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Volumn 70, Issue 3, 1996, Pages 387-413

The invisible general practitioner: The careers of Scottish medical students in the late nineteenth century

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; GENERAL PRACTITIONER; HISTORY; HUMAN; MEDICAL SCHOOL; MEDICAL STUDENT; UNITED KINGDOM;

EID: 0030236580     PISSN: 00075140     EISSN: None     Source Type: Journal    
DOI: 10.1353/bhm.1996.0121     Document Type: Article
Times cited : (13)

References (91)
  • 5
    • 0346415221 scopus 로고
    • London: Routledge
    • For the history of specialist hospitals, see particularly Lindsay Granshaw and Roy Porter, eds., The Hospital in History (London: Routledge, 1989);
    • (1989) The Hospital in History
    • Granshaw, L.1    Porter, R.2
  • 7
    • 0028490025 scopus 로고
    • Mapping Medical Specialization in Paris in the Nineteenth and Twentieth Centuries
    • The problems of self-ascription in the profession, and the association of elite status with specialization, are outlined by George Weisz, "Mapping Medical Specialization in Paris in the Nineteenth and Twentieth Centuries," Soc. Hist. Med., 1994, 7: 177-211.
    • (1994) Soc. Hist. Med. , vol.7 , pp. 177-211
    • Weisz, G.1
  • 12
    • 0024152544 scopus 로고
    • Doctors and Patients in an Era of National Health Insurance and Private Practice, 1913-38
    • Anne Digby and Nicholas Bosanquet, "Doctors and Patients in an Era of National Health Insurance and Private Practice, 1913-38," Econ. Hist. Rev., 1988, 41: 74-94;
    • (1988) Econ. Hist. Rev. , vol.41 , pp. 74-94
    • Digby, A.1    Bosanquet, N.2
  • 15
    • 24944552579 scopus 로고
    • Special Report of the Select Committee on the Medical Act (1858) Amendment (No. 3) Bill
    • [Lords]. . . and Appendix 29 July
    • "Special Report of the Select Committee on the Medical Act (1858) Amendment (No. 3) Bill," [Lords]. . . Proceedings of the Committee, Minutes of Evidence, and Appendix 29 July 1879, Q.186, Q.362, Q.2056;
    • (1879) Proceedings of the Committee, Minutes of Evidence
  • 22
    • 0013235987 scopus 로고
    • London: Hodder & Stoughton
    • Reminiscences by GPs who were also famous Scottish writers include Arthur Conan Doyle, Memories and Adventures (London: Hodder & Stoughton, 1924);
    • (1924) Memories and Adventures
    • Doyle, A.C.1
  • 24
    • 0026181812 scopus 로고
    • A Profile of the Medical Profession in Scotland in the Early Twentieth Century: The Medical Directory as a Historical Source
    • Marguerite W. Dupree and M. Anne Crowther, "A Profile of the Medical Profession in Scotland in the Early Twentieth Century: The Medical Directory as a Historical Source," Bull. Hist. Med., 1991, 65: 209-33.
    • (1991) Bull. Hist. Med. , vol.65 , pp. 209-233
    • Dupree, M.W.1    Crowther, M.A.2
  • 26
    • 0020930111 scopus 로고
    • 2,000 Medical Men in 1847
    • See also Irvine Loudon, "2,000 Medical Men in 1847," Bull. Soc. Hist. Med., 1983, 33: 4-8.
    • (1983) Bull. Soc. Hist. Med. , vol.33 , pp. 4-8
    • Loudon, I.1
  • 27
    • 12444264491 scopus 로고
    • published between and 1918 and in 1925 and
    • The Medical Who's Who, published between 1912 and 1918 and in 1925 and 1927, gave practitioners an opportunity to indicate the nature of their practice and thus whether they were general practitioners and, if so, in what area they were particularly interested.
    • (1912) Medical Who's Who
  • 28
    • 24944506155 scopus 로고
    • London: Grafton
    • London Doctors and Dental Surgeons 1923-1924 (London: Grafton, 1923) also gave practitioners an opportunity to describe their practice, noting whether it was general, specialist, consultant, or in public health. These publications, however, include far fewer practitioners than the Medical Directory and were not successful in the long term.
