[2] She married James Hoff in 1869 and they had five children together[1] before she chose to pursue a career in medicine.
"[2] To prepare herself for the State Board Examinations, Dew Hoff studied the medical books from her father's library.
[3] She traveled to Wheeling, West Virginia to take the exam, which lasted a day and a half and included both written and oral segments.
[2] Following the exam on April 19, 1889,[4] she was informed she was the first woman to pass the examination and earned the highest score of anyone who had taken the tests.
[2] After earning her medical license, Dew Hoff returned to her home in West Milford without the intention of opening her father's office, but she was approached by her father's former patients due to her reputation as his assistant.