License to Practice: Validating Medical Studies of Foreign Doctors in Nineteenth-Century Mexico, Guatemala, and Cuba

This paper is part a larger project revealing how patients and health care providers influenced health care and public health administration in societies undergoing modernization and political reorganization. My dissertation will analyze the modernization and institutionalization of healthcare in Mexico and Guatemala during the transition from colonialism to independence, as a basis for comparison with nineteenth-century Cuba under continued Spanish control. Research in archives in Mexico City, Guatemala City, Havana, Madrid, and Seville reveals the ways in which each of these regions was re-structuring medical education and governance (constitutions, boards, licensing). One unexpected aspect of the modification of the medical administration that I encountered is the authorization of foreign medical degrees. Doctors from other countries, including France, Ireland, England, and the United States, applied to practice medicine in post-colonial Mexico and Guatemala, and nineteenth-century Cuba. These doctors had difficulty fulfilling all of the excessive requisites that they encountered. My paper will introduce these doctors and their influence on the modernization of medical boards, practice, and education. By examining the requests, the rejections, the appeals, and the compromises reached, I will present the ways in which the subjects of these new medical boards negotiated the terms of incorporation and created unique relationships with the structures that sought to control them. While they present interesting individual case studies, as a group these doctors were one of the forces that shaped the modernization of health care by challenging the established requirements for practicing medicine. Ultimately, a study of these negotiations will illustrate how the politicization of medical boards and medical education improved medical care by forcing the evaluation of alternative methods and training.