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Focusing both on international comparisons and on the personal histories of many of the pioneers, their determination and dedication, their setbacks and successes, he shows how European and American women gradually broke through the wall of resistance to women in medicine. In pre-Civil War America, in Tsarist Russia, in Victorian England, special schools of medicine for women were widely established as early as 1850 as a kind of way-station on the road to medical coeducation. Only in Switzerland and France, at first, could women study medicine in classes with men. As a result, hundreds and then thousands of women from Russia, Eastern Europe, England, and the United States enrolled in Swiss or Parisian universities to gain the first-class education that was denied them at home. 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