After her schooling, Dr Cole interned at Elizabeth Blackwell's New York Infirmary for Indigent Women and Children. In New York, Dr Cole was assigned the task of going into tenements to teach prenatal care and hygiene to women. Cole was a pioneer in providing these impoverished women and children access to medical care. Cole went on to practice in South Carolina, then returned to Philadelphia, and in 1873 opened a Women's Directory Center with Charlotte Abbey that provided medical and legal services to destitute women and children. In January 1899, she was appointed superintendent of a home, run by the Association for the Relief of Destitute Colored Women and Children in Washington, D.C.. The annual report for that year stated that she possessed "all the qualities essential to such a position-ability, energy, experience, tact." A subsequent report noted that: