The Evolution of Medical Education in the Nineteenth Century

Abstract

This thoughtful review of medical education in England in the past century is based on the Fitzpatrick Lectures delivered at the Royal College of Physicians by the author. The portrayal of medical education and practice at the beginning of the 19th century serves as a good background for understanding modern developments. In 1800, medical practice and medical education were almost solely concerned with symptoms and their empirical treatment. The difference between educated and uneducated physicians was determined mostly by the presence or absence of knowledge outside of medicine, for neither group possessed any great knowledge of medicine. The author's study of the old London hospitals' records indicates that the importance of physical examination started with Laennec's introduction of the stethoscope in 1819. The evolution of clinical medicine from 1825 to 1850 through correlation of physical findings with the morbid anatomy revealed at autopsy lead the author to observe that medical