The History of the Royal College of Physicians and Surgeons of Glasgow: Physicians and Surgeons in Glasgow, 1599-1858; The History of the Royal College of Physicians and Surgeons of Glasgow: The Shaping of the Medical Profession, 1858-1999BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7260.577 (Published 02 September 2000) Cite this as: BMJ 2000;321:577
The History of the Royal College of Physicians and Surgeons of Glasgow: Physicians and Surgeons in Glasgow, 1599-1858
Johanna Geyer-Kordesch, Fiona Macdonald
Hambledon Press, £30, pp 478
ISBN 1 85285 186 4
The History of the Royal College of Physicians and Surgeons of Glasgow: The Shaping of the Medical Profession, 1858-1999
Andrew Hull, Johanna Geyer-Kordesch
Hambledon Press, £30, pp 288
ISBN 1 85285 187 2
Most of the major royal colleges have commissioned solid scholarly histories. Here is the latest, representing five years' work by three historians of medicine funded by the Wellcome Trust. But the titles are misleading because, rather than merely being an account of the Glasgow Faculty and of the physicians and surgeons of Glasgow, the pair of books are admirably more comprehensive and interesting. They cover the whole history of medicine, in the broadest sense, of Glasgow and western Scotland from the 16th century, and even the medical novels of Smollett and John Moore.
When it was founded in 1599, the Glasgow Faculty included not only physicians and surgeons but also apothecaries and barbers, who were dropped in 1722 as surgeons rose up the social scale. The faculty became royal in 1909 and a college in 1962.
As with most faculties, colleges, and guilds in Europe, the motive was to regulate training, registration, and practice—ostensibly protecting the public from incompetent irregulars and women but also protecting the doctors from competition. In 1714 Glasgow encouraged anatomy courses taught at the university and examined by the faculty, soon followed by clinical teaching. The necessary corpses were robbed from graves by students or shipped from Ireland. The faculty controlled midwives and taught obstetrics from 1802.
By the 1830s, Scotland produced more doctors than could be absorbed into civil society or into the army and navy. This might explain why NHS expenditure per person and the ratio of doctors and nurses per person are both higher in Scotland than in England. Throughout this period, when Glasgow was “the best place to study medicine,” the faculty was at odds with the university and its medical school over control of the teaching of fee paying students at the hospitals.
British universities struggled to make medical degrees the sole registrable qualification, but the colleges kept their conjoint diplomas registrable for another century and a half. As in England, Scottish medical schools were forced in the 20th century to create full time clinical chairs in the teaching hospitals on the model of Johns Hopkins University. The many new English medical schools encouraged students to qualify by their degrees rather than by conjoint diplomas so that the latter eventually disappeared.
Colleges then saw their role as providing postgraduate education. They specified curriculums, set examinations, and approved hospital training posts. There were and are interminable arguments about whether college exams should be entry or exit diplomas for consultant posts in NHS, and now European, hospitals. At least cooperation has now produced a common MRCP(UK), with its exams sometimes held overseas.
In 1791 the Glasgow Faculty moved from its 1697 Trongate Building to St Enoch Square and then, in 1862, moved to neoclassical St Vincent Street, with alterations, expansion, women's toilets in the 1950s, and modernisation up to 1999. I noted that Scottish reticence seems to have so faded in the 21st century as to allow an author in the Introduction to thank his wife for her love and to wish his mother better.
I was mystified that the second book made no mention of Scotland's opposition in the 1930s to English barriers to medical refugees seeking asylum. The Medical Practitioners Union and the BMA did not want German and Austrian doctors to be admitted to practise in the United Kingdom, and the English royal colleges lengthened the time for refugee doctors to re-qualify to three years. The Scottish colleges allowed re-qualification within a year and saved the honour of British medicine by repeatedly rejecting English pressure to be equally restrictive and by reminding the English colleges that “the purpose of the medical licensing bodies was to protect the public and not the medical profession.”
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