J. Marion Sims: a defense of the father of gynecology

J. Marion Sims, MD: Why He and His Accomplishments Need to Continue to be Recognized a Commentary and Historical Review

This review provides a fresh perspective on the work of J. Marion Sims, an Antebellum era physician who invented the vaginally speculum that bears his name. His accent to become the "Father of Modern Gynecology" was his groundbreaking development of the surgical techniques for the repair for vesicovaginal fistula. Recent scholarship, however, has pointed to the dark side of Sims in that his techniques were perfected through his use of Black slave women as his research subjects. In addition, he has been criticized for his failure to use anesthesia during his research operations. This article argues that Sims's work needs to be understood in a broader historical context and within the broader framework of other forms of human experimentation that took place in the nineteenth and twentieth centuries. There is a strong argument that recent attempts to remove Sims from history also have the unintended consequence of removing the contributions of not only the Black slave women who were his subjects in the development of modern obstetrical medicine, but the important role Blacks played in the development of other medical procedures.

The core competencies of James Marion Sims, MD

The concept of core competencies in graduate medical education was introduced by the Accreditation Council for Graduate Medical Education of the American Medical Association to semiquantitatively assess the professional performance of students, residents, practitioners, and faculty. Many aspects of the career of J. Marion Sims, MD, are exemplary of those core competencies: MEDICAL KNOWLEDGE: Author of the first American textbook related to gynecology. MEDICAL CARE: Innovator of the Sims' Vaginal Speculum, Sims' Position, Sims' Test, and vesico-/rectovaginal fistulorrhaphy; advocated abdominal exploration for penetrating wounds; performed the first cholecystostomy. PROFESSIONALISM: Served as President of the New York Academy of Medicine, the American Medical Association, and the American Gynecologic Society. INTERPERSONAL RELATIONSHIPS/COMMUNICATION: Cared for the indigent, hearthless, indentured, disenfranchised; served as consulting surgeon to the Empress Eugénie (France), the Duchess of Hamilton (Scotland), the Empress of Austria, and other royalty of the aristocratic Houses of Europe; accorded the National Order of the Legion of Honor. PRACTICE-BASED LEARNING: Introduction of silver wire sutures; adoption of the principles of asepsis/antisepsis; adoption of the principles of general anesthesia. SYSTEMS-BASED PRACTICE: Established the Woman's Hospital, New York City, New York, the predecessor of the Memorial Sloan-Kettering Center for the Treatment of Cancer and Allied Diseases; organized the Anglo-American Ambulance Corps under the patronage of Napoleon III. What led him to a life of clinical and humanitarian service? First, he was determined to succeed. His formal medical/surgical education was perhaps the best available to North Americans during that era. Second, he was courageous in experimentation and innovation, applying new developments in operative technique, asepsis/antisepsis, and general anesthesia. Third, his curiosity was not burdened by rigid adherence to old doctrines or antiquated theories. Fourth, he broadened his professional experience and knowledge by travels to renowned intellectual centers in Western Europe. Fifth, he was perceived as cautiously optimistic and judiciously positive as he interacted with patients, students, and colleagues. Courage, confidence, creativity, compassion, charisma, character, and controversy marked his career. His legacy is illustrative and exemplary of the core competencies fostered contemporaneously in graduate medical educational programs.