P_EMS.qxd 27/04/2004 10:19 Page 1 (Black plate) HISTORY 'THE MOST POWERFUL MEDICAL MAGNET IN EUROPE': EDINBURGH UNIVERSITYS MEDICAL SCHOOL AND THE OVERSEAS WORLD, 18801914 I Wotherspoon, Freelance Historian and Writer, Edinburgh The international influence of Scottish medical culture and framework appropriate for a new imperial education has long been one of its distinguishing age Certificate and Diploma courses in the diseases of features1 This was particularly evident at the end of the tropical climates, and in tropical medicine and hygiene, nineteenth century when British expansion overseas for example, were introduced in 1899 and 1905 provided new areas of influence for Scotlands medical respectively3 Moreover, ad hoc courses were provided schools and enhanced opportunities for students from for medical students seeking appointments in India, abroad wishing to study medicine in Scotland The Africa and elsewhere4 interface that developed then between medical education in Scotland and the overseas world was Contemporaries certainly recognised the importance of vibrant and multifaceted Awareness of the educational the overseas world to the Faculty of Medicine Britains challenges and emerging professional medical expanding Empire not only reinforced a web of opportunities hastened the engagement of Scotlands established relationships and employment opportunities, universities, and the Scottish Extra Mural Schools, with but also provided opportunities for students from newly the healthcare needs of evolving communities abroad colonised areas At the present time the largest number The contribution of Scottish trained doctors to global of our students is not derived from Scotland, the Dean healthcare during this period is well recognised, but the of the Faculty of Medicine and subsequently a President institutional dynamics that moulded their interests and of the Royal College of Physicians of Edinburgh, shaped their careers abroad have been little studied Professor Sir TR Fraser,told a luncheon meeting in 1884, Focusing on the University of Edinburghs Faculty of Medicine, then the largest in Scotland, this article Many come from England, and a very considerable examines how one Scottish medical school responded number from the great Australian colonies, and from to the health and social challenges posed by the growth India, Canada and South Africa We must no doubt of an Empire on which the sun never set anticipate that the formation of well-equipped (medical) schools in countries that greatly assist in The University of Edinburgh has had a long history of filling our classrooms will result in lessening our contact with scholars and academic institutions outside supplies from these sources [But] if any gloomy Scotland Nowhere was this more marked than in forebodings should be entertained, I think they must medical education, where Edinburghs position was both be removed by the consideration that large areas of as a centre of theoretical learning and vocational the Earths surface still remain uncolonised 5 training2 The academic and clinical achievements of men such as Simpson and Lister were complemented by That Edinburghs medical school had an influential and practical improvements in hospital and teaching ongoing overseas role was a theme often rehearsed As accommodation A new medical school was opened in Great Britain stands in the relation of Mother to the premises adjacent to the then new Royal Infirmary in Colonies, the Dean of the Faculty of Law noted in 1884 (see Figure 1) At the same time, the curriculum 1902, so amongst British Universities this University was progressively overhauled to ensure an academic has long been par excellence the Alma Mater of colonial FIGURE 1 The New Edinburgh Medical School in 1884 Courtesy of Edinburgh University Archives J R Coll Physicians Edinb 2004; 34:153159 153 P_EMS.qxd 27/04/2004 10:19 Page 2 (Black plate) HISTORY youth6 Sir Francis Gordon Bell (MBChB 1910) later met in Australasia and southern Africa, where local endorsed this view, recalling that Edinburgh was then provision was either insufficient to meet demand, or seen as the Mecca for prospective Medical students non-existent Australias first medical school opened at from New Zealand7 In the case of students from the University of Melbourne in 1862 Two further southern Africa, Edmund Burrows similarly concluded schools were established subsequently at the that it had been nothing less than the most powerful Universities of Sydney and Adelaide in 1883 and 1885 medical magnet in Europe8 respectively These new institutions all faced constraints on student numbers arising from the limited extent of Three major factors shaped the relationship of teaching resources and restricted availability of hospital Edinburgh