Alexander Thomas Augusta was born in Norfolk, Virginia, in 1825. His parents were free African Americans. Growing up in Baltimore, he worked as a barber while he pursued his dream of attending medical school.

After earning his medical degree in Canada, Dr. Augusta offered his services to the U.S. military. In a letter to President Abraham Lincoln, he offered his services as a surgeon.

But Augusta was initially rejected due to his race. Nevertheless, he traveled to Washington, D.C., to plead his case and was finally accepted.

In April 1863, he passed the Army's medical examination and the Army commissioned him at the rank of major. He became a surgeon for African American troops, making him the Army's first African American doctor.

At the time, Augusta was the highest ranking African American officer. He served as the Regimental Surgeon of the Seventh U.S. Colored Troops. He was awarded a promotion to lieutenant colonel in March 1865.