When Blackwell arrived at the college, she was rather nervous. Nothing was familiar – the surroundings, the students and the faculty. She did not even know where to get her books. However, she soon found herself at home in medical school. While she was at school, she was looked upon as an oddity by the townspeople of Geneva. She also rejected suitors and friends alike, preferring to isolate herself. In the summer between her two terms at Geneva, she returned to Philadelphia, stayed with Dr. Elder, and applied for medical positions in the area to gain clinical experience. The Guardians of the Poor, the city commission that ran Blockley Almshouse, granted her permission to work there, albeit not without some struggle. Blackwell slowly gained acceptance at Blockley, although some young resident physicians still would walk out and refuse to assist her in diagnosing and treating her patients. During her time there, Blackwell gained valuable clinical experience, but was appalled by the syphilitic ward and those afflicted with typhus. Her graduating thesis at Geneva Medical College ended up being on the topic of typhus. The conclusion of this thesis linked physical health with socio-moral stability – a link that foreshadows her later reform work.

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