had 94 students who were required to study four terms instead of the original two. In 1910 the medical and dental schools merged to become the Birmingham Medical, Dental and Pharmaceutical College. One of the school’s achievements was the 1899 graduation of Elizabeth White. She was the second female to graduate from an Alabama medical school, following Louisa Shepard who had graduated from the Graefenberg Medical Institute in in the 1850s.

Five years before the UAB medical school began operation, the County Commission opened the sixteen-story Jefferson Hospital on the same block as the Hillman buildings. The structures on that block became the clinical nucleus of the new medical school. By the 2013-4 year, the university hospital complex had over 49,000 patient discharges, delivered over 4000 babies, had over 91,000 emergency room visits and a budget of more than 1.4 billion. More than 18,000 students attended the university, which is one of Alabama’s largest employers.

Today “Old” and “New” Hillman and the annex between them are still used by the UAB School of Medicine. The nurses’ home also survives as the Roy Kracke Building, named after the medical school’s first dean. A decade or more ago the university floated a trial balloon: the Hillman buildings would be torn down to create a grand new entrance to the campus. So far such destruction hasn’t happened, and the Hillman complex remains as a reminder of the city’s healthcare past and the historic heart of a major university.

Further reading

1. Holley, Howard L. A History of Medicine in Alabama. Tuscaloosa: University of Alabama School of Medicine, 1982
2. Holmes, Jack D.L. A History of the University of Alabama Hospitals. Birmingham: University Hospital Auxiliary, 1974.