The High Cost of Medical Education, Circa 1825

December 14, 2018

“Medical Expenses – New York. Garrit Terhune” written in an elegant, highly legible script is the heading on one student’s meticulous accounting of the cost of his medical education almost 200 years ago.  The four page document, in excellent condition, was recently donated to Archives & Special Collections by one of Terhune’s direct descendants.  It provides rare evidence for the real cost of medical education in early 19thcentury America.

Garrit Terhune was born in 1801 in New Barbados Township, New Jersey (now Hackensack), son of Richard and Hannah Terhune.  He is said to have had a “good English and classical education” [1] and, after the traditional year or two apprenticing with local doctors, entered the College of Physicians & Surgeons (P&S), now the Columbia University Vagelos College of Physicians & Surgeons, in Fall 1825.

It was a momentous year for the College: at the end of the 1825-26 academic session a faculty revolt over governance and compensation led to the secession of almost all the professors and the bulk of the students – including Terhune – to a new medical school. Called the Rutgers Medical College, it was located in New York City but operated under a charter from Rutgers College in New Jersey.  Terhune received his medical degree from Rutgers in the spring of 1827.

Just how much a P&S education cost in this era is not clear.  The annual flyers announcing the start of the academic year rarely mentioned the fees involved. The exception is the 1819 announcement which includes the cost of the matriculation fee ($5) as well as that of lecture tickets ($10-$20 each depending on the course).  These fees had not changed by 1825 when Terhune entered P&S, but his accounting includes an additional $50 payment to Dr. John W. Francis noted as being “for the session” but otherwise unexplained.  Francis served as the College Registrar so this may have been a payment to the College rather than to Francis personally but it’s a hefty sum at a time when skilled bricklayers in New York were earning $1.50 a day [2]. Terhune’s total tuition at P&S in 1825/26 was $140 for five courses, the matriculation fee, and that mysterious $50 to Dr. Francis.  His expenses for the following year at Rutgers were considerably more: $193 but this also included the cost of the optional summer and winter sessions ($75), a dissection fee of $10, a $20 graduation fee, and $10 for admission as a student to New York Hospital.  So for his education alone Terhune spent $333.

Fortunately, however, Terhune also listed all his other student expenses.  His room and board for two years – including washing, firewood, and candles – was $155.81.  He spent $51.55 on medical books and instruments, including $10 for a “case of surgical instruments and lancets,” 80 cents for a copy of Anthelme Richerand’s Elements of Physiology, an English translation of which had been published in New York in 1825, and $3.25 for blank books and Sir Astley Cooper’s surgical lectures.

In total, the cost of Terhune’s medical education – exclusive of what he may have paid in apprenticeship fees – came to $814.84. According to one online calculator that’s the equivalent of almost $20,000 in 2017 money [3] – considerably less expensive than present-day medical school tuition and board but not an inconsiderable sum.  In Terhune’s obituary his father is described as a “large landowner” so it’s possible his parents paid for some if not all of his education [4]. That Terhune finished his medical education in two years makes him unusual: most P&S students  in this era needed to take time off to work and save money for their tuition, meaning it could take them 3-4 years to complete their education.

Terhune went on to practice in his hometown of Hackensack. But after only two years he relocated to the growing village of Acquackanonk, soon to be renamed Passaic. In time it became one of the country’s major textile manufacturing centers.  He was a founding member of the Passaic County Medical Society and at his death on July 2, 1885 was the oldest physician in the county.  His son Richard (P&S 1850) had long been a partner in his practice. It’s amazing to think that a physician who was educated in the verities of humoral medicine with its purging and bloodletting lived to practice medicine well into the era of Pasteur and Lister!

For more information about the recently opened Terhune Papers please consult the finding aid.

[1] W. Woodford Clayton and William Nelson, History of Bergen and Passaic Counties, New Jersey, with Biographical Sketches of Many of its Pioneers and Prominent Men(Philadelphia: Everts & Peck, 1882), p. 360.

[2] “Wages of Early American Building-Trades Workers,” U.S. Dept. of Labor, Monthly Labor Review, v. 30, n. 1 (Jan. 1930), p. 13.

[3] CPI Inflation Calculator:; accessed Dec. 14, 2018.

[4] Undated Terhune obituary from unidentified newspaper in the Terhune Papers.