Educating physicians in seventeenth-century England

Jonathan Barry

doi:10.1017/s0269889719000188

Abstract

ArgumentThe tension between theoretical and practical knowledge was particularly problematic for trainee physicians. Unlike civic apprenticeships in surgery and pharmacy, in early modern England there was no standard procedure for obtaining education in the practical aspects of the physician’s role, a very uncertain process of certification, and little regulation to ensure a suitable reward for their educational investment. For all the emphasis on academic learning and international travel, the majority of provincial physicians returned to practice in their home area, because establishing a practice owed more to networks of kinship, patronage and credit than to formal qualifications. Only when (and where) practitioners had to rely solely on their professional qualification to establish their status as young practitioners that the community could trust would proposals to reform medical education, such as those put forward to address a crisis of medicine in Restoration London, which are examined here, be converted into national regulation of medical education in the early nineteenth century, although these proposals prefigured many informal developments in medical training in the eighteenth century.

Highlights

The tension between minds and hands was problematic for trainee physicians in seventeenth-century England
In early modern times, in England at least, there was no standard procedure for obtaining the correct medical education, nor funding except from family resources, a very uncertain process of certification, and a mixed level of regulation to ensure any kind of protection for those offering their medical services in competition with others without such qualifications to ensure that they reaped a suitable reward for their educational investment
There is no sign that the London College of Physicians as an institution ever seriously explored the possibility of putting these reform proposals into practice, and there were no further significant proposals along these lines after 1676, even though the broader medical disputes continued to rage unabated in London

Summary

Introduction

The tension between minds and hands (or theoretical and practical knowledge) was problematic for trainee physicians in seventeenth-century England. The only recognized educational path for the physician was through university training This performed the key role of distinguishing the physician as a man of learning, whose mental capacities had been developed by knowledge of the traditional authorities and ability to analyze cases logically, so placing him (supposedly) above other types of healer who relied on hands-on knowledge and experience. It did not, in itself, prepare the student for the practical aspects, either of treating the sick or running a business as a medical practitioner. These proposals foreshadowed many of the later developments in terms of skills training, but the proposed Restoration model of collegial partnership controlled by physicians themselves was not followed in the later period

Training for a Medical Career

The Crisis in London Medicine

The Need for Reform of Medical Education

The Proposals for Reform

Conclusion