    • (1923) London Doctors and Dental Surgeons 1923-1924
  • 29
    • 24944486093 scopus 로고
    • Interpreting Datasets: The Experience of Third-Party Use of a Machine-Readable Source
    • All Scottish students "matriculate" every year at the beginning of the first term, by signing the university's register or filling in a form, and paying a fee. The Glasgow University cohort includes all students who first matriculated in the Medical Faculty between 1866/7 and 1874/5; the Edinburgh University cohort includes all students who first matriculated in the Medical Faculty between 1868/9 and 1872/3. For information on the method used to identify and select the individuals in the cohorts, see James Bradley and Marguerite Dupree, "Interpreting Datasets: The Experience of Third-Party Use of a Machine-Readable Source," Hist. Comput., 1993, 5: 169-78;
    • (1993) Hist. Comput. , vol.5 , pp. 169-178
    • Bradley, J.1    Dupree, M.2
  • 30
    • 24944473645 scopus 로고    scopus 로고
    • Micros and Medical Students: Sources and Methods for Exploring the Educational Careers and Completing Rates of Scottish Medical Students in the Late Nineteenth and Early Twentieth Centuries
    • ed. Peter Denley (Göttingen: Max Planck Institute, in press)
    • James Bradley Marguerite Dupree, idem, "Micros and Medical Students: Sources and Methods for Exploring the Educational Careers and Completing Rates of Scottish Medical Students in the Late Nineteenth and Early Twentieth Centuries," in Computing Techniques and the History of Universities, ed. Peter Denley (Göttingen: Max Planck Institute, in press). Once a student is identified from his (or, in the case of the Edinburgh University cohort, her) matriculation record, it is possible to link this basic information with many other types of record.
    • Computing Techniques and the History of Universities
    • Bradley, J.1    Dupree, M.2
  • 32
    • 24944502027 scopus 로고    scopus 로고
    • note
    • Those who go abroad to practice may disappear from the British publications - though colonial practitioners usually remained on the British register, and those who went to the United States could be traced from American equivalents.
  • 33
    • 24944445712 scopus 로고    scopus 로고
    • note
    • The Scottish Calendar of Confirmations is equivalent to the English probate register, and is available in the Scottish Record Office, Edinburgh. The set we used is available in the University of Glasgow Archives, UGD 174/1-123. Also, see below, n. 64.
  • 34
    • 0029680972 scopus 로고    scopus 로고
    • Mobility and Selection in Scottish University Medical Education, 1858-1886
    • These assessments are based on their failure to appear in the Medical Register of 1885. The largest loss is accounted for by those who never intended a medical career, or who failed examinations (we have investigated these issues in James Bradley, Anne Crowther, and Marguerite Dupree, "Mobility and Selection in Scottish University Medical Education, 1858-1886," Med. Hist., 1996, 40: 1-24). In addition, a small number are known to have died; another small group may have gone abroad to practice without qualifying in Britain.
    • (1996) Med. Hist. , vol.40 , pp. 1-24
    • Bradley, J.1    Crowther, A.2    Dupree, M.3
  • 35
    • 24944446525 scopus 로고    scopus 로고
    • note
    • In the location of obituaries for our cohorts, we have been assisted by a data source that already exists on computer: some years ago the University of Glasgow Archives systematically sifted through the obituary columns of four major medical journals - the British Medical Journal, the Lancet, the Edinburgh Medical Journal, and the Glasgow Medical Journal - and collected references to the obituaries of all graduates from Scottish medical schools and licentiates of the Scottish Royal Colleges. We have been able to compare this with our cohorts of Glasgow and Edinburgh university students and collect their obituaries. An additional source was the Edinburgh Journal, the University's own magazine for graduates, which includes some obituaries: this appeared only from 1925, and it is not included in our calculations here because its obituaries are generally less informative than those in the medical journals; adding its information to the other sources did not appreciably alter the results. The Archives database has limitations in not identifying all obituaries of Edinburgh students who did not graduate, including most of the first women students (see below).
  • 36
    • 24944559486 scopus 로고    scopus 로고
    • note
    • The story of the non-GPs will be explored elsewhere: their careers are extremely complex, and require more analysis of medical specialties than is possible here.
  • 37
    • 24944575828 scopus 로고    scopus 로고
    • note
    • Of the 96 in the Edinburgh cohort who were ever GPs and the 124 in the Glasgow cohort who were ever GPs, 11 appear in both cohorts, having matriculated for the first time in medicine at each university during the specified years; since the cohorts are treated separately in the discussion in the paper, these 11 have been left in both cohorts.
  • 38
    • 24944506990 scopus 로고    scopus 로고
    • note
    • Four appear on both the Edinburgh and Glasgow lists, because they followed Lister from Glasgow to Edinburgh.
  • 39
    • 24944558603 scopus 로고
    • William Caskie
    • hereafter GMJ
    • "William Caskie," Glasgow Medical Journal (hereafter GMJ), 1921, 96: 41.
