Dr. Hosack's Trouble with Diplomas

Without a charter, Dr. Hosack’s medical school was unable to confer diplomas, which meant any student that studied at the school would be unable to legally practice medicine and made an education from the school pointless. Dr. Hosack and the other faculty members attempted to affiliate themselves with another institution that could grant diplomas to their students. They first turned to Columbia University and Union College, but both New York institutions denied the proposals. The group then turned to Rutgers College in New Jersey—they agreed to the proposal. The two bodies created an agreement in which students attended classes in New York City, at the school on Duane Street under the guidance of Dr. Hosack and his faculty. Once students completed all the required courses, Dr. Hosack would recommend them to the Board of Trustees of Rutgers College who would grant them a diploma from the New Jersey institution.

This immediately drew criticism from the New York State medical community, especially those that defended the monopoly, who decried that Dr. Hosack was operating an illegal medical school. They argued that a medical college in New York should not be able to circumnavigate the state's authority to regulate higher education within its borders and grant diplomas conferred from a body outside of the state. Despite this criticism, on November 6, 1826, Dr. Hosack gave the inaugural address and the Rutgers Medical College was opened.

In response to the criticism and at the behest of the College of Physicians and Surgeons, the New York State Legislature passed a law in 1827 making all diplomas granted by an authority based outside of New York State invalid. This new law threatened to permanently close the institution unless another affiliation could be formed.