Universitys medical school with the wider training facilities TP Anderson Stuart (MBCM 1880, MD world and deepened its involvement in imperial affairs 1882, LLD 1900), who arrived in Australia in March 1883 between 1880 and 1914 The first was the increase in as Sydneys first Professor of Anatomy and Physiology, the number of students from abroad enrolling to study recalled that his teaching accommodation then medicine at Edinburgh The second was the slow pace consisted of the foundations of a little four bedroomed at which Western medical training was introduced in cottage, and walls about half way-up It was in this that other parts of the world The large number of I was to begin the Medical School a few days later12 Edinburgh medical graduates finding employment, or Medical faculty matriculations remained modest in service opportunities, throughout the Empire and colonial institutions such as Melbourne where they did beyond was the third not exceed 300 in total until 190713 In the same year nearly 1,500 students matriculated to study medicine at Increasing numbers of undergraduates came to the University of Edinburgh The position was not Edinburgh from areas of formal and informal British dissimilar in New Zealand where the medical school at influence as diverse as Mauritius and China as well as the University of Otago had only 155 students in 191414 from established settlement colonies, such as New In southern Africa it was not until 1904 that a start was South Wales or the Cape Colony, where there were made with the development of formal medical education often sizeable numbers of Scottish immigrants Indeed, when the University of Edinburgh recognised the first so great was this influx that overseas-born student year of the medical course at the South Africa College in numbers increased from 400 in 1880 to nearly 700 in Cape Town15 1914 In that year, overseas-born students, the vast bulk of whom hailed from the British Empire, accounted for By contrast, the accelerated development of medical nearly one-quarter of the Universitys enrolments education in Canada and the US led to a reduction in the overall Significantly, over 80% of them came to number of North American students matriculating to Edinburgh University to study medicine9 They were all study medicine at Edinburgh University between 1880 there, wrote Richard Berry (MBCM 1891, MD 1894) and 191416 As new and expanded medical teaching remembering his student days in the 1880s, English, facilities became available in both countries, the numbers Scottish, Irish, Welsh,West Indians, black men from the of American and Canadian students seeking a medical Sudan, princes from India, yellow men from China and education at the University of Edinburgh gradually Japan we were a motley crowd Australians, South declined, such that in 1914 only a handful matriculated Africans and New Zealanders, and even one or two for the MBChB degree course17 Americans from Buffalo and California10 His assertion that Edinburgh was the most cosmopolitan university in Not all overseas-born students returned home on the world may have been something of an completing their studies Some travelled extensively overstatement, but it certainly highlights how important before going into practice in Europe or elsewhere CV the University had become as a medical training centre Delepine (MBCM 1881) from Switzerland, for example, for young people from abroad made his career in the USA Others stayed on in Britain where they became closely involved with the Underpinning the growth in overseas student numbers communities in which they lived MM Mamourian was the demand for tertiary education by often (MBChB 1904) from Smyrna on the Levant (Izmir in privileged elites living in societies where the availability present day Turkey) practised for much of his life in of medical teaching was restricted In India, for example, Lancashire, England Moreover, some graduates who there were only a very limited number of places available worked abroad returned to Edinburgh where they drew for those wishing to study medicine By 1896, the on their overseas experience After a distinguished career Universities of Bombay, Calcutta, Madras and the Punjab as a researcher at the Kings Institute of Preventive together had a combined enrolment of only 1,067 Medicine in Madras, for example, WS Patton (MBChB medical students of whom just 76 graduated that year11 1901) entered academia, being appointed Lecturer in Medical Entomology at Edinburgh University in 192118 The problems facing the development of medical education in India were not too different from those Probably the most important factor powering the 154 J R Coll Physicians Edinb 2004; 34:153159 P_EMS.qxd 27/04/2004 10:19 Page 3 (Black plate) HISTORY FIGURE 2