▁of ▁medical ▁education . ▁Gil man ▁was ▁very ▁concerned ▁about ▁the ▁more ▁rig orous ▁academic ▁standards . ▁In ▁the ▁late ▁nin ete enth ▁century , ▁most ▁of ▁the ▁medical ▁schools ▁in ▁the ▁United ▁States ▁were ▁" small ▁profit - making ▁enter pr ises " ▁owned ▁by ▁the ▁fac ult ies . ▁The ▁medical ▁schools ▁sold ▁medical ▁degrees ▁to ▁who ever ▁paid ▁the ▁tu ition ▁fee . ▁No ▁pre lim inary ▁education ▁was ▁required ▁for ▁ad mission . ▁When ▁Harvard ▁University ▁and ▁University ▁of ▁Pennsylvania ▁raised ▁the ▁academic ▁standards ▁earlier , ▁they ▁faced ▁a ▁re venue ▁drop ▁as ▁fewer ▁students ▁were ▁qualified ▁for ▁ad mission . ▁The ▁prec ari ous ▁financial ▁situation ▁of ▁Hop kins ▁wor ried ▁Gil man ; ▁he ▁could ▁not ▁afford ▁a ▁new ▁financial ▁d ile m ma . ▁He ▁tried ▁to ▁conv ince ▁Gar rett ▁to ▁lower ▁her ▁standards , ▁but ▁failed . ▁Through ▁negoti ations , ▁Gar ret ▁finally ▁agreed ▁to ▁modify ▁two ▁paragraph s ▁of ▁her ▁terms , ▁emphas izing ▁that ▁her ▁terms ▁of ▁gift ▁" w ould ▁not ▁inter f ere ▁with ▁the ▁operation ▁of ▁the ▁university ." ▁ ▁She ▁also ▁added ▁that ▁the ▁university ▁could ▁modify ▁the ▁ad mission ▁requirement , ▁but ▁the ▁standard ▁should ▁remain ▁the ▁same . ▁On ▁February ▁ 2 0 , ▁ 1 8 9 3 , ▁she ▁approved ▁the ▁statement ▁and ▁terms ▁and ▁signed ▁the ▁Re quire ments ▁of ▁Ad mission . ▁By ▁forcing ▁the ▁university ▁to ▁accept ▁females ▁on ▁the ▁same ▁basis ▁as ▁males ▁and ▁increasing ▁the ▁ad mission ▁requirements