A slew of medical schools in Philadelphia during the 1850s competed with Penn for students, faculty members, and patients. The success of Penn’s Medical School as a proprietary institution led to the emergence of similar schools in Philadelphia. Jefferson Medical College, Penn Medical University, Philadelphia College of Medicine, and the Medical Department of Pennsylvania College had sizable enrollments, respected faculties, and access to Philadelphia’s hospitals. Young men from every state flocked to Philadelphia to attend the numerous medical schools in the city. Penn’s decision to lengthen its courses in 1847 made its regional rivals much more attractive to many of these students. A student at Jefferson College, which had a four-month course length, could obtain his medical degree faster and cheaper than his Penn counterpart. Students from Penn, Jefferson, Pennsylvania College, and other colleges all had access to the Pennsylvania Hospital and Blockley Almshouse. The faculties of these medical schools largely consisted of Penn graduates young and old. In fact, Joseph Leidy and Alfred Stillé established their academic reputations while they were faculty members at Franklin Medical College and Pennsylvania College, respectively. Some Philadelphians, including Penn Provost Edgar F. Smith, believed the Faculty of the Medical Department of Pennsylvania College “was superior to any other in Philadelphia.” As the Civil War approached, Penn’s Medical School faced an uncertain future.