Medical Monopoly: Twentieth Century Expansion of MCV

Shaye Ellis


In the mid-twentieth century, business and industry in Richmond experienced substantial growth and the city plan became more organized. Businesses with similar purposes clustered together as the layout of the city moved away from isolated and self-sufficient urban neighborhoods towards that of a modern metropolis. The commercial development in the city revealed steady expansion in various industry sectors, including medicine. The Medical College of Virginia, in particular, experienced continuous growth in its enrollment and facilities. As the campus spread, dominating the East end of Clay Street and surrounding blocks, the college’s infrastructure and practices exposed the divisive consequences of the period’s segregation. The success of the institution was far reaching, its early progress included distinct and separate plans for advancing the medical training and treatment of the region’s white and black populations. These needs, along with the region’s growth, prompted the Medical College of Virginia to continue its development and establish a substantial presence that the campus has maintained in the city ever since.

From its inception in 1854, the Medical College of Virginia, MCV, flourished and expanded into an extensive institute for medical care and higher education. MCV constructed and filled numerous buildings throughout the first half of the twentieth century and city directories spanning twenty years of history between 1950 and 1970 document the creeping expansion of the college’s presence in real estate.[i]The photograph showing the construction in 1972 of the new Medical College of Virginia Clinic depicts how the campus stretched out in all directions.

Construction of Medical College of Virginia Clinic, 1972 (Courtesy of The Valentine History Center)

In the foreground, the newest addition is under construction; the MCV West Hospital, built in 1941, towers in the background, and the oldest of the three buildings anchors them in the middle. Residential lots and small shops lingering in the 1950s slowly gave way to vacant plots that filled with parking lots to serve the medical facilities cropping up along the street. With each rising wave of students, staff, and patients, the college administration set its sights on new property, and the land surrounding the burgeoning hospital facilities was highly valued and sought after.  A Richmond Times Dispatch article from August 1950 explains that the college president, Dr. W. T. Sanger, was “authorized to acquire the land by gift, purchase or condemnation.”[ii] By 1953, the college unveiled an extensive “$1,000,000 expansion program west and northwest of its present grounds.”[iii] Among these potential purchases was the Juvenile and Domestic Relations Court Building at 12th and Clay. For an offer of $150,000, the college hoped to acquire the space for use as a laboratory, as “it would cost too much to convert the building for use as a health and welfare center.”[iv] The Medical College sought to expand even beyond these projects. Under prevalent segregation practices, MCV established a separate nursing school for African Americans to provide them with advanced training and education.

The St. Philip School of Nursing and hospital expanded simultaneously but separately from MCV until racial integration replaced the former segregated medical system. MCV established the school of nursing in 1920 to train nurses who would treat the African American patients at St. Philip Hospital. The hospital, though built to treat the black community in Richmond, was “the most modern type of hospital in Virginia.”[v]

St. Philip Hospital, 1963 (Courtesy of Tompkins-McCaw Library Special Collections and Archives)

The Medical College held their blacks–only counterpart to the same high standards. Despite the inferior quality and availability of resources for black nursing students, “from its inception, [St. Philip] was on parity with the established white nursing school,”[vi] in terms of the rigor and quality of the education. The initial boom in enrollment made it necessary to move the students from the first floor of St. Philip Hospital to four houses across the street. The student population grew so much that a separate dormitory was warranted, which also housed classroom facilities in the basement because buildings of the African American branch of the Medical College were required to be more multi-functional. Again the arrangement changed as the growing demands of the school and the city made it imperative to expand the St. Philip Hall Dormitory further. Ultimately, “seventy-four bedrooms were added, increasing the capacity to 160.”[vii] The hospital facilities also improved when the “St. Philip Division of Ennion G. Williams Hospital was completed in 1958,” providing ample beds for African American patients seeking medical care. Massive resistance to integration in Virginia encouraged the expansion and continuation of these separate facilities until the slow deterioration of segregation commenced in the region.

The two medical institutions remained distinct until the first signs of integration in 1957. In that year, the MCV School of Nursing accepted its first African American student. Within the next five years, MCV decided to close the St. Philip School for Nursing and officially integrate the student body into the Medical College, and the final graduating class for St. Philip was in 1962.[viii] While this suggests that social perceptions and race relations had evolved, the change was not absolute. Black students were allowed to intern or complete their residency at MCV, but they were not allowed to treat patients in the same space. In fact, in 1963, MCV rejected respected Doctor George C. Branche’s application for a faculty position citing that “the climate was not right for his acceptance.”[ix] The hospital facilities could be shared, but black doctors were prohibited from actually claiming space for their own patients in the same vicinity as whites. Moreover, at that time in the city, there existed only “40 or 50 beds available to patients of black physicians.”[x] Despite the reality that the MCV and St. Philip hospitals had a concrete affiliation, as well as tunnels physically connecting the facilities, the two spaces still represented racial distinctions even though serving the same functions. While segregated building expansion had ceased, social pressures ensured that separate medical practices remained.

