This article investigates the development of clinical academic units and the concept of a university model of medical education. It argues that clinical academic units emerged from debates about the nature of the medical education and the role of science and the laboratory in the construction of medical knowledge and in the curriculum. Although the integration of clinical academic units into medical schools was seldom harmonious, from the 1920s onwards the appointment of full-time professors to head them imposed a new intellectual order on bedside teaching and research. They provided a means through which laboratory medicine was included in the curriculum and brought the ward and the laboratory closer together. The ideal of a university medical education and the creation of university medical schools took longer to establish and it was only in the 1970s after a number of royal commissions that opposition was finally eroded.