The undergraduate curriculum determines the quality of student preparation and serves to ensure consistency in clinical practice, thus promoting acceptance of music therapy by the medical community. As members of the newly-formed American Music Therapy Association strive to integrate diverse viewpoints, a historical review of the curriculum may provide direction for future revisions. Columbia University offered the first music therapy course in 1919, yet the profession did not establish an official undergraduate curriculum until 1952. This paper chronicles the events occurring prior to 1952 which contributed to curriculum development. Preceding university degree offerings, hospitals provided music therapy training. Hospital music directors established detailed guidelines for both lecture courses and clinical work. Authorities also outlined specific qualifications for potential students, including musical ability and suitable personality traits, and discouraged students who did not meet these criteria. As university programs grew in number, notable figures such as Roy Underwood and E. Thayer Gaston influenced curricular decisions through their personal beliefs and professional activities. Exploring this chain of events may assist contemporary authorities in understanding and strengthening the educational foundation for music therapists.