Elizabeth started teaching in 1846 at a boarding school in Charleston

Once again, through her sister Anna, Blackwell procured a job, this time teaching music at an academy in Asheville, North Carolina, with the goal of saving up the $3,000 necessary for her medical school expenses. In Asheville, Blackwell lodged with the respected Reverend John Dickson, who happened to have been a physician before he became a clergyman. Dickson approved of Blackwell's career aspirations and allowed her to use the medical books in his library to study. During this time, Blackwell soothed her own doubts about her choice and her loneliness with deep religious contemplation. She also renewed her antislavery interests, starting a slave Sunday school that was ultimately unsuccessful. Dickson's school closed down soon after, and Blackwell moved to the residence of Reverend Dickson's brother, Samuel Henry Dickson, a prominent Charleston physician. She started teaching in 1846 at a boarding school in Charleston run by a Mrs. Du Pré. With the help of Reverend Dickson's brother, Blackwell inquired into the possibility of medical study via letters, with no favorable responses.