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Becoming a PhysicianMedical Education in Great Britain, France, Germany, and the United States, 1750-1945$
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Thomas Neville Bonner

Print publication date: 1996

Print ISBN-13: 9780195062984

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195062984.001.0001

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Between Clinic and Laboratory: Students and Teaching at Midcentury

Between Clinic and Laboratory: Students and Teaching at Midcentury

8 (p.203) Between Clinic and Laboratory: Students and Teaching at Midcentury
Becoming a Physician

Thomas Neville Bonner

Oxford University Press

Despite the gathering momentum for a single standard of medical education, the portals of access to medicine remained remarkably open at the middle of the nineteenth century. From this time forward, governments and professional associations—in the name of science and clinical knowledge and the protection of the public’s health—steadily limited further entrance to medicine to those with extensive preparatory education and the capacity to bear the financial and other burdens of ever longer periods of study. But in 1850, alternative (and cheaper) paths to medicine, such as training in a practical school or learning medicine with a preceptor, were still available in the transatlantic nations. Not only were the écoles secondaires (or écoles préparatoires) and the medical-surgical academies still widely open to those on the European continent without a university-preparatory education, but British and American training schools for general practitioners, offering schooling well below the university level, were also widely available to students and growing at a rapid pace. “The establishment of provincial medical schools,” for those of modest means, declared Joseph Jordan of Manchester in 1854, was an event “of national importance. . . . Indeed there has not been so great a movement [in Britain] since the College of Surgeons was established.” A decade before, probably unknown to Jordan, a New York professor, Martyn Paine, had voiced similar views about America’s rural colleges when he told students that “no institutions [are] more important than the country medical schools, since these are adapted to the means of a large class of students . . . [of] humble attainments.” In both Britain and America, according to Paine’s New York contemporary John Revere, the bulk of practitioners “are generally taken from the humbler conditions in society, and have few opportunities of intellectual improvement.” The social differences between those who followed the university and the practical routes to medicine were nearly as sharp as they had been a halfcentury before. Even when a medical degree was awarded after what was essentially a nonuniversity education, as it was in the United States, Paine distinguished between graduates of country schools, “where lectures and board are low,” and “the aristocrats of our profession, made so through the difference of a few dollars.”

Keywords:   Boston, Chicago, Detroit, Edinburgh, Foreign students, Glasgow, London, Montpellier, New Orleans

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