Alun Roberts, The Welsh National School of Medicine 1893–1931: the Cardiff years, Cardiff, University of Wales Press, 2008, pp. xxiv, 389, illus., £55.00 (hardback 978-0-7083-2174-4).

Abstract

Welsh medical education has been poorly served by historians, something which was partly rectified in the three volumes on the history of Welsh universities published by Williams and Morgan in the 1990s. While Alun Roberts claims that these gave proper treatment to the history of the medical school, Williams suggested that the Welsh School of Medicine deserved a separate history. Roberts, a former registrar of the school and a trained historian, took up the challenge. The Cardiff Medical School, as it was originally known, was established in 1893, ten years after the creation of the University College of South Wales and Monmouthshire. Arguments put forward in support of this included the economic, linguistic and moral advantages of providing medical education for Welsh students at home. In the early years the school offered pre-clinical training only. It was shaped by advice from Sir Donald MacAlister, principal of Glasgow University and chairman of the GMC, and Sir William Osler, with the latter advocating a clinical unit structure modelled on that adopted at Johns Hopkins. While this led to Rockefeller Foundation support in the 1920s, it also exacerbated tensions within the medical and university communities. One of the strengths of the book is the way in which it analyses these clashes. As the Western Mail observed in 1927, “Complication follows complication in the efforts to lift the Welsh National School of Medicine from the arena of controversy.” As happened elsewhere, there were bitter disputes over the threat to private practice posed by part-time academic appointments, and the struggle for clinical control between professors and hospital clinicians. The 1920s were also marked by constitutional wrangles between the school and local hospital managers. A further complication came with the territorial disputes between Cardiff and North Wales, and the debates as to what constituted a national school. Roberts tackles all of these issues with clarity and balance. At the same time, he never loses sight of the individuals for whom the school was established. Chapter 9 examines the family, educational and social backgrounds of the students and outlines the subsequent careers of sixty of the sixty-four who graduated between 1916 and 1931. One of the most interesting statistics is the fact that only 3 per cent of the students were domiciled in North Wales; rather than journey to Cardiff, it seems that they preferred to study in Liverpool. Alun Roberts has written an unashamedly old-fashioned narrative history, a “biography of an institution” as he describes it in the preface—and it is none the worse for that. He writes clearly and sustains the story with meticulous footnotes, though at times the essential clarity of the text is swamped by detail. Extended biographical sketches often interrupt the flow of the narrative but do flesh out what is clearly intended as a tribute to Welsh medicine. While much of the information is useful, there are times when a good copy editor might have tempered Roberts’ enthusiasm. Did we really need to know of (Sir) Ewen Maclean, appointed “professor extraordinary” of obstetrics in 1921, that “[h]is nephew in due course achieved notoriety as the spy Donald Maclean”? Despite such minor cavils, this is a worthwhile contribution to the historiography of medical education in Britain.