The increase in MCV’s capacity and facilities greatly dictated development in the surrounding area as well as the city on a larger scale. In buying up the spaces occupied by other city offices and businesses, the institution single-handedly began to reorganize and structure the city.  The college’s expansion strategy spurred local planning committees to evaluate available space and “three previous surveys said the court and detention center should be built in the downtown area,”[xi] providing a new address for the Health and Welfare Departments as well. These and other relocations along Clay Street and in surrounding neighborhoods provided MCV with sufficient opportunity and space to fill in the gaps. College President, Dr. Sanger, sought as much leeway as possible to expand the campus and wanted to know “how far west the college could go on Marshall, Clay, Leigh and Broad Streets.”[xii]However, the expressway due to be constructed in the city presented an obstacle that could limit the extensive campus, or potentially even divide it.

Medical College of Virginia campus, 1960; view from the Marshall Street viaduct (Courtesy of The Valentine History Center)

Though the City Planning Commission’s design proposal in 1953 was vague on “where, if at all, an expressway would be built in the Medical College area,”[xiii]the 1960s photograph overlooking the MCV campus illustrates that the campus remained in tact despite the introduction of the major roadways. The Medical College campus dominates the view from the smokestacks to the parking garage and reaches all the way back to the dormitories. The city planners did not provide other sections of the region with such a generous berth. Instead MCV, not the city planners, primarily dictated how the surrounding area would change and which buildings would be left standing, as evidenced in the image showing the MCV dormitories as the only structures visible on the skyline. In the midst of construction and change in the Clay Street neighborhood, the MCV campus was untouched.

Clay to Leigh Streets with MCV Dormitories in the background (Courtesy of The Valentine History Center)

The ongoing expansion of the Medical College of Virginia occurred in stages. MCV repurposed old buildings to meet new needs, leveled dated hospitals to make way for modern medical facilities, and stretched and constructed additions to hold the ever-growing numbers the college served. The slow progress towards racial integration also allowed the expansion to become more cohesive and focused, as separate development efforts ceased to be necessary. Undeniably, the steady growth of the Medical College of Virginia had a profound impact on the East boundary of Clay Street and the surrounding neighborhood. While the organization brought tremendous medical facilities and services to the area, the sprawl of its campus changed the character of the community, dwarfing the historically significant buildings that once reigned on the street, including the former White House of the Confederacy.

Construction of Medical College of Virginia parking deck on East Clay Street, 1961 (Courtesy of The Valentine History Center)

Even the tourist sign standing in front of 1961 construction of an MCV parking deck alludes to the prevalence of the campus extending in either direction, and enveloping both landmarks referenced. As MCV’s reputation grew, its capabilities, influence, and revenue-generating opportunities outweighed the organization’s unfavorable impact on the surrounding neighborhood and its historical context. In modernized mid-century Richmond, Clay Street’s transformation from residential to commercial space made sense and money. The Medical College of Virginia continuously used and adapted this area to meet its evolving needs and as a result created a clearly defined function for that portion of the city.

[i] Hill’s Richmond City Directory (Chesterfield and Henrico Counties, Va.) (Richmond: Richmond: John Maddox [etc.], 1950, 1957, 1962, 1970.

[ii] Richmond Times Dispatch, “MCV Acquiring More Ground In Condemnation Proceedings,” August 30, 1950.

[iii] Richmond Times Dispatch, “MCV Moves Closer to Buying Court Building: Price $135,000,” January 27, 1953.

[iv] Richmond Times Dispatch, “MCV Given Expansion ‘Guide’ Lines: Planners Suggest Western Limits,” February 19, 1953.

[v] Bernard Fisher, “St. Philip School of Nursing Marker,” The Historical Marker Database, under “St. Philip Hospital and St. Philip School of Nursing plaque,” accessed April 15, 2011,

[vi] “St. Philip School of Nursing (1920-1962),” in MCV/VCU School of Nursing: A Proud Heritage 100 Years of Nursing Education, ed. Linda Mills (Richmond, VA: Virginia Commonwealth University, 1992), 29, accessed April 14, 2011,

[vii] ibid, 31

[viii] Bonnie V. Winston, “Many Black Traditions Are Victims of Desegregation,” Richmond, VA – News, Business, Virginia Politics, Opinion, Sports, Flying Squirrels Baseball, Entertainment and Weather Reports | Richmond Times-Dispatch, February 9, 2009, under “St. Philip School of Nursing,” accessed April 12, 2011,

[ix] Richmond Times Dispatch, “Negro Doctor Leaves City, Vainly Sought MCV Position,” June 3, 1962.

[x] ibid

[xi] Richmond Times Dispatch, “$135,000 Price Put on Court Building Here,” January 27, 1953, Page 4, Column 2 sec.

[xii] Times Dispatch, “MCV Given Expansion ‘Guide’ Lines”

[xiii] ibid

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