    • (1921) Glasgow Medical Journal , vol.96 , pp. 41
  • 40
    • 84936628744 scopus 로고
    • trans. Peter Collier Cambridge: Polity Press
    • Further thoughts on the interpretation of obituaries are to be found in Pierre Bourdieu, Homo Academicus, trans. Peter Collier (Cambridge: Polity Press, 1988), pp. 210-25.
    • (1988) Homo Academicus , pp. 210-225
    • Bourdieu, P.1
  • 42
    • 24944565682 scopus 로고    scopus 로고
    • note
    • This does not count the 15 at Glasgow and 7 at Edinburgh whose ages were not stated in the matriculation records.
  • 43
    • 24944488598 scopus 로고    scopus 로고
    • Including the 16 who were previously GPs
    • Including the 16 who were previously GPs.
  • 44
    • 24944509334 scopus 로고    scopus 로고
    • Including those mentioned above who moved with Lister from Glasgow to Edinburgh
    • Including those mentioned above who moved with Lister from Glasgow to Edinburgh.
  • 45
    • 24944464758 scopus 로고    scopus 로고
    • In addition, 65 fathers are simply listed as "deceased."
    • In addition, 65 fathers are simply listed as "deceased."
  • 46
    • 0011249173 scopus 로고
    • Edinburgh: Edinburgh University Press
    • See Matriculation Album 1865-70, p. 186, University of Glasgow Archives; the entry is for William Smart from Renfrewshire. For a discussion of the difficulties of using this information for social analysis, see Robert D. Anderson, Education and Opportunity in Victorian Scotland: Schools and Universities, 2d ed. (Edinburgh: Edinburgh University Press, 1989), p. 308;
    • (1989) Education and Opportunity in Victorian Scotland: Schools and Universities, 2d Ed. , pp. 308
    • Anderson, R.D.1
  • 47
    • 24944567356 scopus 로고
    • Scottish Universities and Industry, 1860-1914
    • Paul Robertson, "Scottish Universities and Industry, 1860-1914," Scot. Econ. Soc. Hist., 1984, 4: 40-42;
    • (1984) Scot. Econ. Soc. Hist. , vol.4 , pp. 40-42
    • Robertson, P.1
  • 48
    • 84919543706 scopus 로고
    • The Development of an Urban University: Glasgow, 1860-1914
    • Paul Robertson, idem, "The Development of an Urban University: Glasgow, 1860-1914," Hist. Educ. Quart., 1990, 30: 50.
    • (1990) Hist. Educ. Quart. , vol.30 , pp. 50
    • Robertson, P.1
  • 51
    • 24944515131 scopus 로고    scopus 로고
    • note
    • The obituaries cannot be relied on for full information on this subject; and these figures do not make an argument for an increase in medical endogamy.
  • 52
    • 24944537672 scopus 로고
    • Sir Garrod Thomas, M.D.
    • 14 February
    • "Sir Garrod Thomas, M.D.," Lancet, 14 February 1931, pp. 383-84.
    • (1931) Lancet , pp. 383-384
  • 53
    • 24944541210 scopus 로고    scopus 로고
    • Calendar of Confirmations and Inventories for 1931 (n. 15). This is the highest estate value left by any of the practitioners in the cohorts whose estate value at death we have been able to trace in the calendars of confirmation thus far.
    • Calendar of Confirmations and Inventories for 1931 , Issue.15
  • 54
    • 24944567976 scopus 로고
    • Samuel MacVie, M.D.
    • (hereafter BMJ), 11 March
    • "Samuel MacVie, M.D.," British Medical Journal (hereafter BMJ), 11 March 1916, p. 398.
    • (1916) British Medical Journal , pp. 398
  • 55
    • 24944452858 scopus 로고
    • Charles Bagge Plowright, M.D.
    • 7 May
    • "Charles Bagge Plowright, M.D.," BMJ, 7 May 1910, p. 1149
    • (1910) BMJ , pp. 1149
  • 56
    • 24944561715 scopus 로고
    • Dr. George Skelton Stephenson
    • 1 June
    • "Dr. George Skelton Stephenson," BMJ, 1 June 1929, pp. 1021-22.
    • (1929) BMJ , pp. 1021-1022
  • 57
    • 24944587698 scopus 로고
    • George Henry Whitaker
    • 14 May
    • "George Henry Whitaker," BMJ, 14 May 1910, p. 1208.
