If success is the best revenge, then America’s first formally accredited female doctor, who was nearly laughed out of medical school, certainly got some great retribution.

In 1847, Elizabeth Blackwell wanted to go to medical school. Never mind that at the time women simply did not get medical degrees. The 26-year-old hadn’t planned to grow up to become a physician—rather, her interest in medicine was sparked by a personal encounter. A dying female friend remarked to Blackwell that her trials would have been made easier had there been a female doctor to care for her. The comment struck a chord.

Drawn by a challenge, she decided to pursue a medical degree and, after studying for a year under several physician friends, made her attempt.

She applied to 12 schools along the Northeast, in addition to every medical program available in New York and Philadelphia. In the end, only Dean Charles Lee of Geneva Medical College in western New York gave her application any real consideration—sort of. PBS’s Howard Markel explains:

Dean Lee and his all male faculty were more than hesitant to make such a bold move as accepting a woman student. Consequently, Dr. Lee decided to put the matter up to a vote among the 150 men who made up the medical school’s student body. If one student voted “No,” Lee explained, Miss Blackwell would be barred from admission. Apparently, the students thought the request was little more than a silly joke and voted unanimously to let her in; they were surprised, to say the least, when she arrived at the school ready to learn how to heal.

And learn she did. Undeterred by her classmates’ and professors’ sometimes open animosity, Blackwell received her medical degree on January 23, 1849.

She went on to study obstetrics and pediatrics in Europe before returning to the United States to start her own practice in New York City. When confronted by the knowledge that patients weren’t too keen on being treated by woman, Dr. Blackwell eventually re-routed and opened a dispensary for Manhattan’s poor, expanding it into the New York Infirmary for Women in Children by 1857. She also wrote medically-relevant texts and was a professor of gynecology at the London School of Medicine for Women—an institute she helped establish. The strides she made in her career opened doors for generations of women in medicine.

Which all goes to show that sometimes the joke is really on the jokers.