Kristin Hay is a medical historian and a doctoral research intern at RCPSG. She is currently working on the ‘Admitting Women’ project which explores gender inequality within the College’s history as part of the Heritage and Inclusion Programme.
In September 2020, in the midst of the Covid-19 pandemic, the College for the first time in its 420-year history held a Virtual Diploma Ceremony to welcome new Members and Fellows into our global medical community. This month, as we once again virtually celebrate the arrival of over 170 new Members and Fellows to the Royal College of Physicians and Surgeons of Glasgow, we are reminded of the history of College enrolment and the legacy of a centuries-old rite of passage for medical professionals.
The benefits and privileges accorded to College enrolment today cannot be understated. Membership to the College signifies a high level of medical expertise and a commitment to education, advancement, community and citizenship on an international level. However, in the late-nineteenth century, not only was College membership a symbol of professional standing and prestige, a Licentiate or Fellow Diploma from a recognised medical Corporation was one of only three ways to gain entry into the newly-implemented British Medical Register. Under the terms of the Medical Act of 1858, registration and possessing a medical licence became mandatory [1]. As such, the College was a crucial and influential licensing body which regulated the medical profession and set the standard of medical practice in Scotland.
Consequently, becoming a Licentiate or Fellow of the then-titled Faculty of Physicians and Surgeons of Glasgow was rigorous and comprehensive process which increased in complexity over the course of the 1800s [2]. Licentiates had to pass an examination, provide evidence of their education, make an affirmation in accordance with the College rules, and pay a fee to receive their Diploma and become registered. In 1876, following increased pressure from parliament and the General Medical Council, the Faculty overhauled their entrance exams with a new ‘Scheme of Professional Examinations for the Faculty’s Diploma’, further tightening their Licensing regulations [3].
The new Faculty Diploma entitled prospective Candidates a Single Licence or Double Qualification, membership to the Faculty, and registration to the Medical Register. Candidates had to sit two professional examinations: the First Professional Examination, consisting of a seven-hour written and oral assessment; and the Second (or Final) Examination, consisting of a two-day written examination, a clinical exam, and an oral test [4]. Throughout the two tests, candidates had to demonstrate their prowess in the following ‘departments’:
‘Anatomy and Physiology…Chemistry…Medicine and Materia Medica…Surgery and Surgical Anatomy…Medical Jurisprudence including Public Health…[and] Midwifery and Diseases of Women’ [5].
Marks were awarded out of 100 and a grade of 25 or less was rejected. The cost of the exams – distinctive to the College dues – ranged between six pounds and six shillings to 12 pounds 12 shillings – over £800 today [6]! After becoming a Licentiate practitioners could, after 5 years of practicing, become Resident Fellow of Faculty qua Physician or Resident Fellow of Faculty qua Surgeon which also required examinations and a declaration to the Council. Their names were immortalised in the College minutes and, from 1894, in the Fellows Register which is still used to this day for honorary Fellows.
The elevated standard of examinations was highlighted frequently by the Faculty and used to further justify their role as a licensing body. In 1879, when all Royal Colleges’ right to licence was under threat, the Faculty stated:
‘Since the passing of the Act of 1858, the improvements in the modes of testing Candidates for licence has been steady and uninterrupted…Examinees shall enter the profession as thoroughly qualified for their duties as licenced by other bodies.
The number of rejections of Candidates…is so large as to indicate that the Standard of Examination is now sufficiently high to tax the powers of the medical schools to turn out Candidates able to pass the examinations.’ [7]
Faculty of Physicians and Surgeons Glasgow
This showed the influence of the College in elevating the quality of the medical profession in Scotland.
However, whilst the College was progressive in its views on regulating and examining medical practitioners, they were still slow to react to gender equality. The Faculty did not admit their first female Licentiate until 1886, despite women being able to receive licences from 1876 and several women applying for ‘Permission’ throughout the late 1870s. Among these women was a ‘Miss Taffe’, from Kelvinside, who despite the support of several Faculty members was refused to even sit the exam in 1878. This was justified by an outdated motion carried in 1873 that:
‘…As the Faculty do not grant their License [sic.] to women, they decline to admit them to any of their examinations.’ [8]
Moreover, they did not admit their first female fellow until 1912. Yet, despite the many institutional barriers to entry, over one century later the College welcomed its first female President, Professor Jackie Taylor.
Thus, looking at the history of College enrolment not only emphasises the legacy and influence of this historic Glaswegian institution, but also shows us how far we have come in diversifying and influencing medical practice in Scotland and beyond. Although the role and function of College membership has changed since the late-nineteenth century, it continues to represent the ideals of our profession and the commitment of our members to innovate, collaborate, and deliver excellence in patient care.
This April, we congratulate all of our new Members and Fellows and welcome you warmly to the Royal College of Physicians and Surgeons of Glasgow!
______________________________________________________________________________________________
[1] Medical Act, 1858, legislation.gov.uk/ukpga/Vict/21-22/90/enacted (accessed 12 Apr 2021)
[2] For more information on the history of RCPSG, see J. Geyer-Kordesch and F. A. MacDonald, Physicians and Surgeons in Glasgow: The History of the Royal College of Physicians and Surgeons of Glasgow 1599-1858 (London: Hambledon, 1999) and H.M. Dingwall, ‘The Triple Qualification examination of the Scottish medical and surgical colleges, 1884-1993’ Journal of the Royal College of Physicians of Edinburgh 40 (2010) pp. 269-76
[3] GB 250 1/1/10, RCPSG, Faculty Minutes, ‘Report by Council as to Scheme’ (3 Jan 1876) p. 202
[4] GB 250 1/1/10, RCPSG, Faculty Minutes, ‘Resolutions regarding fees to be paid by Candidates for examination’ (3 July 1876) pp. 230-233
[5] GB 250 1/1/10, RCPSG, Faculty Minutes, ‘Revised interim report’ (6th Mar 1876) pp. 206-208
[6] ‘Resolutions regarding fees’, p. 230, conversion obtained from National Archives https://www.nationalarchives.gov.uk/currency-converter/#currency-result (accessed 12 Apr 2021)
[7] GB 250 1/1/10, RCPSG, Faculty Minutes, ‘Further Report by Council on Medical Act Amendment Bill’, (7th Apr 1879) pp. 375-377
[8] GB 250 1/1/10, RCPSG, Faculty Minutes, ‘Application by Miss Taffe for Permission to enter to the preliminary examination of the Faculty’ (1 Jul 1878) pp. 340-341, GB 250 1/1/10, RCPSG, Faculty Minutes, ‘Application of Miss Jane Ingleton to be admitted to Preliminary Examination’, (7 Apr 1873) pp. 67-68
Leave a Reply