    • (1910) BMJ , pp. 1208
  • 60
    • 24944540058 scopus 로고
    • 20 January and 24 February 1912
    • For an obituary and the value of the estate of Sophia Jex-Blake, see BMJ, 20 January 1912, p. 165, and 24 February 1912, p. 461.
    • (1912) BMJ , pp. 165
    • Jex-Blake, S.1
  • 61
    • 24944501022 scopus 로고
    • 25 April
    • For an obituary of Edith Pechey-Phipson, see BMJ, 25 April 1908, p. 1025.
    • (1908) BMJ , pp. 1025
    • Pechey-Phipson, E.1
  • 62
    • 24944484815 scopus 로고
    • 10 April
    • For Alice Ker, see Lancet, 10 April 1943, p. 479. Further details of the 39 women in our cohort of Edinburgh students who matriculated and the 8 who qualified are to be found in Bradley, Crowther, and Dupree, "Mobility and Selection" (n. 16). For the careers of the first generation of women university graduates in medicine at Glasgow University,
    • (1943) Lancet , pp. 479
    • Ker, A.1
  • 64
    • 24944469297 scopus 로고
    • Dr. T. Edgar Underhill
    • 19 May
    • "Dr. T. Edgar Underhill," BMJ, 19 May 1917, p. 667.
    • (1917) BMJ , pp. 667
  • 65
    • 24944521323 scopus 로고
    • Dr. William Donald
    • 13 February
    • "Dr. William Donald," BMJ, 13 February 1904, p. 404;
    • (1904) BMJ , pp. 404
  • 66
    • 24944549776 scopus 로고
    • Robert Davies Evans
    • 16 August
    • "Robert Davies Evans," BMJ, 16 August 1924, p. 301.
    • (1924) BMJ , pp. 301
  • 67
    • 24944482244 scopus 로고
    • George Middlemiss
    • 30 August
    • "George Middlemiss," BMJ, 30 August 1913, p. 582.
    • (1913) BMJ , pp. 582
  • 68
    • 24944502026 scopus 로고
    • Archibald Sloan
    • "Archibald Sloan," GMJ, 1923, 100: 326.
    • (1923) GMJ , vol.100 , pp. 326
  • 69
    • 24944524637 scopus 로고
    • Russell Elliot Wood
    • hereafter EMJ
    • "Russell Elliot Wood," Edinburgh Medical Journal (hereafter EMJ), 1917, 18: 217.
    • (1917) Edinburgh Medical Journal , vol.18 , pp. 217
  • 70
    • 24944492993 scopus 로고
    • Peter MacGregor
    • 8 December
    • "Peter MacGregor," BMJ, 8 December 1917, p. 779.
    • (1917) BMJ , pp. 779
  • 71
    • 24944549775 scopus 로고
    • E. O. Price
    • 22 February
    • "E. O. Price," BMJ, 22 February 1919, p. 234.
    • (1919) BMJ , pp. 234
  • 72
    • 24944518187 scopus 로고    scopus 로고
    • "Russell Elliot Wood" (n. 44), pp. 216-18.
    • Russell Elliot Wood , Issue.44 , pp. 216-218
  • 74
    • 24944579718 scopus 로고
    • Alexander Napier
    • "Alexander Napier," GMJ, 1928, 110: 279-82.
    • (1928) GMJ , vol.110 , pp. 279-282
  • 75
    • 24944491450 scopus 로고
    • William Muir
    • "William Muir," GMJ, 1907, 68: 33-34.
    • (1907) GMJ , vol.68 , pp. 33-34
  • 76
    • 24944447590 scopus 로고
    • Archibald Brown
    • "Archibald Brown," GMJ, 1904, 62: 103.
    • (1904) GMJ , vol.62 , pp. 103
  • 77
    • 24944572828 scopus 로고
    • Dove M'Calman
    • 6 June
    • "Dove M'Calman," BMJ, 6 June 1908, p. 1400.
    • (1908) BMJ , pp. 1400
  • 78
    • 24944455645 scopus 로고
    • Robert Thomson Forbes
    • "Robert Thomson Forbes," GMJ, 1907, 67: 374.
    • (1907) GMJ , vol.67 , pp. 374
  • 79
    • 24944520600 scopus 로고    scopus 로고
    • chaps. 10, 11, 15, 16
    • Mair, Sir James Mackenzie (n. 9), chaps. 10, 11, 15, 16.
    • Sir James Mackenzie , Issue.9
    • Mair1
  • 80
    • 24944540434 scopus 로고    scopus 로고
    • note
    • The total figure is based on the list of publications from four editions of the Medical Directory up to 1901, and thus includes only the articles that practitioners chose to list in their Directory entries.
  • 81
    • 24944529712 scopus 로고    scopus 로고
    • For the breadth and depth of Scottish medical education in general, and midwifery in particular, relative to England, see Loudon, Death in Childbirth (n. 2), pp. 192-93.
    • Death in Childbirth , Issue.2 , pp. 192-193
    • Loudon1
  • 82
    • 24944578084 scopus 로고
    • Opening the Knee Joint
    • 1 December
    • A. Garrod Thomas, "Opening the Knee Joint," BMJ, 1 December 1883, pp. 1066-67.
    • (1883) BMJ , pp. 1066-1067
    • Thomas, A.G.1
  • 83
    • 24944546236 scopus 로고
    • Henry Ambrose Lediard, M.D.
    • 19 November
    • "Henry Ambrose Lediard, M.D.," BMJ, 19 November 1932, p. 946.
    • (1932) BMJ , pp. 946
  • 84
    • 24944515130 scopus 로고
    • Charles Watson MacGillivray
    • "Charles Watson MacGillivray," EMJ, 1932, 39: 691.
    • (1932) EMJ , vol.39 , pp. 691
  • 85
    • 24944538523 scopus 로고
    • James Wilkie Smith, M.D.
    • 8 December
    • "James Wilkie Smith, M.D.," BMJ, 8 December 1928, p. 1073.
    • (1928) BMJ , pp. 1073
  • 86
    • 24944537671 scopus 로고
    • Sir George Thomas Beatson
    • 25 February
    • "Sir George Thomas Beatson," BMJ, 25 February 1933, p. 344.
    • (1933) BMJ , pp. 344
  • 87
    • 24944557735 scopus 로고
    • Malcolm McMurrick
    • "Malcolm McMurrick," GMJ, 1898, 50: 364.
    • (1898) GMJ , vol.50 , pp. 364
  • 89
    • 24944514509 scopus 로고
    • ed. A. E. McRae Edinburgh: W. Green and Son
    • The most widely used source for wealth in Scotland is the Calendar of Confirmations and Inventories, an index, printed annually from 1876, to all estates whose appointment of executors was ratified or "confirmed" by a court. The entries are arranged alphabetically; each gives the name and designation or occupation of the deceased, the date and place of death, whether testate or intestate, where and when the confirmation was granted, the name of the executor, and the value of the estate. The value of the estate is the sum of the deceased person's wealth as itemized on an inventory that includes movable property (e.g., cash, household goods, and furnishings), investments in partnerships, government stock, securities, bank deposits, and rents due - but not land, houses, or other buildings. For a definitive account of the Calendars' origins and content, see James Geddes Currie, The Confirmation of Executors in Scotland according to the Practice in the Commissariat of Edinburgh, 7th ed., ed. A. E. McRae (Edinburgh: W. Green and Son, 1973); for a critique of their use by historians,
    • (1973) The Confirmation of Executors in Scotland According to the Practice in the Commissariat of Edinburgh, 7th Ed.
    • Currie, J.G.1
  • 90
    • 84977330416 scopus 로고
    • Listing the Wealthy in Scotland
    • see Nicholas Morgan and Michael Moss, "Listing the Wealthy in Scotland," Bull. Inst. Hist, Res., 1986, 59: 189-95.
    • (1986) Bull. Inst. Hist, Res. , vol.59 , pp. 189-195
    • Morgan, N.1    Moss, M.2
  • 91
    • 84958314394 scopus 로고
    • Wealthy Scots, 1876-1913
    • We have found confirmations for 113 of 335, or 34 percent of all those in our cohorts with obituaries. Of the 113, 72 (64 percent) were GPs at the end of their careers, 11 (10 percent) were GPs at some time but did not end their careers as GPs, and 30 (26 percent) were never GPs. Thus, general practitioners are overrepresented among those in our cohorts with confirmations. The only medical representation among the wealthiest Scots (the ten highest-valued entries in the Calendar of Confirmations for each year between 1876 and 1913) was a surgeon with the East India Company; see Rachel Britton, "Wealthy Scots, 1876-1913," Bull. Inst. Hist. Res., 1985, 58: 78-94. The comparable figures for the average values of the personal estates of Scottish clergymen (£2,264) and lawyers (£40,464) come from the values of the confirmations for those occupations in 1901 extracted from the machine-readable database created by the University of Glasgow Archives. The lower value for Scottish clergymen is not surprising, as they had no equivalent of the value of a general practitioner's partnership or practice, which could be bought and sold.
    • (1985) Bull. Inst. Hist. Res. , vol.58 , pp. 78-94
    • Britton, R.1


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